The health benefits of breastfeeding for both infants and mothers are well-documented. The aim of this study was to clarify factors associated with successful breastfeeding. We performed a prospective, multi-centre cohort study of 443 mothers in person using a standardised questionnaire on postpartum day 1. Women who had started to breast-feed were interviewed by telephone after 3, 6 and 12 months. A statistical analysis was performed using the SAS system. 92 % of women (409/443) were initially breastfeeding. After three months the rate decreased to 74 %, after six months to 61 % and after 12 months to 28 %, respectively. Bivariate analysis revealed a significant positive association with the following factors: maternal age > 35 years, higher educational level, intention to breastfeed on postpartum day one, high motivation after three months, partner's support of the decision to breastfeed, satisfaction with the care provided in the maternity clinic, a positive breastfeeding experience and follow-up care by a midwife. Elective caesarean delivery, the use of breastfeeding aids, formula supplementation early on and the mother's concern about the amount of milk correlated negatively. Following a multivariate logistic regression analysis, four factors were correlated with having a positive influence on duration of breastfeeding: higher educational level, satisfaction with the care provided within the maternity clinic, follow-up care by a midwife, and a positive current experience of breastfeeding. Our data demonstrate certain factors successfully influence breastfeeding. Competent care in the maternity clinic, postpartum care by a midwife and a positive experience with breastfeeding increase the rate of breastfeeding and thus have a positive impact on the health of mother and newborn.
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http://dx.doi.org/10.1055/s-0031-1280470 | DOI Listing |
Obstet Gynecol
January 2025
Medical Practice Evaluation Center, the Division of Infectious Disease, and the Division of Maternal Fetal Medicine, Massachusetts General Hospital, Boston, Massachusetts; the Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada; and the Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, New York.
The purpose of this review is to serve as an update on congenital cytomegalovirus (CMV) evaluation and management for obstetrician-gynecologists and to provide a framework for counseling birthing people at risk for or diagnosed with a primary CMV infection or reactivation or reinfection during pregnancy. A DNA virus, CMV is the most common congenital viral infection and the most common cause of nongenetic childhood hearing loss in the United States. The risk of congenital CMV infection from transplacental viral transfer depends on the gestational age at the time of maternal infection and whether the infection is primary or nonprimary.
View Article and Find Full Text PDFAm J Public Health
January 2025
Stacey L. Rowe is with the School of Nursing and Health Professions, University of San Francisco, San Francisco, CA. Sheena G. Sullivan is with the School of Clinical Sciences, Monash University, Melbourne, Australia. Flor M. Munoz is with the Department of Pediatrics, Baylor College of Medicine, Houston, TX. Matthew M. Coates and Onyebuchi A. Arah are with the Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles. Annette K. Regan is with the Department of Research and Evaluation, Kaiser Permanente Research, Pasadena, CA.
To estimate maternal COVID-19, influenza, and pertussis vaccine uptake during pregnancy by insurance type and identify factors characterizing those vaccinated and unvaccinated. We conducted a US cohort study of pregnant individuals (for pregnancies ending December 11, 2020-September 30, 2022) using insurance claims data. We calculated vaccination probability using Kaplan-Meier methods and identified factors associated with vaccination through binomial regression with inverse probability weights.
View Article and Find Full Text PDFDiarrhea is a global public health problem that is the third leading cause of death in under five years, with an estimated 1.7 billion cases in 2023 and 1.8 million deaths from diarrhea diseases every year.
View Article and Find Full Text PDFNEJM Evid
January 2025
Gynuity Health Projects, New York.
Background: The current regimen for early medication abortion in many countries is mifepristone and misoprostol, but mifepristone is relatively expensive and limited in many regions. Ulipristal acetate, with a similar chemical profile, might be an alternative. This proof-of-concept study evaluated ulipristal acetate and misoprostol for medication abortion through 63 days of gestation.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Division of Research, Kaiser Permanente Northern California, Pleasanton.
Importance: Food insecurity is a growing public health concern, but its association with perinatal complications remains unclear.
Objective: To examine whether food insecurity in pregnancy was associated with the risk of perinatal complications and determine whether these potential associations differed by receipt of food assistance.
Design, Setting, And Participants: This cohort study used data from a pregnancy survey conducted between June 22, 2020, and September 9, 2022, at Kaiser Permanente Northern California, an integrated health care system serving a diverse population of 4.
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