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目的了解婴儿生后2个月和4个月时的母乳喂养终止率,探讨生后4个月内母乳喂养终止及喂养行为改变的影响因素。方法对1841名待产初产妇在分娩前进行问卷调查,了解孕妇的一般人口统计学信息、分娩前抑郁状况以及孕期社会支持情况。在分娩后记录分娩方式、孕周、出生体重和新生儿出生情况,新生儿生后2个月和4个月进行电话随访了解母乳喂养状况。对研究变量进行多因素Logistic回归分析,计算各变量的RR值。结果早产儿组生后2个月和4个月的母乳喂养终止率分别为24.8%和34.3%,明显高于足月儿的14.5%和23.0%。早产(RR=1.94,95%CI:1.20～3.14)、剖宫产(RR=1.95,95%CI:1.45～2.62)、自评家庭经济为上等(RR=1.65,95%CI:1.01～2.69)、社会支持得分≥44分(RR=2.71,95%CI:1.18～6.22)是生后2个月时母乳喂养终止的危险因素;生后4个月时,早产(RR=1.85,95%CI:1.21～2.83)和剖宫产(RR=1.58,95%CI:1.25～2.00)仍是母乳喂养终止的危险因素。居住在城镇是导致婴儿生后2～4个月母乳喂养行为改变的危险因素(RR=1.58,95%CI:1.03～2.43)。结论早产和剖宫产是导致婴儿生后早期母乳喂养终止的重要危险因素。与农村居民相比,城镇居民更易在2～4个月放弃母乳喂养。
Objective To understand the termination rate of breastfeeding at 2 months and 4 months after birth and to explore the factors influencing the termination of breastfeeding and changes in feeding behavior within 4 months after birth. Methods 1841 primiparous women were surveyed before delivery to find out the general demographic information of pregnant women, the state of depression before delivery and the social support during pregnancy. The mode of delivery, gestational age, birth weight and newborns’ birth were recorded after childbirth. The newborns were followed up by telephone for two months and four months after birth to find out the status of breastfeeding. Multivariate logistic regression analysis of the study variables, calculate the RR value of each variable. Results The rates of termination of breastfeeding in preterm infants at 2 and 4 months after birth were 24.8% and 34.3% respectively, significantly higher than those of term infants (14.5% and 23.0%). (RR = 1.95, 95% CI: 1.20-3.14), cesarean section (RR = 1.95, 95% CI: 1.45-2.62) 2.69). Social support score ≥44 (RR = 2.71, 95% CI: 1.18-6.22) were the risk factors for termination of breastfeeding at 2 months after birth. Premature birth was found at 4 months after birth (RR = 1.85,95 % CI: 1.21-2.83) and cesarean section (RR = 1.58, 95% CI: 1.25-2.00) were still risk factors for the termination of breastfeeding. Living in urban areas was a risk factor for changes in breastfeeding behavior 2 to 4 months after birth (RR = 1.58, 95% CI: 1.03 to 2.43). Conclusions Premature delivery and cesarean section are important risk factors for termination of early infant breastfeeding. Compared with rural residents, urban residents are more likely to give up breastfeeding in 2 to 4 months.