孕前体质量指数和孕期体质量增加对早期母乳喂养行为建立的影响

Influence of Pre-Pregnancy Body Mass Index and Gestational Weight Gain on the establishment of early breastfeeding behavior

目的 :探讨孕前体质量指数及孕期体质量增加对早期母乳喂养行为建立的影响,识别早期母乳喂养行为建立困难的高危人群。方法 :采用便利抽样法选取2020年3月—7月在南京市某妇幼保健院分娩的364对产妇和新生儿为研究对象,观察产后最初几天的母乳喂养过程,比较母乳喂养过程指标(含接吸吮情况、母乳喂养频次、母乳喂养准备时间、单次母乳喂养持续时间)和早期纯母乳喂养率。结果 :调整混杂因素,分别以孕前体质量正常和孕期增重适宜女性为参照,孕前消瘦增加了含接吸吮困难的风险(OR=2.025,P=0.044),孕前超重增加了低频喂养的风险(OR=2.057,P=0.021),孕前超重(OR=0.392,P=0.015)和孕期增重过多(OR=0.538,P=0.021)均降低了早期纯母乳喂养率。结论 :孕前消瘦或超重、孕期增重过多的女性均是早期母乳喂养行为建立困难的高危人群。应对高危人群提供针对性的母乳喂养支持,改善母乳喂养现况。

Objective: To investigate the influence of Pre-Pregnancy Body Mass Index(PPBMI) and Gestational Weight Gain(GWG) on the establishment of early breastfeeding behavior, and to identify high-risk groups with difficulty in establishing early breastfeeding behavior. Methods: A total of 364 women were selected in a Nanjing maternity and child health care hospital from March 2020 to July 2020 by convenience sampling. The breastfeeding process at the first postpartum few days was observed. The breastfeeding process indicators(including latching and sucking, breastfeeding frequency, breastfeeding preparation time, and single breastfeeding duration) and rate of early breastfeeding were compared.Results: After adjusting confounding factors, compared with women with normal-weight and adequate GWG, maternal underweight increased the risk of latch difficulty(OR=2.025, P=0.044), and low-frequency feeding(OR=2.057, P=0.021).Overweight(OR=0.392, P=0.015) and excessive GWG(OR=0.538, P=0.021) reduced the rate of early exclusive breastfeeding.Conclusion: Women who were underweight or overweight before pregnancy and excessive GWG were at high risk for establishing early breastfeeding behavior. Therefore, it is necessary to comprehensively implement weight management and pregnancy weight gain counseling in women of childbearing age. At the same time, health care professionals should provide targeted breastfeeding support to high-risk groups to improve breastfeeding status.