Yolanda Tinajero, Nisha I Parikh, Ian S Harris, Juan M Gonzalez, Anushree Agarwal, Nasim C Sobhani
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Logistic regression was used to obtain odds ratios (ORs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong> Among 211 gravidas with MCD, 12% were not breastfeeding at the time of postpartum hospital discharge. Compared with the BF group, the NBF group had a significantly higher proportion of women with cardiomyopathy (21% NBF vs. 7% BF, OR = 3.44, 95% CI: 1.12-10.71), with modified World Health Organization (WHO) classification ≥III (33 vs. 14%, OR = 3.16, 95% CI: 1.22-8.15), and with prepregnancy ejection fraction (EF) < 50% (55 vs. 14%, OR = 7.20, 95% CI: 1.92-27.06). There were otherwise no differences between the two groups with regards to other cardiac diagnoses or cardiac risk scores.</p><p><strong>Conclusion: </strong> In women with MCD, cardiomyopathy, modified WHO class ≥III, and a prepregnancy EF < 50% were associated with NBF in the immediate postpartum period. 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引用次数: 0
摘要
研究目的本研究旨在确定患有产妇心脏病(MCD)的产妇产后立即母乳喂养的预测因素:本研究纳入了 2012 年至 2018 年在一家医疗机构分娩的所有患有 MCD 的孕产妇。病历摘要包括产妇人口统计学、产科结果、心脏诊断、心脏风险分层评分和孕前超声心动图检查结果。Kruskal-Wallis 检验和费雪精确检验用于比较母乳喂养(BF)组与非母乳喂养(NBF)组。采用逻辑回归法得出几率比(ORs)及 95% 置信区间(CIs):结果:在211名患有MCD的孕产妇中,12%在产后出院时未进行母乳喂养。与BF组相比,NBF组患有心肌病(21% NBF vs. 7% BF,OR 3.44,95% CI 1.12-10.71)、世界卫生组织(WHO)分类≥III(33 vs. 14%,OR 3.16,95% CI 1.22-8.15)和孕前射血分数(EF)的妇女比例明显更高:在患有 MCD、心肌病、改良 WHO 分级≥III 且孕前射血分数为 EF 的女性中,关键点:- 82%的心脏病患者在产后出院时处于哺乳期。- 心肌病与产后出院时未进行母乳喂养的几率增加有关。- 不进行母乳喂养的理由很少记录在病历中。
Immediate Postpartum Breastfeeding following Pregnancy with Cardiac Disease.
Objective: This study aimed to identify predictors of immediate postpartum breastfeeding among women with maternal cardiac disease (MCD).
Study design: This study included all gravidas with MCD who delivered at a single institution from 2012 to 2018. Charts were abstracted for maternal demographics, obstetrical outcome, cardiac diagnoses, cardiac risk stratification scores, and prepregnancy echocardiogram findings. Kruskal-Wallis and Fisher's exact tests were used to compare the breastfeeding (BF) group versus the nonbreastfeeding (NBF) group. Logistic regression was used to obtain odds ratios (ORs) with 95% confidence intervals (CIs).
Results: Among 211 gravidas with MCD, 12% were not breastfeeding at the time of postpartum hospital discharge. Compared with the BF group, the NBF group had a significantly higher proportion of women with cardiomyopathy (21% NBF vs. 7% BF, OR = 3.44, 95% CI: 1.12-10.71), with modified World Health Organization (WHO) classification ≥III (33 vs. 14%, OR = 3.16, 95% CI: 1.22-8.15), and with prepregnancy ejection fraction (EF) < 50% (55 vs. 14%, OR = 7.20, 95% CI: 1.92-27.06). There were otherwise no differences between the two groups with regards to other cardiac diagnoses or cardiac risk scores.
Conclusion: In women with MCD, cardiomyopathy, modified WHO class ≥III, and a prepregnancy EF < 50% were associated with NBF in the immediate postpartum period. These findings may guide providers in identifying a subset of women with MCD who can benefit from increased breastfeeding counseling and support.
Key points: · Eighty-two percent of patients with cardiac disease are breastfeeding at the time of postpartum discharge.. · Cardiomyopathy is associated with an increased odds of not breastfeeding at postpartum discharge.. · Rationale for not breastfeeding is infrequently documented in the medical record..
期刊介绍:
The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields.
The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field.
All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication.
The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.