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Predictors of Breastfeeding Among Women Admitted with Severe Preeclampsia Before 34 weeks.

Publication ,  Conference
Grundy, SJ; Santoli, CMA; Dillon, J; Darling, A; Zemtsov, GE; Cate, JJ; Wheeler, S; Dotters-Katz, S
Published in: Am J Perinatol
March 26, 2024

BACKGROUND: Patients with severe preeclampsia(sPREX) face barriers to successful breastfeeding(BF), including an increased risk of maternal and newborn complications, prematurity, and low birth weight. Patients with early-onset sPREX (before 34 weeks' gestation) may be at even greater risk, yet there is little data available on factors associated with BF challenges in this population. OBJECTIVE(S): We describe rates of BF initiation at hospital discharge and BF continuation at postpartum visit, and identify factors associated with BF non-initiation and BF cessation among patients admitted with early onset sPREX. STUDY DESIGN: Retrospective cohort study of women with sPREX admitted at less than 34 weeks' gestation to a single tertiary center(2013-2019). Demographic, antepartum, and delivery characteristics were evaluated. Factors associated with BF non-initiation at maternal discharge and with BF cessation at routine postpartum(PP) were assessed. Patients with intrauterine or neonatal demise and those missing BF data were excluded. Bivariate statistics were used to compare characteristics and Poisson regression was used to estimate relative risks(RR). RESULTS: Of 255 patients with early-onset sPREX, 228(89.4%) had BF initiation at maternal hospital discharge. Initiation of BF occurred less frequently among patients with tobacco use in pregnancy(7.5% vs 37.0%,Chi2 p<0.001,RR 0.69,[95%CI0.52-0.92]). At 6 weeks PP, 159 of 199(79.9%) patients had BF continuation. Maternal age under 20 years(1.9% vs 17.5%,Chi2 p=0.01,RR 0.36,[95%CI 0.14-0.91]) and experiencing maternal morbidity (25.2% vs 45.0%, Chi2 p=0.01,RR 0.80,[95%CI 0.66-0.96]) were associated with BF cessation at the PP visit. CONCLUSION: Among patients with early sPREX, tobacco use in pregnancy was associated with non-initiation of BF at discharge, while young maternal age and maternal morbidity were associated with cessation of BF by routine PP visit. Further research is needed on how to support BF in this population, especially among patients with these associated factors.

Duke Scholars

Published In

Am J Perinatol

DOI

EISSN

1098-8785

Publication Date

March 26, 2024

Location

United States

Related Subject Headings

  • Obstetrics & Reproductive Medicine
  • 4204 Midwifery
  • 3215 Reproductive medicine
  • 3213 Paediatrics
  • 1114 Paediatrics and Reproductive Medicine
  • 1103 Clinical Sciences
 

Citation

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Grundy, S. J., Santoli, C. M. A., Dillon, J., Darling, A., Zemtsov, G. E., Cate, J. J., … Dotters-Katz, S. (2024). Predictors of Breastfeeding Among Women Admitted with Severe Preeclampsia Before 34 weeks. In Am J Perinatol. United States. https://doi.org/10.1055/a-2295-3412
Grundy, Sara J., Carmen Maria Avram Santoli, Jacquelyn Dillon, Alice Darling, Gregory Ethan Zemtsov, Jennifer J. Cate, Sarahn Wheeler, and Sarah Dotters-Katz. “Predictors of Breastfeeding Among Women Admitted with Severe Preeclampsia Before 34 weeks.” In Am J Perinatol, 2024. https://doi.org/10.1055/a-2295-3412.
Grundy SJ, Santoli CMA, Dillon J, Darling A, Zemtsov GE, Cate JJ, et al. Predictors of Breastfeeding Among Women Admitted with Severe Preeclampsia Before 34 weeks. In: Am J Perinatol. 2024.
Grundy, Sara J., et al. “Predictors of Breastfeeding Among Women Admitted with Severe Preeclampsia Before 34 weeks.Am J Perinatol, 2024. Pubmed, doi:10.1055/a-2295-3412.
Grundy SJ, Santoli CMA, Dillon J, Darling A, Zemtsov GE, Cate JJ, Wheeler S, Dotters-Katz S. Predictors of Breastfeeding Among Women Admitted with Severe Preeclampsia Before 34 weeks. Am J Perinatol. 2024.
Journal cover image

Published In

Am J Perinatol

DOI

EISSN

1098-8785

Publication Date

March 26, 2024

Location

United States

Related Subject Headings

  • Obstetrics & Reproductive Medicine
  • 4204 Midwifery
  • 3215 Reproductive medicine
  • 3213 Paediatrics
  • 1114 Paediatrics and Reproductive Medicine
  • 1103 Clinical Sciences