A cohort study of exclusive breastfeeding from birth to hospital discharge and associated risk factors among infants born in hospital in three communities in Newfoundland and Labrador
Notice bibliographique
Résumé
Objective: To identify maternal (e.g. age, education level, partnership status), infant (e.g. gestational age, Apgar scores, ventilation), and hospital-level characteristics (e.g. type of delivery, facility, pain management) associated with exclusive breastfeeding in hospital in three communities in Newfoundland and Labrador. Methods: A retrospective cohort study of 1,556 infants born in Clarenville, Corner Brook, and Gander from 2015 to 2016. The primary outcome variable was exclusive breastfeeding from birth to hospital discharge, defined as the infant ingesting only mother’s own milk during hospital stay. For descriptive statistics, mean/standard deviation and frequency/proportion were provided for continuous and categorical variables, respectively. Logistic regression was used to identify significant risk factors associated with exclusive breastfeeding in hospital in the univariate and multivariate analysis. Results: 50.3% of the study population exclusively breastfed from birth to hospital discharge. There were significant differences (p < 0.05) in exclusive breastfeeding between hospital sites, with Gander having the highest rate at 59.5%, followed by Clarenville (49.7%), and Corner Brook (48.0%). There were differences across hospital sites in maternal education levels, gestational age, cesarian section rates, epidural use, episiotomies, induction rates, length of stay, forceps, and vacuum use (p < 0.05). Intervention rates were greatest in Clarenville, with a higher proportion of individuals undergoing induction, epidural, cesarian section, and operative vaginal delivery (p < 0.05). In the multivariate model, compared to Gander, infants from Clarenville (OR = 0.61, 95% CI: 0.41 – 0.92) and Corner Brook (OR = 0.55, 95% CI: 0.39 – 0.78) had significantly lower exclusive breastfeeding rates in hospital. Other significant factors associated with increased likelihood of exclusive breastfeeding from birth to discharge from hospital included no pre-existing diabetes (OR = 4.262, 95% CI: 1.201 – 15.118), not smoking (OR = 2.473, 95% CI: 1.814 – 3.371), post-secondary education (OR = 2.178, 95% CI: 1.624 – 2.922), infants not requiring bag-mask ventilation (OR = 1.928, 95% CI: 1.163 – 3.194), non-cesarian delivery (OR = 1.660, 95% CI: 1.297 – 2.126), and no narcotics and epidural during labour (OR = 1.475, 95% CI: 1.022 – 2.129). Vacuum use during delivery was associated with decreased likelihood of exclusive breastfeeding in hospital (OR = 0.472, 95% CI: 0.318 – 0.701). Conclusions: Hospital site of birth is significantly associated with exclusive breastfeeding from birth to discharge in Newfoundland and Labrador, adding to the literature that maternity practices and health policies contribute to infant feeding in hospital. Several other maternal and infant characteristics and interventions also contribute to exclusive breastfeeding from birth to discharge.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».