Suriyawongpaisal Wichukorn, Kittikul Punpawee, Lee Eun Young, Chien Li-Yin, Chang Yan-Shing, Coca Kelly Pereira, Buntup Doungjai, Hong Seo Ah
ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, 73170, Thailand.
Breastfeeding Clinic Nakhon Pathom Hospital, Nakhon Pathom, Thailand.
BMC Public Health. 2025 Apr 11;25(1):1366. doi: 10.1186/s12889-025-22672-w.
Maternal beliefs towards COVID-19 vaccine safety may be associated with infant feeding practice and postpartum depression (PPD). Since there is a paucity of studies, this study aims to identify associations of COVID-19-related cognitive factors (e.g., COVID-19-vaccination-related belief and COVID-19-related knowledge and attitude) with infant feeding practices and their associations with PPD during the COVID-19 pandemic in Thai postpartum mothers.
A cross-sectional online survey was conducted among 840 postpartum mothers whose infants were less than or equal to 6 months old. Mothers with a score ≥ 13 using the Edinburgh Postnatal Depression Scale (EPDS) were considered to have PPD. Student t-tests were used to measure the association between infant feeding practices and COVID-19-related cognitive factors, and Chi-square tests were used to assess their associations with PPD. Significant variables (p < 0.05) from the chi-square test were included in the logistic regression analysis. Multivariable logistic regression analyses were performed to identify factors associated with PPD. The associations were reported in adjusted odds ratio at 95% confidence interval.
This study showed one-third of the participants (32.4%) were at risk of having PPD. Mothers who fed expressed breastmilk had positive beliefs towards COVID-19 vaccination and higher scores on COVID-19 knowledge and attitude, while mothers who fed infant formula or solid, semi-solid, or soft food had negative beliefs towards the vaccination compared to their counterparts. Multivariable logistic regression showed women who fed their infant with solid, semi-solid, and soft foods (AOR = 3.28; 95% CI = 1.35-10.92) had significantly higher odds of PPD. Among COVID-19-related cognitive factors, negative or moderate COVID-19-related attitudes were associated with higher odds of PPD (1.91; 1.19-3.07 and 1.85; 1.20-2.86, respectively). Socio-demographic factors associated with PPD included living in urban areas, residing outside the Southern region, having food insecurity during the pandemic, having unintended pregnancy, and having health problems during the perinatal period.
The association of COVID-19-related cognitive factors and feeding practices with PPD may suggest that proper education on prevention, control, and vaccination of emerging infectious diseases such as COVID-19, as well as support for appropriate infant feeding practices, should be provided to postpartum mothers, which ultimately contributes to improving their mental health.
母亲对新冠疫苗安全性的认知可能与婴儿喂养方式及产后抑郁（PPD）有关。由于相关研究较少，本研究旨在确定新冠相关认知因素（如新冠疫苗接种相关信念、新冠相关知识和态度）与泰国产后母亲在新冠疫情期间的婴儿喂养方式之间的关联，以及它们与产后抑郁的关联。
对840名婴儿年龄小于或等于6个月的产后母亲进行了横断面在线调查。使用爱丁堡产后抑郁量表（EPDS）得分≥13分的母亲被认为患有产后抑郁。采用学生t检验来衡量婴儿喂养方式与新冠相关认知因素之间的关联，采用卡方检验来评估它们与产后抑郁的关联。卡方检验中具有统计学意义的变量（p<0.05）被纳入逻辑回归分析。进行多变量逻辑回归分析以确定与产后抑郁相关的因素。关联以95%置信区间的调整比值比报告。
本研究表明，三分之一的参与者（32.4%）有患产后抑郁的风险。母乳喂养的母亲对新冠疫苗接种持积极信念，在新冠知识和态度方面得分较高，而与母乳喂养的母亲相比，用婴儿配方奶粉或固体、半固体或软质食物喂养婴儿的母亲对疫苗接种持消极信念。多变量逻辑回归显示，用固体、半固体和软质食物喂养婴儿的女性患产后抑郁的几率显著更高（比值比=3.28；95%置信区间=1.35-10.92）。在新冠相关认知因素中，消极或中度的新冠相关态度与更高的产后抑郁几率相关（分别为1.91；1.19-3.07和1.85；1.20-2.86）。与产后抑郁相关的社会人口学因素包括居住在城市地区、居住在南部地区以外、在疫情期间存在粮食不安全、意外怀孕以及在围产期有健康问题。
新冠相关认知因素和喂养方式与产后抑郁之间的关联可能表明，应该为产后母亲提供关于新冠等新发传染病的预防、控制和疫苗接种的适当教育，以及对适当婴儿喂养方式的支持，这最终有助于改善她们的心理健康。
