A community-based prospective cohort study of exclusive breastfeeding in central Nepal.
A community-based prospective cohort study of exclusive breastfeeding in central Nepal.
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DOI：
10.1186/1471-2458-14-927
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发表时间：
2014-09-08
影响因子：
4.5
通讯作者：
Binns CW
中科院分区：
文献类型：
--
作者：
Karkee R;Lee AH;Khanal V;Binns CW
在尼泊尔等低收入国家，关于母乳喂养的现有信息主要来自跨部门人口健康调查。这项研究调查了纯母乳喂养率，并使用替代队列方法比较了尼泊尔中部农村和城市母亲纯母乳喂养的持续时间。在尼泊尔卡斯基地区代表的639名最近分娩的母亲中进行了一项基于社区的前瞻性队列研究。通过使用经验证的问卷进行重复访谈，在出生（n = 639）、4周（n = 639）、12周（n = 615; 96.2%）和22周（n = 515; 80.6%）时获得母乳喂养信息。通过考克斯回归分析评估停止纯母乳喂养的风险。绝大多数妇女（74%）得到了母乳喂养的信息，并得到了保健人员或家庭成员（81%）的鼓励。尽管几乎所有母亲（98%）都母乳喂养了6个月，但报告的纯母乳喂养率从出生时的90.9%迅速下降到22周时的29.7%。城市女性经历的时间明显缩短（p = 0.02）纯母乳喂养持续时间（平均104.5，95% CI 95.8 - 113.1天），更有可能停止纯母乳喂养（风险比（HR）1.28，95% CI 1.03至1.60）比农村同行（平均144.7，95% CI 132.3至157.1天）。母乳喂养问题（HR 2.07，95%CI 1.66至2.57）和剖腹产（HR 1.88，95%CI 1.36至2.62）也与纯母乳喂养停止显著相关。尽管母乳喂养几乎普遍，但报告的纯母乳喂养率随着时间的推移大幅下降。在尼泊尔中部，6个月以下的纯母乳喂养在农村地区比在城市地区更为普遍。城市母亲的纯母乳喂养时间也比农村母亲短。本文的在线版本（doi：10.1186/1471-2458-14-927）包含补充材料，可供授权用户使用。
Existing information on breastfeeding in low income countries such as Nepal has been largely derived from cross-sectional demographic health surveys. This study investigated exclusive breastfeeding rates, and compared the duration of exclusive breastfeeding between rural and urban mothers in central Nepal using an alternate cohort methodology. A community-based prospective cohort study was conducted among 639 recently delivered mothers representative of the Kaski district of Nepal. Breastfeeding information was obtained at birth (n = 639), 4 weeks (n = 639), 12 weeks (n = 615; 96.2%) and 22 weeks (n = 515; 80.6%) through repeated interviews using validated questionnaires. Risk of cessation of exclusive breastfeeding was assessed by Cox regression analysis. The great majority of women received breastfeeding information (74%) and were encouraged to breastfeed by health personnel or family members (81%). Although nearly all mothers (98%) breastfed up to six months, the reported exclusive breastfeeding rate declined rapidly from 90.9% at birth to 29.7% at 22 weeks. Urban women experienced significantly shorter (p = 0.02) exclusive breastfeeding duration (mean 104.5, 95% CI 95.8 to 113.1 days) and were more likely to cease exclusive breastfeeding (hazard ratio (HR) 1.28, 95% CI 1.03 to 1.60) than their rural counterparts (mean 144.7, 95% CI 132.3 to 157.1 days). Breastfeeding problem (HR 2.07, 95% CI 1.66 to 2.57) and caesarean delivery (HR 1.88, 95% CI 1.36 to 2.62) were also significantly associated with exclusive breastfeeding cessation. Despite the almost universal practice of breastfeeding, the reported exclusive breastfeeding rates declined substantially over time. Exclusive breastfeeding up to six months was more common in rural than urban areas of central Nepal. Urban mothers also exclusively breastfed shorter than rural mothers. The online version of this article (doi:10.1186/1471-2458-14-927) contains supplementary material, which is available to authorized users.
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