| Abstract |
Background: Human milk is the optimal form of nutrition for the infant, providing many health benefits for both mother and baby. The effects of gestational age at birth on initiation and duration of breastfeeding have been less studied than other determinants of breastfeeding. The number of studies available in the literature investigating breastfeeding practices in infants with different gestational age is limited and mostly focused on the differences between term and preterm infants. Preterm infants are metabolically and physiologically immature. As a consequence they are at a disadvantage in initiating and maintaining breastfeeding.
Objective: The objective of this study, was to evaluate the association between gestational age at birth (completed weeks) and breastfeeding practices (initiation and duration) in the population-based Mother-Child cohort in Crete (“Rhea” Study), in Crete and in particular in infants born over 34 completed weeks of gestation.
Methods: The present study was conducted within the prospective Mother-Child cohort in Crete. We evaluated 1226 mother-child pairs. Women included in the analysis had singleton pregnancies and provided complete data for birth outcomes as well as breastfeeding practices 6 to 9 months postpartum. As a prerequisite for inclusion in the study, infant’s gestational age had to be over 34 completed weeks. Gestational age was categorized into three different groups: a) infants born with gestational age between 340/7 and 366/7 weeks (late preterm) b) infants born with gestational age 370/7 and 386/7 weeks (early term) and c) infants born with gestational age 390/7 and 416/7 weeks (late term). Participants were asked to complete detailed questionnaires that covered socio-demographic and medical information and breastfeeding practices. Information on anthropometric measures at birth was
Δημόσια Υγεία & Διοίκηση Υπηρεσιών Υγείας
Τμήμα Ιατρικής – Πανεπιστήμιο Κρήτης
10
obtained from the hospital delivery logs and medical records. Multivariate logistic and linear regression models were used to estimate the association between gestational age at birth and breastfeeding practices, adjusting for potential confounders.
Results: For each week of increase in gestational age at birth, infants had 15% higher odds of having been breastfed (OR 1.15, 95% CI= 1.01,1.29), after adjustment for maternal age at birth, maternal education, parity, maternal smoking habits during pregnancy, maternal BMI pre pregnancy and type of delivery. In particular, compared with infants born 340/7 – 366/7 weeks of gestational age, term infants presented higher odds of breastfeeding initiation (OR of infants born at 370/7 – 386/7 weeks of gestation 1.79, 95% CI= 1.08,2.96; OR of infants born at 390/7 – 416/7 weeks of gestation 1.72, 95% CI= 1.02,2.90). As far as breastfeeding duration is concerned, for each week of increase in gestational age at birth, infants had longer duration of breastfeeding (β-coeff 0.21, 95% CI=0.046,0.383), after adjustment for maternal age at birth, maternal ethnicity, maternal education, maternal smoking habits during pregnancy, maternal BMI pre pregnancy and type of delivery . In spite of that, no statistically important differences in breastfeeding duration were found between the gestational age groups of term infants and late preterm newborns.
Conclusion: According to the findings, there is clear evidence to suggest that gestational age at birth is associated with both breastfeeding initiation and duration. Nevertheless, the existing knowledge is limited. Further investigation is needed in order to fully determine the mechanisms through which the gestational age affects breastfeeding practices.
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Ηλικία κύησης κατά τη γέννηση του νεογνού και πρακτικές θηλασμού στα πλαίσια της μελέτης Μητέρας-Παιδιού Κρήτης (Μελέτη Ρέα)
