婴儿早期母乳喂养影响因素的随访研究

目的了解婴儿生后2个月和4个月时的母乳喂养终止率,探讨生后4个月内母乳喂养终止及喂养行为改变的影响因素。方法对1841名待产初产妇在分娩前进行问卷调查,了解孕妇的一般人口统计学信息、分娩前抑郁状况以及孕期社会支持情况。在分娩后记录分娩方式、孕周、出生体重和新生儿出生情况,新生儿生后2个月和4个月进行电话随访了解母乳喂养状况。对研究变量进行多因素Logistic回归分析,计算各变量的RR值。结果早产儿组生后2个月和4个月的母乳喂养终止率分别为24.8%和34.3%,明显高于足月儿的14.5%和23.0%。早产(RR=1.94,95%CI:1.20～3.14)、剖宫产(RR=1.95,95%CI:1.45～2.62)、自评家庭经济为上等(RR=1.65,95%CI:1.01～2.69)、社会支持得分≥44分(RR=2.71,95%CI:1.18～6.22)是生后2个月时母乳喂养终止的危险因素;生后4个月时,早产(RR=1.85,95%CI:1.21～2.83)和剖宫产(RR=1.58,95%CI:1.25～2.00)仍是母乳喂养终止的危险因素。居住在城镇是导致婴儿生后2～4个月母乳喂养行为改变的危险因素(RR=1.58,95%CI:1.03～2.43)。结论早产和剖宫产是导致婴儿生后早期母乳喂养终止的重要危险因素。与农村居民相比,城镇居民更易在2～4个月放弃母乳喂养。

Follow-up survey of risk factors for early cessation of breastfeeding in early infancy

Objective To study breastfeeding cessation rates in premature infants at 2 months and 4 months postpartum and identify the factors influencing the duration of breastfeeding.Methods This retrospective study is based on data from 1841 parturient women(105 cases was preterm infants and 1736 cases was term infants)giving birth in the Hospital.Demographic characteristics,history of neurological depression within 2 weeks and antepartum,social support during pregnancy and the delivery outcomes including gestational age at birth,birthweight,mode of delivery and the condition of babies were collected by interviewing or from medical charts.The breastfeeding status was followed up by phone at 2 and 4 months old.Multivariate logistic regression analyses were performed after controlling maternal age, registered permanent residency and educational level.Results Obviously higher than term infants,the breastfeeding cessation rate of preterm infants at 2 and 4 months was 24.8%and 34.3%,respectively. Breastfeeding cessation at 2 months was associated with premature delivery(RR=1.94,95%CI:1.20-3.14),the score of social support≥44(RR=2.71,95%CI:1.18-6.22),self-rating upper family income(RR=1.65,95%CI:1.01-2.69)and caesarean section(RR=1.58,95%CI:1.25-2.00). Premature delivery(RR=1.85,95%CI:1.21-2.83)and caesarean section(RR=1.58,95%CI:1.25 -2.00)were still the risk factors of breastfeeding cessation at 2-4 months.And living in town contributed to the change of breastfeeding behavior at 2-4 months(RR=1.58,95%CI:1.03-2.43). Conclusions Preterm infants were at greater risk of ceasing breastfeeding than term infants.Premature delivery and caesarean section are the most important risk factors of breastfeeding cessation both at 2 months and 4 months.Mothers living in town were more likely to discontinue breastfeeding than mothers in rural areas at 2-4 months.