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在孟加拉国,母亲就业与婴幼儿喂养有怎样的关联?一项系统文献综述与荟萃分析。

How is maternal employment associated with infant and young child feeding in Bangladesh? A systematic literature review and meta-analysis.

作者信息

Rifat M A, Sarkar Plabon, Rimu Israth Jahan, Alam Syeda Saima, Ara Tasnu, Battle Tobias Lindström, Kader Manzur, Saha Sanjib

机构信息

Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.

Caritas Bangladesh, Dhaka, Bangladesh.

出版信息

PLoS One. 2025 Jan 24;20(1):e0316436. doi: 10.1371/journal.pone.0316436. eCollection 2025.

Abstract

BACKGROUND

In the last three decades, the increasing trend in female employment in Bangladesh has been critically analyzed from a socioeconomic point of view; however, its impact on infant and young child feeding (IYCF) practices has yet to be systematically reviewed. The aim of this systematic review and meta-analysis is to investigate the association between these variables.

METHODS

A systematic literature search was conducted in PubMed, Medline, Web of Science, Embase, CINAHL, and Google Scholar to retrieve relevant records with no restriction of publication period. The Covidence tool was used for screening and data extraction. Meta-analysis was carried out using random effect models. The Newcastle-Ottawa scale was used for the quality assessment of the included articles.

RESULTS

A total of 24 articles were included. Of these, 16 focused on breastfeeding-related indicators, 6 focused on complementary feeding-related indicators, and 2 focused on both. Maternal employment was found to have both positive (protective) and negative (detrimental) associations with exclusive breastfeeding, whereas it was mainly positively associated with complementary feeding practices. Meta-analysis showed the pooled odds ratio of recommended early initiation of breastfeeding, exclusive breastfeeding, and complementary feeding among employed mothers were 0.79 (95% CI: 0.49, 1.27; p = 0.33), 0.32 (95% CI:0.16, 0.67; p = 0.002), and 1.07 (95% CI: 0.81, 1.42; p = 0.63) compared to their counterparts, respectively.

CONCLUSIONS

Maternal employment appears not to be a protective factor for some important breastfeeding indicators in Bangladesh. For example, there was a statistically significant lower likelihood of exclusive breastfeeding practice among employed mothers as compared to those who were not employed. Therefore, these issues should be taken into consideration when formulating relevant policies and interventions, e.g., breastfeeding-friendly workplace.

摘要

背景

在过去三十年里,已从社会经济角度对孟加拉国女性就业的增长趋势进行了批判性分析;然而,其对婴幼儿喂养(IYCF)做法的影响尚未得到系统综述。本系统综述和荟萃分析的目的是调查这些变量之间的关联。

方法

在PubMed、Medline、科学网、Embase、CINAHL和谷歌学术中进行了系统的文献检索,以检索不受出版期限制的相关记录。使用Covidence工具进行筛选和数据提取。采用随机效应模型进行荟萃分析。使用纽卡斯尔-渥太华量表对纳入文章进行质量评估。

结果

共纳入24篇文章。其中,16篇关注与母乳喂养相关的指标,6篇关注与辅食喂养相关的指标,2篇两者都关注。发现母亲就业与纯母乳喂养既有正相关(保护作用)又有负相关(有害作用),而它主要与辅食喂养做法呈正相关。荟萃分析显示,与未就业母亲相比,就业母亲中推荐的早期开始母乳喂养、纯母乳喂养和辅食喂养的合并比值比分别为0.79(95%CI:0.49,1.27;p = 0.33)、0.32(95%CI:0.16,0.67;p = 0.002)和1.07(95%CI:0.81,1.42;p = 0.63)。

结论

在孟加拉国,母亲就业似乎不是一些重要母乳喂养指标的保护因素。例如,与未就业母亲相比,就业母亲进行纯母乳喂养的可能性在统计学上显著更低。因此,在制定相关政策和干预措施(如对母乳喂养友好的工作场所)时应考虑这些问题。

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