Li Jiuming, Hong Xiang, Zhu Xiaoqi, Wu Jingying, Yang Haitao, Zhang Xuening, Wang Bei
Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
National Health Commission Contraceptives Adverse Reaction Surveillance Center, Nanjing, China.
PLoS One. 2025 Sep 5;20(9):e0331877. doi: 10.1371/journal.pone.0331877. eCollection 2025.
This study aimed to investigate the relationship between women's fecundability and postpartum breastfeeding.
We used a prospective cohort study design to recruit pregnant women who came to the hospital for antenatal checkups before 20 weeks' gestation between April 2019 and March 2020 at the Maternal and Child Health Hospital of Gulou District, Nanjing, China. Women were categorized into prolonged time to pregnancy (TTP) group (>3 months) and shorten TTP (≤3 months) groups. A telephone follow-up was conducted 42 days postpartum to collect breastfeeding practice data. Logistic regression models were employed to analyze the association between TTP and exclusive breastfeeding.
A total of 535 pregnant women were initially included in the study cohort and 478(89.35%) completed the follow-up, among 79 (16.5%) in the prolonged TTP group, and the rest in the short TTP group (n = 399, 83.5%). According to the follow-up, 271 (56.7%) were in the exclusive breastfeeding group and the rest in the non-exclusive breastfeeding group (n = 207, 43.3%). A significant decrease in exclusive breastfeeding rate was observed in the prolonged TTP group compared to the short TTP group (OR=0.46, 95% CI: 0.27-0.74). After adjusting for potential confounders such as age, husband's age, BMI, and regularity of menstruation, the negative association between TTP and exclusive breastfeeding remained (OR=0.50, 95% CI: 0.29-0.84). In stratified analyses, the results were generally consistent.
The probability of postpartum breastfeeding is lower in women with lower fecundability. These findings suggest that women with lower fecundability may benefit from targeted breastfeeding support.
本研究旨在探讨女性受孕能力与产后母乳喂养之间的关系。
我们采用前瞻性队列研究设计，招募了2019年4月至2020年3月期间在中国南京鼓楼区妇幼保健院进行产前检查的孕周小于20周的孕妇。将女性分为怀孕时间延长（TTP）组（>3个月）和怀孕时间缩短（≤3个月）组。产后42天进行电话随访，收集母乳喂养情况数据。采用逻辑回归模型分析TTP与纯母乳喂养之间的关联。
共有535名孕妇最初纳入研究队列，478名（89.35%）完成随访，其中怀孕时间延长组79名（16.5%），其余在怀孕时间缩短组（n = 399，83.5%）。根据随访结果，271名（56.7%）在纯母乳喂养组，其余在非纯母乳喂养组（n = 207，43.3%）。与怀孕时间缩短组相比，怀孕时间延长组的纯母乳喂养率显著降低（OR = 0.46，95%CI：0.27 - 0.74）。在调整年龄、丈夫年龄、BMI和月经规律等潜在混杂因素后，TTP与纯母乳喂养之间的负相关仍然存在（OR = 0.50，95%CI：0.29 - 0.84）。在分层分析中，结果总体一致。
受孕能力较低的女性产后进行母乳喂养的概率较低。这些发现表明，受孕能力较低的女性可能会从有针对性的母乳喂养支持中受益。
