Breastfeeding in women with rheumatic diseases.
Breastfeeding in women with rheumatic diseases.
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DOI：
10.1136/lupus-2021-000491
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发表时间：
2021-04
影响因子：
3.9
通讯作者：
Clowse MEB
中科院分区：
文献类型：
--
作者：
Ikram N;Eudy A;Clowse MEB
许多风湿病学家和患有风湿病的妇女担心这种疾病或治疗会阻止母乳喂养。然而，国际指南规定，大多数抗风湿药物与母乳喂养相容。我们试图确定风湿性疾病妇女的母乳喂养意愿和实际母乳喂养的频率和预测因素。前瞻性招募患有风湿性疾病的孕妇。在研究开始时收集人口统计学和母乳喂养意愿，而产后记录实际母乳喂养决定。在整个研究过程中收集母亲诊断、人口统计学和药物使用情况。采用逐步Logistic回归分析确定母乳喂养和意向的预测因素。共有265名孕妇被纳入研究，其中88名患有SLE，33名患有未分化结缔组织病，100名患有关节炎，44名患有其他罕见的风湿性疾病。其中，79%的妇女打算母乳喂养，84%的妇女曾经母乳喂养，65%的妇女在产后平均7.6周仍在母乳喂养。药物问题是最常引用的不母乳喂养的原因，尽管只有5%的妇女在产后访视时正在服用或计划开始服用与哺乳期无关的药物。在多变量分析中，具有大学学历的女性更有可能母乳喂养，而SLE女性不太可能母乳喂养。实际母乳喂养是最强烈的预测妇女的母乳喂养的意图，但也增加了母亲的年龄，减少，如果婴儿早产和减少进一步产后约会发生分娩。这项研究表明，大多数患有风湿性疾病的妇女希望并能够成功地进行母乳喂养。此外，很少有妇女需要与母乳喂养不相容的药物来控制产后风湿病。尽管如此，少数患者由于个人担心抗风湿药物对婴儿的风险而没有继续母乳喂养。
Many rheumatologists and women with rheumatic disease worry that the disease or treatment will prevent breast feeding. International guidelines establish, however, that most antirheumatic medications are compatible with breast feeding. We sought to identify the frequency and predictors of desire to and actually breast feeding in women with rheumatic diseases. Pregnant women with rheumatic disease were enrolled prospectively. Demographics and breastfeeding intention were collected at study entry, while actual breastfeeding decision was recorded postpartum. Maternal diagnosis, demographics and medication use was collected throughout the study. Predictors of breast feeding and intention were identified using stepwise logistic regression. A total of 265 pregnancies were included in the study, 88 with SLE, 33 with undifferentiated connective tissue disease, 100 with arthritis and 44 with other rare rheumatic diagnoses. Of these, 79% intended to breastfeed, 84% of women ever breast fed and 65% were still breast feeding at an average of 7.6 weeks postpartum. Medication concern was the most commonly cited reason not to breastfeed though only 5% of women were taking or planning to start a non-lactation compatible medication at their postpartum visit. In multivariate analysis, women with a college degree were more likely and women with SLE were less likely to intend to breastfeed. Actual breast feeding was most strongly predicted by the woman’s intention to breastfeed, but also increased with maternal age, decreased if the baby was born preterm and decreased the further the postpartum appointment occurred from delivery. This study demonstrates that the majority of women with rheumatic disease want to and can breastfeed successfully. Additionally, very few women required a medication that was not compatible with breast feeding to control their rheumatic disease in the postpartum period. Despite this, an important minority of patients did not continue breast feeding due to their personal concerns about the risks of antirheumatic medications to their infant.
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影响因子：
2.3
作者：
Keenan-Devlin, Lauren S.;Awosemusi, Yetunde F.;Borders, Ann E. B.
通讯作者：
Borders, Ann E. B.
影响因子：
1.9
作者：
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通讯作者：
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影响因子：
8
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通讯作者：
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影响因子：
5.5
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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