Duration of breastfeeding and breastfeeding problems in relation to length of postpartum stay:: a longitudinal cohort study of a national Swedish sample
Duration of breastfeeding and breastfeeding problems in relation to length of postpartum stay:: a longitudinal cohort study of a national Swedish sample
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DOI：
10.1080/08035250410023755
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发表时间：
2004-05-01
期刊：
影响因子：
3.8
通讯作者：
Aarts, C
中科院分区：
文献类型：
--
作者：
Waldenström, U;Aarts, C
目的：探讨产后停留时间与母乳喂养持续时间及母乳喂养问题的关系，特别关注早期出院情况。方法：1999年至2000年，在瑞典所有产前诊所招募瑞典语妇女，平均分布在1岁以上，为期3周。总共有3293名女性（71%的女性符合条件）同意参加这项研究。数据通过怀孕早期、产后2个月和1个月的问卷调查以及瑞典医疗出生登记册收集。为了本研究的目的，只分析了2709名女性（82%）在2个月问卷中填写的关于停留时间的数据。根据产后停留时间（第1天< 24 h至第6天大于或等于120 h）分为6组。结果：在第1天出院的妇女中位母乳喂养持续时间为7个月，在随后任何一天出院的妇女中位母乳喂养持续时间为8个月；差异无统计学意义（p = 0.66）。除了住院时间（居住区域）和出诊次数等医院政策外，提前出院还与以下产妇特征有关，这些特征可分为三类：(1)高龄、多子女、多子女；(2)出生后第一次母乳喂养的积极体验；(3)学历低、经济问题、吸烟、缺乏伴侣支持。延迟出院与手术分娩、早产和婴儿出生体重低有关。当这些因素被Cox回归分析控制后，六组之间停止母乳喂养的相对风险没有统计学差异。母乳喂养问题，如充血和乳腺炎，没有差异，但在第6天或更晚出院的妇女在第一周内出现疼痛或乳头破裂的问题较少，而在产后4-8周出现更多问题。结论：与产后住院时间相比，母亲特征可能是母乳喂养时间更重要的预测因素。赡养的效果有待进一步研究。
Aim: To investigate the association between length of postpartum stay and duration of breastfeeding and breastfeeding problems, with special focus on early hospital discharge. Methods: Swedish-speaking women were recruited from all antenatal clinics in Sweden during 3 wk evenly spread over 1 y in 1999 to 2000. In total, 3293 women (71% of those who were eligible) consented to participate in the study. Data were collected by questionnaires in early pregnancy, 2 mo and 1 y postpartum, and from the Swedish Medical Birth Register. For the purpose of this study, only data from the 2709 women (82%) who filled in the question about length of stay in the 2-mo questionnaire were analysed. Women were divided into six groups according to length of postpartum stay (day 1: < 24 h to day 6: greater than or equal to120 h). Results: The median duration of any breastfeeding was 7 mo in women discharged on day 1, and 8 mo in women discharged on any of the following days; a non-significant difference ( p = 0.66). Besides hospital policies regarding length of stay (residential area) and number of domiciliary visits, early discharge was associated with the following maternal characteristics, which could be divided into three categories: ( 1 ) older, multipara, many children; ( 2 ) positive experience of the first breastfeeding after birth; ( 3 ) low education, economic problems, smoking, lack of support from partner. Late discharge was associated with operative delivery, preterm birth and low infant birthweight. When these factors were controlled for by Cox regression analysis, no statistical differences were found between the six groups in the relative risk of discontinuing to breastfeed. Breastfeeding problems, such as engorgement and mastitis, did not differ, but women discharged on day 6 or later had fewer problems with sore or cracked nipples during the first week and more problems 4-8 wk postpartum.Conclusion: Maternal characteristics may be more important predictors of the duration of breastfeeding than length of stay in hospital after the birth. The effect of domiciliary support needs further research.