The effect of pre-pregnancy BMI on intention, initiation and duration of breast-feeding
The effect of pre-pregnancy BMI on intention, initiation and duration of breast-feeding
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DOI：
10.1017/s1368980011002667
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发表时间：
2012-05-01
影响因子：
3.2
通讯作者：
Vansant, Greet
中科院分区：
文献类型：
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作者：
Guelinckx, Isabelle;Devlieger, Roland;Vansant, Greet
目标：确定孕前体重指数是否影响母乳喂养。设计：回顾性流行病学研究。地点：比利时鲁汶天主教大学鲁汶大学医院。受试者：200名妇女（中位年龄29岁，四分位距（IQR）4; 52%未产妇）根据孕前BMI使用WHO截止值分为四类。与正常体重（92%）和超重妇女（80%）相比，体重不足妇女（64%）和肥胖妇女（68%）的母乳喂养意向和开始母乳喂养的发生率显著降低。开始妊娠也与产次有关（OR = 0.582; 95%CI 0.400，0.846），但与妊娠期体重增加、分娩方式或高血压疾病无关。52%的体重不足妇女、70%的体重正常妇女和56%的超重妇女在婴儿出生后的第一个月内完全用母乳喂养。肥胖组的发生率显著较低（34%; P = 0.030）。只有40%的婴儿在3个月大时完全母乳喂养，肥胖妇女的患病率最低（P = 0.001）。肥胖组母乳喂养的中位持续时间（1.8个月，IQR 3.4）显著短于体重不足组（3.0个月，IQR 3.1）、体重正常组（3.0个月，IQR 2.4）和超重组（3.0个月，IQR 3.5; P = 0.024）。肥胖组停止母乳喂养的原因是母亲并发症（29%），母乳供应不足（23%），吸吮问题（21%）和工作恢复（21%）。结论：母乳喂养的做法在总人口中，但特别是肥胖妇女，没有达到全球世界卫生组织推荐的标准。政策举措和地方干预措施应继续支持母乳喂养，但也要防止产妇肥胖。
Objective: To determine whether pre-pregnancy BMI influences breast-feeding practice.Design: Retrospective epidemiological study.Setting: University Hospital Leuven, Catholic University Leuven, Belgium.Subjects: Two hundred women (median age 29 years, interquartile range (IQR) 4; 52% nulliparae) were grouped into four categories according to pre-pregnancy BMI using WHO cut-offs.Results: The incidence of intention and initiation of breast-feeding was significantly lower in underweight (64%) and obese women (68%) compared with normal weight (92%) and overweight women (80%). Initiation was also related to parity (OR = 0.582; 95% CI 0.400, 0.846), but not to gestational weight gain, method of delivery or hypertensive disorders. Fifty-two per cent of underweight, 70% of normal weight and 56% of overweight women were exclusively breast-feeding their infant during the first month of life. This incidence was significantly lower in the obese group (34%; P = 0.030). Only 40% of all infants were exclusively breast-fed at 3 months of age, with the lowest prevalence among women with obesity (P = 0.001). The median duration of any breast-feeding in the obese group (1.8 months, IQR 3.4) was significantly shorter than in the underweight (3.0 months, IQR 3.1), normal weight (3.0 months, IQR 2.4) and overweight group (3.0 months, IQR 3.5; P = 0.024). Reasons given for ceasing breast-feeding in the obese group were maternal complications (29%), insufficient milk supply (23%), sucking problems (21%) and work resumption (21%).Conclusions: Breast-feeding practice in the total population, but especially among women with obesity, fell short of global WHO recommended standards. Policy initiatives and local interventions should continue to support breast-feeding, but also prevent maternal obesity.