孕前身体质量指数对母乳喂养持续时间影响的前瞻性队列研究

The effect of pre-pregnancy body mass index on duration of breastfeeding:a prospective cohort study

目的探讨孕前身体质量指数对母乳喂养持续时间的影响,筛选早期中断母乳喂养的高危人群和时间节点,为实施针对性母乳喂养指导提供依据。方法便利抽取370例孕妇为研究对象,入院待产时建立研究队列,电话随访2年内母乳喂养情况。结果研究对象总体母乳喂养持续时间为11.0(7.0,13.0)个月,12个月内母乳喂养中断速度较快;孕前消瘦组的母乳喂养持续时间较孕前体质量正常组短2.0个月;多因素Cox回归分析显示,调整混杂因素后,孕前消瘦会增加早期中断母乳喂养的风险[HR=1.429,95%CI(1.028,1.985),P<0.05];孕前超重对母乳喂养持续时间无显著影响[HR=1.105,95%CI(0.813,1.502),P>0.05]。结论孕前消瘦是早期中断母乳喂养的高危因素,12个月内是母乳喂养中断的时间节点。建议育龄期女性孕前将体质量控制在正常范围内,卫生保健人员进行母乳喂养指导时需考虑产妇的孕前营养状态,行个性化的母乳喂养指导,合理延长母乳喂持续时间。

Objective To explore the effect of pre-pregnancy body mass index(BMI)on the duration of breastfeeding,identify the high-risk population and time points of early breastfeeding cessation,and provide evidence for the implementation of targeted breastfeeding guidance.Methods A total of 370 pregnant women were selected as the research objects by convenience sampling.A research cohort was established when they were admitted to the hospital for delivery,and the breastfeeding duration within 2 years was followed up by telephone.Results The overall duration of breastfeeding was 11.0(7.0,13.0)months,and breastfeeding was interrupted rapidly within 12 months.The duration of breastfeeding in the underweight group was 2.0 months shorter than that in the normal pre-pregnancy weight group.Multivariate Cox regression analysis showed that pre-pregnancy emaciation would increase the risk of early breastfeeding interruption after adjusting for confounding factors[HR=1.429,95%CI(1.028,1.985),P<0.05].Pre-pregnancy overweight had no significant effect on the duration of breastfeeding[HR=1.105,95%CI(0.813,1.502),P>0.05].Conclusion Pre-pregnancy emaciation is a high-risk factor for early breastfeeding interruption,and the first 12 months are the time node for breastfeeding interruption.It is suggested that women of childbearing age should control their weight within the normal range before pregnancy.Health care personnel should consider the maternal pre-pregnancy nutritional status when providing breastfeeding guidance,offer personalized breastfeeding guidance,and reasonably extend the duration of breastfeeding.