Corrigendum.
Corrigendum.
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DOI：
10.1111/mcn.12450
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发表时间：
2017-04-01
影响因子：
3.4
通讯作者：
中科院分区：
文献类型：
--
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本研究的目的是量化美国因母乳喂养率不理想而导致的儿科和孕产妇疾病、死亡和成本的超额病例。利用目前关于母乳喂养与9种儿科疾病和5种孕产妇疾病的健康结果之间关系的文献，我们创建了Monte Carlo模拟，模拟了一个假设的美国队列，该队列的女性从15岁到70岁，她们的孩子从出生到20岁。我们使用（a）2012年母乳喂养率和（B）假设90%的婴儿根据医学建议进行母乳喂养来检查疾病结局。我们以2014年美元为单位，使用2%的贴现率来衡量年度超额病例、死亡和相关成本。每年因母乳喂养不佳导致的死亡人数增加了3,340人（95%置信区间[1,886 - 4,785]），其中78%是由于心肌梗死（n= 986）、乳腺癌（n= 838）和糖尿病（n= 473）而导致的产妇死亡。额外的儿科死亡总数为721例，主要是由于婴儿猝死综合征（n= 492）和坏死性小肠结肠炎（n= 190）。医疗费用总额为30亿美元，其中79%是产妇费用。过早死亡的成本总计142亿美元。为预防婴儿肠胃感染而需要按照医学建议进行母乳喂养的妇女人数为0.8人;急性中耳炎3人;下呼吸道感染住院95人;产妇高血压55人;糖尿病162人;心肌梗塞235人。每597名妇女进行最佳母乳喂养，就可避免一名产妇或儿童死亡。增加最佳母乳喂养的政策可以带来巨大的公共卫生收益。母乳喂养对妇女健康的影响比以前认识到的要大。
The aim of this study was to quantify the excess cases of pediatric and maternal disease, death, and costs attributable to suboptimal breastfeeding rates in the United States. Using the current literature on the associations between breastfeeding and health outcomes for nine pediatric and five maternal diseases, we created Monte Carlo simulations modeling a hypothetical cohort of U.S. women followed from age 15 to age 70 years and their children from birth to age 20 years. We examined disease outcomes using (a) 2012 breastfeeding rates and (b) assuming that 90% of infants were breastfed according to medical recommendations. We measured annual excess cases, deaths, and associated costs, in 2014 dollars, using a 2% discount rate. Annual excess deaths attributable to suboptimal breastfeeding total 3,340 (95% confidence interval [1,886 to 4,785]), 78% of which are maternal due to myocardial infarction (n= 986), breast cancer (n= 838), and diabetes (n= 473). Excess pediatric deaths total 721, mostly due to Sudden Infant Death Syndrome (n= 492) and necrotizing enterocolitis (n= 190). Medical costs total $3.0 billion, 79% of which are maternal. Costs of premature death total $14.2 billion. The number of women needed to breastfeed as medically recommended to prevent an infant gastrointestinal infection is 0.8; acute otitis media, 3; hospitalization for lower respiratory tract infection, 95; maternal hypertension, 55; diabetes, 162; and myocardial infarction, 235. For every 597 women who optimally breastfeed, one maternal or child death is prevented. Policies to increase optimal breastfeeding could result in substantial public health gains. Breastfeeding has a larger impact on women's health than previously appreciated.