The rates of any breastfeeding at the time of postpartum hospital discharge for early term (370-386 weeks) versus full term (390-416 weeks) infants

Abstract

Objectives To compare the rates of any breastfeeding at the time of postpartum hospital discharge between early term (370–386 weeks) and full term (390–416 weeks) infants. Methods A retrospective cohort study of women with live, singleton pregnancies who delivered in St. John's, NL between April 2001 and March 2018 was completed. The primary outcome was any breastfeeding at the time of postpartum hospital discharge. Secondary analyses included a comparison of breastfeeding by week of gestational age at term, and by maternal/neonatal demographics and outcomes of pregnancy. Univariate and multiple logistic regression (MLR) analyses were performed. Results A total of 34 511 women were included. Early term infants were less likely to be breastfed than full term infants (67.9 versus 70.4%) (aOR 0.91; 95% CI 0.86–0.97). MLR analysis also showed a significant effect of maternal age (aOR 1.07; 95% CI 1.05–1.09), partner status (aOR 1.56; 95% CI 1.20–2.03), smoking (aOR 0.32, 95% CI 0.26–0.41), prenatal education (aOR 2.43; 95% CI 1.99–2.97), pre-pregnancy BMI (kg/m2) (aOR 0.97; 95% CI 0.96–0.98), and cesarean section (aOR 0.72; 95% CI 0.60–0.88). When compared by week of gestational age at term, the likelihood of breastfeeding significantly increased with each successive week (aOR 1.08; 95% CI 1.007–1.16). Conclusions Early term delivery is an independent risk factor for not breastfeeding at the time of postpartum hospital discharge. It is important to target and support these women in order to increase breastfeeding rates. Additionally, these findings further validate recommendations to avoid non-medically indicated early term deliveries due to increased risks of adverse outcomes. To compare the rates of any breastfeeding at the time of postpartum hospital discharge between early term (370–386 weeks) and full term (390–416 weeks) infants. A retrospective cohort study of women with live, singleton pregnancies who delivered in St. John's, NL between April 2001 and March 2018 was completed. The primary outcome was any breastfeeding at the time of postpartum hospital discharge. Secondary analyses included a comparison of breastfeeding by week of gestational age at term, and by maternal/neonatal demographics and outcomes of pregnancy. Univariate and multiple logistic regression (MLR) analyses were performed. A total of 34 511 women were included. Early term infants were less likely to be breastfed than full term infants (67.9 versus 70.4%) (aOR 0.91; 95% CI 0.86–0.97). MLR analysis also showed a significant effect of maternal age (aOR 1.07; 95% CI 1.05–1.09), partner status (aOR 1.56; 95% CI 1.20–2.03), smoking (aOR 0.32, 95% CI 0.26–0.41), prenatal education (aOR 2.43; 95% CI 1.99–2.97), pre-pregnancy BMI (kg/m2) (aOR 0.97; 95% CI 0.96–0.98), and cesarean section (aOR 0.72; 95% CI 0.60–0.88). When compared by week of gestational age at term, the likelihood of breastfeeding significantly increased with each successive week (aOR 1.08; 95% CI 1.007–1.16). Early term delivery is an independent risk factor for not breastfeeding at the time of postpartum hospital discharge. It is important to target and support these women in order to increase breastfeeding rates. Additionally, these findings further validate recommendations to avoid non-medically indicated early term deliveries due to increased risks of adverse outcomes.