Association Between Gestational Weight Gain and Delayed Onset of Lactogenesis II: a Systematic Review and Meta-Analysis.

IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Breastfeeding Medicine Pub Date : 2024-08-01 Epub Date: 2024-07-04 DOI:10.1089/bfm.2024.0032
Zhongyan Cao, Meiling Huang, Yun Chen, JinZhu Yin, Yao Li, Bing Liu, JiaYi Peng, Chun Ling Liu
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Abstract

Background: Gestational weight gain (GWG) may be associated with delayed onset of lactogenesis II (DOL II), but it is still unclear and controversial. Object: The study aims to evaluate the relationship between GWG and DOL II. Methods: A comprehensive search was performed in 10 electronic databases from inception to May 21, 2023, for studies that reported outcomes in breastfeeding. Data were extracted by two independent reviewers. A meta-analysis was conducted to calculate the pooled estimates of association using random-effect models with Review Manager (RevMan) software version 5.4. The primary outcome was the rate of DOL II. Results: In this study, 248,515 women were included in 16 eligible articles. Women with excessive GWG have a higher risk of DOL II (odds ratio [OR] = 1.28; 95% confidence interval [CI]: 1.15-1.43). Specifically, prepregnancy overweight and obese women with GWG above recommendations (OR = 3.01, 95% CI: 1.38-6.57) and underweight women with excessive GWG before pregnancy have a higher risk of DOL II (OR = 3.32, 95% CI: 1.69-6.53). Nonetheless, there is no distinction between women with inadequate GWG and those with adequate GWG in DOL II(OR = 1.08, 95% CI: 0.88-1.33). In addition, the women whose GWG is above the recommendations also tend to stop exclusive breastfeeding 1 month postpartum (OR = 0.82, 95% CI: 0.80-0.85). Conclusion: Excessive GWG has a negative influence on the timing of the onset of lactogenesis and exclusive breastfeeding within 1 month postpartum.

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妊娠体重增加与乳汁生成延迟II之间的关系:系统综述与元分析。
背景:妊娠体重增加(GWG)可能与泌乳发生延迟II(DOL II)有关,但目前仍不清楚,也存在争议。研究目的本研究旨在评估 GWG 与 DOL II 之间的关系。研究方法从开始到 2023 年 5 月 21 日,在 10 个电子数据库中对报告母乳喂养结果的研究进行了全面检索。数据由两名独立审稿人提取。采用随机效应模型,使用 5.4 版评论管理器 (RevMan) 软件进行荟萃分析,计算相关性的汇总估计值。主要结果是 DOL II 的比率。结果在这项研究中,16 篇符合条件的文章共纳入了 248,515 名女性。GWG 过高的女性罹患 DOL II 的风险更高(几率比 [OR] = 1.28;95% 置信区间 [CI]:1.15-1.43)。具体而言,孕前 GWG 超过建议值的超重和肥胖女性(OR = 3.01,95% 置信区间 [CI]:1.38-6.57)和孕前 GWG 过高的体重不足女性罹患 DOL II 的风险更高(OR = 3.32,95% 置信区间 [CI]:1.69-6.53)。然而,在 DOL II 中,GWG 不足的妇女与 GWG 充足的妇女没有区别(OR = 1.08,95% CI:0.88-1.33)。此外,GWG 高于建议值的妇女也倾向于在产后 1 个月停止纯母乳喂养(OR = 0.82,95% CI:0.80-0.85)。结论过高的 GWG 会对产后 1 个月内开始泌乳和纯母乳喂养的时间产生负面影响。
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来源期刊
Breastfeeding Medicine
Breastfeeding Medicine OBSTETRICS & GYNECOLOGY-PEDIATRICS
CiteScore
4.20
自引率
11.10%
发文量
130
审稿时长
6-12 weeks
期刊介绍: Breastfeeding Medicine provides unparalleled peer-reviewed research, protocols, and clinical applications to ensure optimal care for mother and infant. The Journal answers the growing demand for evidence-based research and explores the immediate and long-term outcomes of breastfeeding, including its epidemiologic, physiologic, and psychological benefits. It is the exclusive source of the Academy of Breastfeeding Medicine protocols. Breastfeeding Medicine coverage includes: Breastfeeding recommendations and protocols Health consequences of artificial feeding Physiology of lactation and biochemistry of breast milk Optimal nutrition for the breastfeeding mother Breastfeeding indications and contraindications Managing breastfeeding discomfort, pain, and other complications Breastfeeding the premature or sick infant Breastfeeding in the chronically ill mother Management of the breastfeeding mother on medication Infectious disease transmission through breast milk and breastfeeding The collection and storage of human milk and human milk banking Measuring the impact of being a “baby-friendly” hospital Cultural competence and cultural sensitivity International public health issues including social and economic issues.
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