决策树与logistic回归模型用于开奶时间延迟影响因素分析

Risk factors for delayed breastfeeding initiation based on decision tree model and logistic regression model

目的:研究开奶时间延迟的相关影响因素。方法:采用调查问卷方式,收集湖南省长沙市某区950例产妇的孕产期资料和新生儿喂养资料,采用logistic回归和决策树模型分析开奶时间延迟的相关影响因素。结果:产后1 h内开始喂奶的有594人(62.5%),超过1 h开始喂奶的有356人(37.5%)。开奶及时组的纯母乳喂养率高于开奶延迟组(P<0.05)。Logistic回归模型和决策树模型均筛选出4个危险因素,即剖宫产、开奶前使用奶瓶、孕期因病就医及孕期呕吐。两个模型的受试者工作特征曲线下面积的差异无统计学意义(Z=0.142,P=0.889)。结论:剖宫产、开奶前使用奶瓶、孕期身体状况都是导致开奶时间延迟的重要因素。医务工作者应帮助产妇及时开始喂奶并树立纯母乳喂养信心。

Objective： To determine influential factors for delayed breastfeeding initiation. Methods： Using questionnaires to collect the data of 950 pregnant women and infants＇ feeding practices in Changsha, Hunan, logistic regression and decision tree model were used to determine influential factors for delayed breastfeeding initiation. Results： Mothers with timely breastfeeding initiation were 594 （62.5%）, and those with delayed breastfeeding initiation accounted for 356 （37.5%）. Mothers with timely breastfeeding initiation were more likely to use exclusive breastfeeding than those with delayed breastfeeding initiation （P〈0.05）. Four risk factors were found by logistic regression model and decision tree model, including cesarean delivery, using feeding-bottle before breastfeeding initiation, falling ill, and vomiting during pregnancy. Receiver operating characteristic curve showed no significant difference in the predictive effect of the 2 models （Z=0.142, P=0.889）.Conclusion： Cesarean delivery） using feeding-bottle before initiation of breastfeeding, and poor physical condition during pregnancy exert negatively effects on breastfeeding initiation. Health workers should help mother to timely initiate breastfeeding and enhance their confidence in exclusive breastfeeding.