Examining the Role of Interpersonal Violence in Racial Disparities in Breastfeeding in North Dakota (ND PRAMS 2017-2019).
Examining the Role of Interpersonal Violence in Racial Disparities in Breastfeeding in North Dakota (ND PRAMS 2017-2019).
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DOI：
10.3390/ijerph20085445
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发表时间：
2023-04-09
影响因子：
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通讯作者：
Williams, Andrew
中科院分区：
文献类型：
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作者：
Kanichy Makah, MichaeLynn;Schmidt, Lexie;Anderson, RaeAnn;Njau, Grace;Stiffarm Aaniiih, Amy;Schmidt, Matthew;Stepanov, Anastasia;Williams, Andrew
背景资料。2019年美国总体母乳喂养启动率为84.1%，但只有76.6%的美国印第安人(AI)女性开始母乳喂养。在北达科他州(ND)，人工智能女性比其他种族/民族群体更容易受到人际暴力的影响。与人际暴力相关的压力可能会干扰对母乳喂养至关重要的过程。我们探讨了人际暴力是否在一定程度上解释了ND在母乳喂养方面的种族/民族差异。方法：研究方法。2161名妇女的数据来自2017-2019年ND怀孕风险评估监测系统。婴儿车中的母乳喂养问题已经在不同的人群中进行了测试。母乳喂养的开始是自我报告的，“你有没有用母乳喂养或抽母乳来喂养你的新生儿，哪怕是很短的一段时间？”(是/否)。母乳喂养持续时间(2个月；6个月)自报母乳喂养周数或月数。怀孕前12个月和怀孕期间的人际暴力，基于丈夫/伴侣、家庭成员、其他人或前夫/伴侣的暴力行为的自我报告(是/否)。如果参与者对任何暴力行为的回答是肯定的，就会创建一个“任何暴力行为”变量。Logistic回归模型估计了AI和其他种族女性与白人女性相比母乳喂养结果的粗略和调整后的优势比(OR)和95%的可信区间(95%CI)。针对人际暴力(丈夫/伴侣、家庭成员、其他人、前夫/伴侣或任何人)的顺序模型进行了调整。结果。与白人妇女相比，人工智能妇女开始母乳喂养的几率降低了45%(OR：0.55，95%CI：0.36，0.82)。包括怀孕期间的人际暴力并没有改变结果。在所有母乳喂养结果和所有人际暴力暴露中也观察到了类似的模式。讨论。人际暴力不能解释ND在母乳喂养方面的差异。考虑到母乳喂养传统的文化联系以及殖民的作用，可能会更好地理解人工智能人群中的母乳喂养。
Background. The 2019 overall breastfeeding initiation rate in the US was 84.1%, yet only 76.6% of American Indian (AI) women initiated breastfeeding. In North Dakota (ND), AI women have greater exposure to interpersonal violence than other racial/ethnic groups. Stress associated with interpersonal violence may interfere with processes important to breastfeeding. We explored whether interpersonal violence partially explains racial/ethnic disparities in breastfeeding in ND. Methods. Data for 2161 women were drawn from the 2017–2019 ND Pregnancy Risk Assessment Monitoring System. Breastfeeding questions in PRAMS have been tested among diverse populations. Breastfeeding initiation was self-report to “Did you ever breastfeed or pump breast milk to feed your new baby, even for a short period?” (yes/no). Breastfeeding duration (2 months; 6 months) was self-reported how many weeks or months of breastmilk feeding. Interpersonal violence for both 12 months before and during pregnancy based on self-report (yes/no) of violence from a husband/partner, family member, someone else, or ex-husband/partner. An “Any violence” variable was created if participants reported “yes” to any violence. Logistic regression models estimated crude and adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for breastfeeding outcomes among AI and Other Race women compared to White women. Sequential models were adjusted for interpersonal violence (husband/partner, family member, someone else, ex-husband/partner, or any). Results. AI women had 45% reduced odds of initiating breastfeeding (OR: 0.55, 95% CI: 0.36, 0.82) compared to white women. Including interpersonal violence during pregnancy did not change results. Similar patterns were observed for all breastfeeding outcomes and all interpersonal violence exposures. Discussion. Interpersonal violence does not explain the disparity in breastfeeding in ND. Considering cultural ties to the tradition of breastfeeding and the role of colonization may provide a better understanding of breastfeeding among AI populations.