Catherine O Buck1,2,3, Annie Gjelsvik2,3,4, Patrick M Vivier2,3,5, Karine Monteiro6, Siraj Amanullah2,3,5,7. 1. 1 Division of Neonatology, Women and Infants Hospital of Rhode Island , Providence, Rhode Island. 2. 2 Department of Pediatrics, Warren Alpert Medical School of Brown University , Providence, Rhode Island. 3. 3 Hassenfeld Child Health Innovation Institute , Providence, Rhode Island. 4. 4 Department of Epidemiology, School of Public Health, Brown University , Providence, Rhode Island. 5. 5 Department of Health Services Policy and Practice, School of Public Health, Brown University , Providence, Rhode Island. 6. 6 Rhode Island Department of Health, Center for Health Data and Analysis , Providence, Rhode Island. 7. 7 Department of Emergency Medicine, Warren Alpert Medical School of Brown University , Providence, Rhode Island.
Abstract
BACKGROUND: Of the various barriers to breastfeeding, limited information is available on the relationship between prenatal stress and breastfeeding. This study investigates the association between prenatal stressful life event (SLE) exposure and breastfeeding initiation postpartum. MATERIALS AND METHODS: Using Rhode Island Pregnancy Risk Assessment Monitoring System data from 2012 to 2014, SLE was defined as self-report of prenatal exposure to 14 predefined life events such as job loss or illness. Exposure to SLE was categorized by number and type of events. Multivariable logistic regression was performed to assess the relationship between SLE and breastfeeding initiation. Results accounted for complex survey design and were adjusted for maternal and infant characteristics (age, race, ethnicity, insurance, delivery type, parity, gestational age, birth weight for gestational age, and neonatal intensive care unit admission). RESULTS: Among 3,353 respondents, 86% reported breastfeeding initiation, 74% reported exposure to ≥1 SLE, and 17% reported exposure to ≥4 SLE. Decreased odds of breastfeeding initiation were associated with prenatal exposure to ≥4 SLE (adjusted odds ratio [aOR] 0.67; 95% confidence interval [CI]: 0.48-0.95), emotional stressors (aOR 0.77; 95% CI: 0.61-0.98), and traumatic stressors (aOR 0.68; 95% CI: 0.50-0.91). CONCLUSION: This study underscores the impact of exposure to prenatal SLE on breastfeeding initiation among postpartum women. Findings may assist providers in identifying at-risk women for anticipatory guidance to improve breastfeeding rates.
BACKGROUND: Of the various barriers to breastfeeding, limited information is available on the relationship between prenatal stress and breastfeeding. This study investigates the association between prenatal stressful life event (SLE) exposure and breastfeeding initiation postpartum. MATERIALS AND METHODS: Using Rhode Island Pregnancy Risk Assessment Monitoring System data from 2012 to 2014, SLE was defined as self-report of prenatal exposure to 14 predefined life events such as job loss or illness. Exposure to SLE was categorized by number and type of events. Multivariable logistic regression was performed to assess the relationship between SLE and breastfeeding initiation. Results accounted for complex survey design and were adjusted for maternal and infant characteristics (age, race, ethnicity, insurance, delivery type, parity, gestational age, birth weight for gestational age, and neonatal intensive care unit admission). RESULTS: Among 3,353 respondents, 86% reported breastfeeding initiation, 74% reported exposure to ≥1 SLE, and 17% reported exposure to ≥4 SLE. Decreased odds of breastfeeding initiation were associated with prenatal exposure to ≥4 SLE (adjusted odds ratio [aOR] 0.67; 95% confidence interval [CI]: 0.48-0.95), emotional stressors (aOR 0.77; 95% CI: 0.61-0.98), and traumatic stressors (aOR 0.68; 95% CI: 0.50-0.91). CONCLUSION: This study underscores the impact of exposure to prenatal SLE on breastfeeding initiation among postpartum women. Findings may assist providers in identifying at-risk women for anticipatory guidance to improve breastfeeding rates.
Authors: Suzanne Bennett Johnson; Kristian F Lynch; Roswith Roth; Markus Lundgren; Hemang M Parikh; Beena Akolkar; William Hagopian; Jeffrey Krischer; Marian Rewers; Jin-Xiong She; Jorma Toppari; Anette G Ziegler; Åke Lernmark Journal: Diabetologia Date: 2021-01-06 Impact factor: 10.460