Antenatal psychological and socioeconomic predictors of breastfeeding in a large community sample
Antenatal psychological and socioeconomic predictors of breastfeeding in a large community sample
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DOI：
10.1016/j.earlhumdev.2017.04.010
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发表时间：
2017-07-01
影响因子：
2.5
通讯作者：
O'Connor, Thomas G.
中科院分区：
文献类型：
--
作者：
Castro, Rita T. Amiel;Glover, Vivette;O'Connor, Thomas G.
背景：尽管做了很多工作来宣传母乳喂养的好处，但大多数妇女并没有按照世界卫生组织的建议坚持母乳喂养的前6个月。成功母乳喂养6个月可能取决于几个因素，包括围产期心理健康。我们的目的是调查产前抑郁症状、对母乳喂养的态度和社会人口因素对预测6个月母乳喂养的影响。方法：样本基于雅芳父母与儿童纵向研究（n = 9479），这是一个大规模的出生队列。母乳喂养在多个时间点进行评估，从出生后第1天到出生后6个月。在妊娠18周和32周以及产后8周时评估母亲自我报告的抑郁症状。在妊娠32周时评估产前对母乳喂养的态度。还评估了产前、产科、社会心理和社会人口变量。结果：妊娠18周和32周的产前抑郁症状与母乳喂养开始和持续时间的减少有关。然而，通过这些症状对母乳喂养的预测受到社会人口统计学和社会心理协变量的干扰。产前对母乳喂养的积极态度是最强的预测因子，并与所有时间点母乳喂养开始和维持率增加20-30%相关。结论：本研究强调了独立预测母乳喂养的广泛因素，并建议改善产前态度的干预计划特别值得调查。
Background: Despite much work to publicise the benefits of breastfeeding most women do not persist for the first 6 months, as recommended by the WHO. Successful breastfeeding for 6 months may depend on several factors, including perinatal mental health. We aimed to investigate the impact of antenatal depressive symptoms, attitudes towards breastfeeding and socio-demographic factors in predicting breastfeeding for 6 months in a large community sample.Methods: The sample was based on the Avon Longitudinal Study of Parents and Children (n = 9479), a large-scale birth cohort. Breastfeeding was assessed at multiple time-points, from postnatal day 1 until 6 months postnatal. Self-reported symptoms of maternal depression were assessed at 18 and 32 weeks gestation and at 8 weeks postnatal. Antenatal attitudes towards breastfeeding were assessed at 32 weeks gestation. Antenatal, obstetric, psychosocial and socio-demographic variables were also assessed.Results: Antenatal depressive symptoms at both 18 and 32 weeks gestation were associated with decreased breastfeeding initiation and duration. However, the prediction of breastfeeding by these symptoms was confounded by socio-demographic and psychosocial covariates. A positive antenatal attitude towards breastfeeding was the strongest predictor and was associated with a 20-30% increase in breastfeeding initiation and maintenance at all time points.Conclusion: This study highlights the wide range of factors that independently predict breastfeeding, and suggests that an intervention program to improve antenatal attitudes especially warrants investigation.