目的 本研究旨在调查武汉地区哺乳期妇女的液体摄入量，分析其与母乳喂养情况及母乳喂养持续时间的关联。方法 研究对象来自同济母婴健康队列(Tongji Maternal and Child Health Cohort, TMCHC)。通过电话访谈了解妇女产后3个月时牛奶、汤、米酒、水的摄入量以及产后3、6、12、24个月时母乳喂养情况和断奶（停止母乳喂养）的月龄。计算3月龄时总液体摄入量的四分位数分布，按3、6月龄的喂养方式分为全母乳喂养和非全母乳喂养，12月龄时分为有母乳喂养和非母乳喂养。采用Logistic模型分析总液体摄入量与母乳喂养方式关联，以最高四分位（Q4）组为参照，计算比值比（OR）及其置信区间95%CI。进一步在3月龄时采用全母乳喂养的母亲中，分析3月龄时总液体摄入量与6月和12月龄时母乳喂养情况的关联。使用生存曲线探究3月龄时母亲总液体摄入量与停止母乳喂养月龄的关联。结果 共2483对单胎母-婴纳入研究，3月和6月时分别有1350(54.4%)和966(38.9%)的婴儿接受全母乳喂养，12月时有646(36.8%)的婴儿有母乳喂养。产后3月时妇女总液体摄入量的中位数（四分位数间距）为1600 ml(1250～2000 ml)，2,352(94.7%)未达推荐值(2600 ml)。与总液体摄入量最高组（Q4）的母亲相比，最低组（Q1）的母亲产后3月时停止全母乳喂养的比OR (95%CI)为3.87(3.03, 4.96)，6月时停止全母乳喂养的OR(95%CI)为3.05(2.38, 3.92)，产后12个月内停止母乳喂养的OR(95%CI)为1.67(1.28, 2.17)。但在3月龄时采用全母乳喂养的母-婴中，3月龄时的液体摄入量与6、12月龄时母乳喂养情况无显著关联。生存曲线显示总液体摄入量较低的母亲12月内停止母乳喂养的时间早于总液体摄入量较大的母亲。结论 总液体摄入量不足可影响哺乳妇女坚持纯母乳喂养，并较早停止母乳喂养，应重视哺乳期妇女的液体摄入。
Abstract
Objective To investigate the potential association between maternal total fluid intake at 3 months of infant age and breastfeeding practices and duration. Methods The study was embedded in the Tongji Maternal and Child Health Cohort. Information on total fluid intake for postpartum women was collected via telephone interviews at 3 months of infant age. Total fluid intake was categorized by quartiles. Information on breastfeeding practices and duration was collected via telephone interviews at 3, 6, 12, and 24 months of infant age. Breastfeeding practice was divided into full breastfeeding (FBF) and any breastfeeding (ABF). Logistic and multivariable linear regression models were used to investigate the association of total fluid intake with breastfeeding practices and duration. Results Among 2483 postpartum women-infants, 1350 (54.4%) and 966 (38.9%) received FBF at 3 and 6 months of infant age, respectively, and 2056 (82.8%), 1774 (71.4%), and 646 (36.8%) received ABF at 3, 6, and 12 months of infant age, respectively. The medium (interquartile range) of total fluid intake was 1600 ml (1250-2000 ml). About 2352 (94.7%) did not meet the recommended intake (2600ml). Compared to the mothers with the highest quartile of total fluid intake, those with the lowest quartile of total fluid intake were more likely to cease FBF at 3 months (OR=3.87; 95% CI = 3.03–4.96) and at 6 months (OR=3.05; 95% CI=2.38–3.92) of infant age, and to cease ABF at 12 months of infant age (OR=1.67; 95% CI=1.28–2.17). However, among mother-infants who received FBF at 3 months of infant age, fluid intake at 3 months of infant age was not significantly associated with breastfeeding practices at 6 and 12 months of infant age. Additionally, compared to the mothers with the highest quartile of total fluid intake, those with the lowest quartile of total fluid intake were more likely to cease breastfeeding early (adjusted β=－1.22; 95% CI=－1.85–0.58). Conclusion The postpartum women with lower total fluid intake were more likely to cease breastfeeding. Short duration of breastfeeding was positively associated with limited total fluid intake in postpartum women.
关键词
母乳喂养 /
产后 /
全母乳喂养 /
营养 /
护理 /
液体摄入
Key words
postpartum /
full breastfeeding /
nutrients /
nursing /
fluid intake
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基金
科技基础资源调查专项（No.2019FY101003）
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