费城Sidney Kimmel医学院Rachel Horowitz表示,这个结果强调了帮助妇女克服哺乳之实际阻碍的重要性;通常,哺乳的决定是根据妇女从事的工作类型。
  至少有一部份餵母乳的白人妇女比率高于黑人妇女(64% vs 53%;P< .05),不过,当研究者校正年龄、胎次、婚姻状况时,种族之间的差异就不再显著(胜算比[OR]0.91,95%信赖区间[CI]为0.52- 1.56)。
  Horowitz报告指出,唯一显著的因素是保险状态。有私人保险的白人妇女多于黑人妇女(60% vs 33%)。
  校正年龄、种族、胎次、教育、婚姻状态之后,如果妇女只有Medicaid而无商业保险,就比较不会至少还有一部份时间餵母乳(48% vs 69%;OR,0.53;95% CI,0.29- 0.77)。
  Albuquerque新墨西哥大学Sharon Phelan表示,这篇研究说明了为什么不能妄下结论与种族有关是很重要的。这个想法跳脱出既有的框架,可以说是对于谈论种族等其它因素时的挑战。
  Native link:Economics Behind Racial Differences in Breast-feeding Rates

Economics Behind Racial Differences in Breast-feeding Rates

By Laird Harrison
Medscape Medical News

SAN FRANCISCO — Economic factors, not culture, might explain racial differences in breast-feeding rates, according to the results of a new study.

This highlights the importance of helping women overcome practical obstacles to breast-feeding, said Rachel Horowitz, BS, from the Sidney Kimmel Medical College in Philadelphia.

Often, the decision to breast-feed depends on the type of work women do, she told Medscape Medical News.

Horowitz presented the study findings here at the American Congress of Obstetricians and Gynecologists Annual Clinical Meeting 2015.

In the United States, breast-feeding rates have long been lower in black women than in white women. A lack of role models and family support have been proposed as explanations for this disparity by some researchers.

To see what other factors might be contributing to the difference, Horowitz and her colleagues analyzed the medical records of 523 women (342 black, 181 white) who delivered singleton term infants from July to December 2013 in their institution.

Of these, they identified 337 women (white and black) for whom method of feeding was documented during a postpartum visit.

More white women than black women fed their babies at least partly with breast milk (64% vs 53%; P < .05). However, when the researchers adjusted for age, parity, and marital status, the difference between races was no longer significant (odds ratio [OR], 0.91, 95% confidence interval [CI], 0.52 - 1.56).

"The only factor that was significant was insurance status," Horowitz reported. More white women than black women had private insurance (60% vs 33%).

Insurance Status and Breast-feeding

In a separate analysis, the research team looked at the association between insurance status and breast-feeding in a mixed-race cohort (including Asian and Hispanic women) of 405 women who delivered singleton term infants from July to December 2013 in their institution.

The women all completed postpartum follow-up within 8 weeks and had feeding methods recorded.

Women were less likely to breast-feed at least part of the time if they were covered by Medicaid than by commercial insurance (48% vs 69%; OR, 0.53; 95% CI, 0.29- 0.77), even after adjustment for age, race, parity, education, and marital status.

The effect of insurance status was much stronger on white women than on black, Hispanic, and Asian women. In fact, in women covered by Medicaid, the rate of breast-feeding was lowest in white women, followed by black women, then Hispanic women and Asian women.

This was thinking outside of the box, and could serve as a challenge to some of the other things we say about ethnicity and race.

The analysis did not pinpoint how insurance status affects breast-feeding, but Horowitz said she believes it is a proxy for other aspects of poverty.

Women in low-paying jobs might not get breaks from work to pump milk and might not have access to refrigerators to store breast milk, she explained.

Previous research has shown that intention is a more important factor in breast-feeding than demographic characteristics, which means clinicians could use prenatal discussions with mothers to encourage breast-feeding, she added.

"If you can plan in advance, hopefully that will increase breast-feeding rates," said Horowitz.

She said she and her colleagues are planning to conduct a clinical trial of this approach.

This study illustrates why it is important not to jump to conclusions about race, said Sharon Phelan, MD, from the University of New Mexico in Albuquerque.

"This was thinking outside of the box, and could serve as a challenge to some of the other things we say about ethnicity and race," she told Medscape Medical News.

Dr Phelan said she agrees that working conditions could be the driving factor behind the racial differences. In fact, many of her patients have told her, "I work in fast food; I can't take off time to breast-feed."

Ms Horowitz and Dr Phelan have disclosed no relevant financial relationships.

American Congress of Obstetricians and Gynecologists (ACOG) Annual Clinical Meeting 2015: Abstracts73 and 78. Presented May3, 2015.

患有妊娠糖尿病的孕妇 宝宝2个月时比较胖
2016/5/27 上午 11:25:54
2015/10/12 上午 11:02:07
2013/11/20 上午 10:53:42

   1   2   3   4   5   6