Breastfeeding Disparities between Multiples and Singletons by NICU Discharge
Por:
Porta, R, Capdevila, E, Botet, F, Ginovart, G, Moliner, E, Nicolas, M, Gutierrez, A, Ponce-Taylor, J, Verd, S
Publicada:
1 sep 2019
Resumen:
Multiple pregnancy increases the risk of a range of adverse perinatal outcomes, including breastfeeding failure. However, studies on predictive factors of breastfeeding duration in preterm twin infants have a conflicting result. The purpose of this observational study was to compare feeding practices, at hospital discharge, of twin and singleton very low birth weight infants. The study is part of a prospective survey of a national Spanish cohort of very low birth weight infants (SEN1500) that includes 62 neonatal units. The study population comprised all infants registered in the network from 2002 to 2013. They were grouped into singletons and multiples. The explanatory variables were first analyzed using univariate models; subsequently, significant variables were analyzed simultaneously in a multiple stepwise backward model. During the twelve-year period, 32,770 very low birth weight infants were included in the database, of which 26.957 were discharged alive and included in this analysis. Nine thousand seven hundred and fifty-eight neonates were multiples, and 17,199 were singletons. At discharge, 31% of singleton infants were being exclusively breastfed, 43% were bottle-fed, and 26% were fed a combination of both. In comparison, at discharge, only 24% of multiple infants were exclusively breastfed, 43% were bottle-fed, and 33% were fed a combination of both (p < 0.001). On multivariable analysis, twin pregnancy had a statistically significant, but small effect, on cessation of breastfeeding before discharge (OR 1.10; 95% CI: 1.02, 1.19). Risks of early in-hospital breastfeeding cessation were also independently associated with multiple mother-infant stress factors, such as sepsis, intraventricular hemorrhage, retinopathy, necrotizing enterocolitis, intubation, and use of inotropes. Instead, antibiotic treatment at delivery, In vitro fertilization and prenatal steroids were associated with a decreased risk for shorter in-hospital breastfeeding duration. Multiple pregnancy, even in the absence of pathological conditions associated to very low birth weight twin infants, may be an impeding factor for in-hospital breastfeeding.
Filiaciones:
Porta, R:
Dexeus Univ Hosp, Neonatal Unit, 5 Sabino Arana St, Barcelona 08028, Spain
Capdevila, E:
Catalonia Hlth Author, Dept Primary Care, Pediat Unit, Balmes St, Barcelona 08007, Spain
Botet, F:
Univ Matern Hosp, Neonatal Unit, 5 Sabino Arana St, Barcelona 08028, Spain
Ginovart, G:
Santa Creu & St Pau Univ Hosp, Neonatal Unit, 87 mSant Quinti St, Barcelona 08041, Spain
Moliner, E:
Santa Creu & St Pau Univ Hosp, Neonatal Unit, 87 mSant Quinti St, Barcelona 08041, Spain
Nicolas, M:
Germans Trias & Pujol Univ Hosp, Neonatal Unit, Canyet Rd, Badalona 08916, Spain
Gutierrez, A:
Son Espases Univ Hosp, IdISBa Balearic Med Res Council, Dept Hematol, Valldemossa Rd 79, Palma de Mallorca 07010, Spain
COMIB Advisory, Passeig Mallorca 42, Palma de Mallorca 07012, Spain
Ponce-Taylor, J:
Balearic Hlth Author, Dept Primary Care, Urgent Care Ctr, 1 Illes Balears St, Palma de Mallorca 07014, Spain
Verd, S:
Balearic Hlth Author, Dept Primary Care, Pediat Unit, Matamusinos St, Palma de Mallorca 07013, Spain
Gold, Green Published
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