The Mood, Mother, and Infant Study: Associations Between Maternal Mood in Pregnancy and Breastfeeding Outcome
The Mood, Mother, and Infant Study: Associations Between Maternal Mood in Pregnancy and Breastfeeding Outcome
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DOI：
10.1089/bfm.2019.0079
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发表时间：
2019-08-19
影响因子：
2.7
通讯作者：
Grewen, Karen
中科院分区：
文献类型：
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作者：
Stuebe, Alison M.;Meltzer-Brody, Samantha;Grewen, Karen
目的：我们试图确定抑郁和焦虑在母乳喂养停止中的作用。材料和方法：参与者在妊娠晚期进行了基线访视和结构化临床访谈。每月电话访谈评估当前情绪症状和婴儿喂养状况。我们使用考克斯比例风险回归评估基线情绪和婴儿喂养结果之间的关联，调整婴儿喂养意图和社会人口学混杂因素。结果：我们招募了222对妊娠晚期的母婴，其中206人在产后12个月内完成了评估。我们通过招募87名当前患有抑郁症或焦虑症的女性（当前），64名有抑郁症或焦虑症病史的女性（过去）和71名无精神病史的女性（从未）来丰富我们的研究。在多变量校正分析中，基线诊断与母乳喂养结果无关，但基线抑郁症状（贝克抑郁量表>= 11）或焦虑（Spielberger状态焦虑>= 40）与较早引入配方奶粉有关（抑郁：调整风险比[HR] 1.52，95%置信区间[CI] 1.01-2.30;焦虑：1.70，95% CI 1.01-2.87）;和任何母乳喂养停止（抑郁：调整HR 2.02，95% CI 1.23-3.31;焦虑：1.83，95% CI 1.00-3.33），与未经治疗的无症状女性相比，接受抗抑郁药治疗的女性中的抑郁症状也是如此。（公式：调整HR 2.27，95% CI 1.29-4.02;停止：2.32，95% CI 1.17-4.61）。童年创伤史（adj HR 1.34，95% CI 1.12-1.61）、饮食失调症状（adj HR 1.22，95% CI 1.02-1.46）和妊娠期睡眠质量差（adj HR 1.32，95% CI 1.09-1.60）与较早引入配方奶粉独立相关。结论：基线情绪症状与早期配方奶引入和停止母乳喂养独立相关。童年创伤史、饮食失调症状和睡眠质量差与早期引入配方奶粉有关。有针对性的支持可以使有这些症状的妇女实现其喂养目标。
Purpose: We sought to determine the role of depression and anxiety in breastfeeding cessation. Materials and Methods: Participants underwent a baseline visit with a structured clinical interview in the third trimester of pregnancy. Monthly phone interviews assessed current mood symptoms and infant feeding status. We assessed the association between baseline mood and infant feeding outcomes using Cox proportional hazards regression, adjusting for infant feeding intention and sociodemographic confounders. Results: We enrolled 222 mother-infant dyads in late pregnancy, of whom 206 completed assessments through 12 months postpartum. We enriched our study with symptomatic women by enrolling 87 women with current depression or anxiety (Current), 64 women with a history of depression or anxiety (Past), and 71 women with no psychiatric history (Never). In multivariable-adjusted analyses, baseline diagnosis was not associated with breastfeeding outcome, but baseline symptoms of depression (Beck Depression Inventory >= 11) or anxiety (Spielberger State Anxiety >= 40) were associated with earlier introduction of formula (depression: adj hazard ratio [HR] 1.52, 95% confidence interval [CI] 1.01-2.30; anxiety: 1.70, 95% CI 1.01-2.87); and any cessation of breastfeeding (depression: adj HR 2.02, 95% CI 1.23-3.31; anxiety: 1.83, 95% CI 1.00-3.33), as were depression symptoms among women who were being treated with antidepressants, compared with untreated asymptomatic women (formula: adj HR 2.27, 95% CI 1.29-4.02; cessation: 2.32, 95% CI 1.17-4.61). History of childhood trauma (adj HR 1.34, 95% CI 1.12-1.61), disordered eating symptoms (adj HR 1.22, 95% CI 1.02-1.46), and poor sleep quality in pregnancy (adj HR 1.32, 95% CI 1.09-1.60) were independently associated with earlier introduction of formula. Conclusions: Baseline mood symptoms were independently associated with earlier formula introduction and cessation of breastfeeding. History of childhood trauma, disordered eating symptoms and poor sleep quality were associated with earlier formula introduction. Targeted support may enable women with these symptoms to achieve their feeding goals.