Vega López M G, González Pérez G J
University of Guadalajara, Regional Institute of Research in Public Health, Jalisco, Mexico.
Bull Pan Am Health Organ. 1993;27(4):350-9.
To investigate breast-feeding patterns and factors encouraging early weaning, a survey was conducted in Tonalá and Tlaquepaque, two suburbs within Guadalajara's metropolitan area, in 1991. For this purpose a multiphase probabilistic sample of infants born in these areas from May 1990 through April 1991 was selected. This was done by choosing at random primary health care units in the study areas, health posts associated with these units, and all infants meeting the above criteria at each selected post. A total of 166 homes was visited and interviews were conducted with 141 mothers (91% of the 155 predicted) in June and July 1991. These interviews made use of a 33-item questionnaire developed for the purpose; the interviewers were social workers previously trained in such activities. Logistic regression models were used to calculate the relative risk (RR) and probability of early weaning being associated with certain variables. To help ensure the validity of the results, several regression models were constructed for the purpose of selecting the one best fitting the data. In addition, the attributable population risk (APR) was calculated. The results indicate that failure to breast-feed and early weaning were prevalent in the study population, 34.8% of the study infants being breast-fed less than 1 month. Three risk factors were associated statistically (P < 0.05) with early weaning, these being maternal age < 20 years (RR = 3.75; 95% CI = 1.53-9.19), maternal marital status single (RR = 2.88; 95% CI = 1.08-7.69), and social status of the main family provider other than "worker"--i.e., employee, professional (RR = 2.72; 95% CI = 1.17-6.28). The likelihood that a study infant would have been breast-fed less than a month was 0.84 if the infant was exposed to all three of these identified risk factors and 0.15 if he or she was exposed to none of them. The high percentages of study mothers less then 20 years old and with a social status other than "worker" were reflected in high attributable population found for these variables. In general, the findings point up a need to reduce the influence of these risk factors and to prolong maternal breast-feeding in the study population.
为了调查母乳喂养模式以及促使早期断奶的因素，1991年在瓜达拉哈拉市大都市区内的两个郊区托纳拉和特拉凯帕克进行了一项调查。为此，选取了1990年5月至1991年4月在这些地区出生的婴儿的多阶段概率样本。这是通过随机选择研究区域内的初级卫生保健单位、与这些单位相关的卫生站以及每个选定卫生站中所有符合上述标准的婴儿来完成的。1991年6月和7月，共走访了166户家庭，对141名母亲（占预测的155名的91%）进行了访谈。这些访谈使用了为此目的编制的一份有33个项目的问卷；访谈者是此前接受过此类活动培训的社会工作者。使用逻辑回归模型来计算相对风险（RR）以及早期断奶与某些变量相关的概率。为了帮助确保结果的有效性，构建了几个回归模型以选择最适合数据的那个。此外，还计算了归因人群风险（APR）。结果表明，在研究人群中，不进行母乳喂养和早期断奶的情况很普遍，34.8%的研究婴儿母乳喂养时间不足1个月。有三个风险因素与早期断奶在统计学上相关（P<0.05），即母亲年龄<20岁（RR = 3.75；95%可信区间 = 1.53 - 9.19）、母亲婚姻状况为单身（RR = 2.88；95%可信区间 = 1.08 - 7.69）以及主要家庭供养者的社会地位不是“工人”——即雇员、专业人员（RR = 2.72；95%可信区间 = 1.17 - 6.28）。如果研究婴儿暴露于所有这三个已确定的风险因素中，其母乳喂养不足1个月的可能性为0.84；如果未暴露于任何一个风险因素中，则可能性为0.15。研究中年龄小于20岁且社会地位不是“工人”的母亲比例较高，这在这些变量的高归因人群中得到了体现。总体而言，研究结果表明有必要减少这些风险因素的影响，并延长研究人群中母亲的母乳喂养时间。
