Factors associated with breastfeeding at six months postpartum in a group of Australian women
Factors associated with breastfeeding at six months postpartum in a group of Australian women
复制标题
DOI：
10.1186/1746-4358-1-18
复制
发表时间：
2006-01-01
影响因子：
3.5
通讯作者：
Lumley, Judith
中科院分区：
文献类型：
--
作者：
Forster, Della A.;McLachlan, Helen L.;Lumley, Judith
背景：尽管澳大利亚的母乳喂养开始水平很高，但只有47%的女性在六个月后开始母乳喂养(完全或部分)，不同社会群体之间存在显著差异。重要的是要确定哪些妇女有更高的风险提前停止母乳喂养。方法：随机对照试验的三个分支的数据被汇集在一起，并作为队列使用Logistic回归分析，以确定哪些因素预测妇女在产后6个月继续母乳喂养。最初的试验包括1999-2001年间在澳大利亚墨尔本一家公立三级妇女医院就诊的981名初产妇女。该试验评估了两种孕中期教育干预措施对母乳喂养开始和持续时间的影响。在889名有6个月结局的妇女中，与标准护理相比，无论是干预措施还是母乳喂养持续时间都没有增加。根据文献和与同行的讨论，将自变量纳入预测模型，并针对因变量(6个月时的母乳喂养)进行单独检验。结果：确定了33个感兴趣的自变量，其中25个变量符合初步回归模型的条件；764个观察数据完整。最终模型中剩余的与六个月时母乳喂养呈正相关的因素包括：对母乳喂养的强烈愿望；婴儿时期曾母乳喂养；出生在亚洲国家；以及较大的产妇年龄。随着年龄的增长，这种关联越来越大。与6个月母乳喂养负相关的因素有：妇女不打算母乳喂养6个月或更长时间；孕前每天吸烟20支或更多；没有接受生育教育；母亲肥胖；在出生后6个月内自我报告患有抑郁症；婴儿在住院期间服用婴儿配方奶粉。结论：除了以前工作中常见的与母乳喂养相关的因素外，本研究还发现母乳喂养结果与在医院给婴儿配方奶粉有关，母亲体重指数高，以及自报婴儿出生后6个月内母亲抑郁或焦虑。寻求增加母乳喂养的干预措施应考虑将重点放在希望母乳喂养但过早停止母乳喂养风险很高的妇女身上。
Background: Despite high levels of breastfeeding initiation in Australia, only 47 percent of women are breastfeeding (exclusively or partially) six months later, with marked differences between social groups. It is important to identify women who are at increased risk of early cessation of breastfeeding.Methods: Data from the three arms of a randomised controlled trial were pooled and analysed as a cohort using logistic regression to identify which factors predicted women continuing to feed any breast milk at six months postpartum. The original trial included 981 primiparous women attending a public, tertiary, women's hospital in Melbourne, Australia in 1999-2001. The trial evaluated the effect of two mid-pregnancy educational interventions on breastfeeding initiation and duration. In the 889 women with six month outcomes available, neither intervention increased breastfeeding initiation nor duration compared to standard care. Independent variables were included in the predictive model based on the literature and discussion with peers and were each tested individually against the dependent variable (any breastfeeding at six months).Results: Thirty-three independent variables of interest were identified, of which 25 qualified for inclusion in the preliminary regression model; 764 observations had complete data available. Factors remaining in the final model that were positively associated with breastfeeding any breast milk at six months were: a very strong desire to breastfeed; having been breastfed oneself as a baby; being born in an Asian country; and older maternal age. There was an increasing association with increasing age. Factors negatively associated with feeding any breast milk at six months were: a woman having no intention to breastfeed six months or more; smoking 20 or more cigarettes per day pre-pregnancy; not attending childbirth education; maternal obesity; having self-reported depression in the six months after birth; and the baby receiving infant formula while in hospital.Conclusion: In addition to the factors commonly reported as being associated with breastfeeding in previous work, this study found a negative association between breastfeeding outcomes and giving babies infant formula in hospital, a high maternal body mass index, and self-reported maternal depression or anxiety in the six months after the baby was born. Interventions that seek to increase breastfeeding should consider focusing on women who wish to breastfeed but are at high risk of early discontinuation.