Effect of breastfeeding on mortality among HIV-1 infected women: a randomised trial
Effect of breastfeeding on mortality among HIV-1 infected women: a randomised trial
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DOI：
10.1016/s0140-6736(00)04820-0
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发表时间：
2001-05-26
期刊：
影响因子：
168.9
通讯作者：
Kreiss, J
中科院分区：
文献类型：
--
作者：
Nduati, R;Richardson, BA;Kreiss, J
背景 我们已经完成了一项母乳喂养和配方奶喂养的随机临床试验，以确定 HIV-1 通过母乳传播给婴儿的频率。然而，我们还分析了该试验的数据，以研究母乳喂养对产后 2 年内孕产妇死亡率的影响。我们报告了二次分析的结果。 方法 在内罗毕市议会的四个诊所就诊的孕妇接受了艾滋病毒检测。在妊娠约 32 周时，425 名 HIV-1 血清阳性妇女被随机分配到母乳喂养或配方奶喂养她们的婴儿。分娩后，第一年每月对母婴进行随访，第二年每季度进行一次随访，直至死亡、或分娩后 2 年或研究结束。结果 母乳喂养组的母亲死亡率高于配方奶粉组（18 例死亡，6 例死亡，对数秩检验，p=0.009）。母乳喂养组产后 24 个月产妇死亡的累积概率为 10.5%，配方奶组为 3.8%（p=0.02）。母乳喂养母亲与配方奶喂养母亲的相对死亡风险为 3.2（95% CI 1.3-8.1，p=0.01）。因母乳喂养导致孕产妇死亡的归因风险为 69%。即使婴儿 HIV-1 感染状态得到控制，孕产妇死亡与随后的婴儿死亡之间仍存在关联（相对风险 7.9，95% CI 3.3-18.6，p
Background We have completed a randomised clinical trial of breastfeeding and formula feeding to identify the frequency of breastmilk transmission of HIV-1 to infants. However, we also analysed data from this trial to examine the effect of breastfeeding on maternal death rates during 2 years after delivery. We report our findings from this secondary analysis.Methods Pregnant women attending four Nairobi city council clinics were offered HIV tests. At about 32 weeks' gestation, 425 HIV-1 seropositive women were randomly allocated to either breastfeed or formula feed their infants. After delivery, mother-infant pairs were followed up monthly during the first year and quarterly during the second year until death, or 2 years after delivery, or end of study.Findings Mortality among mothers was higher in the breastfeeding group than in the formula group (18 vs 6 deaths, log rank test, p=0.009). The cumulative probability of maternal death at 24 months after delivery was 10.5% in the breastfeeding group and 3.8% in the formula group (p=0.02). The relative risk of death for breastfeeding mothers versus formula feeding mothers was 3.2 (95% CI 1.3-8.1, p=0.01). The attributable risk of maternal death due to breastfeeding was 69%. There was an association between maternal death and subsequent infant death, even after infant HIV-1 infection status was controlled for (relative risk 7.9, 95% CI 3.3-18.6, p