产妇残疾与母乳喂养的开始和持续时间:加拿大横断面调查分析

IF 2.9 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Hilary K. Brown, Lesley Pablo, Natalie V. Scime, Amira M. Aker, Cindy-Lee Dennis
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引用次数: 0

摘要

世界卫生组织推荐母乳喂养是喂养婴儿的最佳方法。不开始母乳喂养和过早停止母乳喂养的已知风险因素多种多样,包括母乳喂养自我效能低、贫困、吸烟、肥胖和慢性疾病。虽然残疾妇女的这些风险因素发生率较高,但很少有研究对她们的母乳喂养结果进行调查。我们的目标是研究残疾妇女和非残疾妇女未开始母乳喂养和过早停止母乳喂养的情况。我们使用了 2017-2018 年加拿大社区健康调查的数据。纳入了 n = 4,817 名年龄在 15-55 岁之间、在过去五年中生育过的女性,其中 26.6% 的女性患有残疾,这些残疾是通过华盛顿功能简易组来确定的。我们计算了残疾妇女与非残疾妇女未开始母乳喂养以及在 6 个月前过早停止任何母乳喂养和纯母乳喂养的发生率(aPR)。我们还按照残疾严重程度(中度/重度和轻度,分别)和受影响的行动领域数量(≥ 2 和 1,分别)对残疾情况进行了研究。主要的多变量模型根据产妇年龄、婚姻状况、教育程度、家庭年收入水平和移民身份进行了调整。未开始母乳喂养的残疾妇女与非残疾妇女之间没有差异(9.6% 对 8.9%;aPR 0.88,95% CI 0.63,1.23)。残疾妇女更有可能过早停止任何母乳喂养(44.4% 对 35.7%),也更有可能在 6 个月前进行纯母乳喂养(66.9% 对 61.3%),在对社会人口因素进行调整后,风险有所降低(aRR 分别为 1.15,95% CI 0.99,1.33 和 aRR 1.07,95% 0.98,1.16)。中度/重度残疾妇女和残疾程度≥ 2 个领域的妇女的差异更大,社会人口因素调整后差异减小。残疾妇女,尤其是中度/重度残疾妇女和多重残疾妇女,可以从关注健康的社会决定因素、量身定制的无障碍母乳喂养支持中获益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Maternal disability and initiation and duration of breastfeeding: analysis of a Canadian cross-sectional survey
The World Health Organization recommends breastfeeding as the best method for infant feeding. Known risk factors for breastfeeding non-initiation and early cessation of breastfeeding are diverse and include low breastfeeding self-efficacy, poverty, smoking, obesity, and chronic illness. Although women with disabilities experience elevated rates of these risk factors, few studies have examined their breastfeeding outcomes. Our objective was to examine breastfeeding non-initiation and early cessation of breastfeeding in women with and without disabilities. We used data from the 2017–2018 Canadian Community Health Survey. Included were n = 4,817 women aged 15–55 years who had a birth in the last five years, of whom 26.6% had a disability, ascertained using the Washington Group Short Set on Functioning. Prevalence ratios (aPR) of breastfeeding non-initiation, and of early cessation of any and exclusive breastfeeding before 6 months, were calculated for women with versus without disabilities. We also examined disability by severity (moderate/severe and mild, separately) and number of action domains impacted (≥ 2 and 1, separately). The main multivariable models were adjusted for maternal age, marital status, level of education, annual household income level, and immigrant status. There were no differences between women with and without disabilities in breastfeeding non-initiation (9.6% vs. 8.9%; aPR 0.88, 95% CI 0.63, 1.23). Women with disabilities were more likely to have early cessation of any (44.4% vs. 35.7%) and exclusive breastfeeding before 6 months (66.9% vs. 61.3%), with some attenuation in risk after adjustment for sociodemographic factors (aRR 1.15, 95% CI 0.99, 1.33 and aRR 1.07, 95% 0.98, 1.16, respectively). Disparities were larger for women with moderate/severe disabilities and disabilities in ≥ 2 domains, with differences attenuated by adjustment for socio-demographics. Women with disabilities, and particularly those with moderate/severe and multiple disabilities, could benefit from tailored, accessible breastfeeding supports that attend to the social determinants of health.
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来源期刊
International Breastfeeding Journal
International Breastfeeding Journal Medicine-Obstetrics and Gynecology
CiteScore
6.30
自引率
11.40%
发文量
76
审稿时长
32 weeks
期刊介绍: Breastfeeding is recognized as an important public health issue with enormous social and economic implications. Infants who do not receive breast milk are likely to experience poorer health outcomes than breastfed infants; mothers who do not breastfeed increase their own health risks. Publications on the topic of breastfeeding are wide ranging. Articles about breastfeeding are currently published journals focused on nursing, midwifery, paediatric, obstetric, family medicine, public health, immunology, physiology, sociology and many other topics. In addition, electronic publishing allows fast publication time for authors and Open Access ensures the journal is easily accessible to readers.
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