"Timing of Breastfeeding Initiation Mediates the Association between Delivery Mode, Source of Breastfeeding Education, and Postpartum Depression Symptoms"

作者全名："Shen, Xinran; Lin, Shunna; Li, Hui; Amaerjiang, Nubiya; Shu, Wen; Li, Menglong; Xiao, Huidi; Segura-Perez, Sofia; Perez-Escamilla, Rafael; Fan, Xin; Hu, Yifei"

作者地址："[Shen, Xinran; Li, Hui; Amaerjiang, Nubiya; Shu, Wen; Li, Menglong; Xiao, Huidi; Hu, Yifei] Capital Med Univ, Sch Publ Hlth, Dept Child & Adolescent Hlth & Maternal Care, 10 Youanmenwai Xitoutiao, Beijing 100069, Peoples R China; [Lin, Shunna] Tianhe Dist Maternal & Child Hosp Guangzhou, Dept Pediat, Guangzhou 510620, Peoples R China; [Segura-Perez, Sofia] Hispan Hlth Council, 175 Main St, Hartford, CT 06106 USA; [Perez-Escamilla, Rafael] Yale Univ, Yale Sch Publ Hlth, New Haven, CT 06510 USA; [Fan, Xin] Chongqing Med Univ, Women & Childrens Hosp, Dept Pediat, 120 Longshan Rd, Chongqing 400042, Peoples R China"

通信作者："Hu, YF (通讯作者)，Capital Med Univ, Sch Publ Hlth, Dept Child & Adolescent Hlth & Maternal Care, 10 Youanmenwai Xitoutiao, Beijing 100069, Peoples R China.; Fan, X (通讯作者)，Chongqing Med Univ, Women & Childrens Hosp, Dept Pediat, 120 Longshan Rd, Chongqing 400042, Peoples R China."

来源：NUTRIENTS

ESI学科分类：AGRICULTURAL SCIENCES

WOS号：WOS:000831515700001

JCR分区：Q1

影响因子：5.9

年份：2022

卷号：14

期号：14

开始页：　

结束页：　

文献类型：Article

关键词：postpartum depression; early initiation of breastfeeding; caesarean section; breastfeeding; maternity services; health care system; China

摘要："Background: Emergency cesarean section (EMCS) and breastfeeding difficulties increase the risk of postpartum depressive (PPD) symptoms. Early initiation of breastfeeding (EIBF) may not only alleviate PPD symptoms but also facilitate subsequent breastfeeding success. EMCS is a risk factor for not practicing EIBF. Therefore, it is important to understand the relationship between EMCS, EIBF, and PPD symptoms. Methods: We conducted a prospective cohort study in three areas of China. At baseline, a total of 965 mothers completed electronic questionnaires within 72 h postpartum. Women were screened for PPD symptoms using the Edinburgh Postpartum Depression Scale (EPDS). Multivariate logistic regression was used to identify the determinants of PPD symptoms. Mediation analysis was used to determine if EIBF mediated the relationship between delivery mode or breastfeeding education source and PPD symptoms. Results: The prevalence of EIBF was 40.6%; 14% of 965 mothers experienced EMCS, and 20.4% had PPD symptoms. The risk factors for developing PPD symptoms were excessive gestational weight gain (adjusted odds ratio [aOR] = 1.55, confidence interval [95% CI]: 1.03-2.33, p = 0.037) and EMCS (aOR = 2.05, 95% CI: 1.30-3.25, p = 0.002). The protective factors for developing PPD symptoms were monthly household income over CNY 10000 (aOR = 0.68, 95% CI: 0.47-0.97, p = 0.034), EIBF (aOR = 0.49, 95% CI: 0.34-0.72, p < 0.001), and prenatal breastfeeding education from nurses (aOR = 0.46, 95% CI: 0.29-0.73, p = 0.001). EIBF indirectly affected PPD symptoms in patients who had undergone EMCS (percentage mediated [PM] = 16.69, 95% CI: 7.85-25.25, p < 0.001). The source of breastfeeding education through EIBF also affected PPD symptoms (PM = 17.29, 95% CI: 3.80-30.78, p = 0.012). Conclusion: The association between EMCS on PPD symptoms was mediated by EIBF. By providing breastfeeding education, nurses could also help alleviate PPD symptoms."

基金机构：Beijing Municipal Natural Science Foundation [7202009]; National Natural Science Foundation of China [82073574]

基金资助正文："This work was supported in part by the Beijing Municipal Natural Science Foundation (grant No. 7202009 to Y.H.), and the National Natural Science Foundation of China (grant No. 82073574 to Y.H.). Funders had no role in the design and implementation of the study, analysis, and interpretation of data, or writing of this study."