Maternal stress perception in the first or second trimester affects breastfeeding behavior: a prospective cohort study
10.3760/cma.j.cn113903-20220402-00324
- VernacularTitle:孕早中期压力感知状况对产后母乳喂养的影响：前瞻性队列研究
- Author:
Xu ZHOU
1
;
Xiang HONG
;
Yan HU
;
Xiaoling DING
;
Jun ZHAO
;
Bei WANG
;
Hong YU
Author Information
1. 东南大学公共卫生学院流行病与卫生统计学系，南京 210009
- Keywords:
Stress, psychological;
Serotonin;
Breast feeding;
Pregnancy trimester,first;
Pregnancy trimester, second
- From:
Chinese Journal of Perinatal Medicine
2022;25(7):513-518
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of maternal stress perception and plasma serotonin level in the first or second trimester on breastfeeding behavior, and to provide evidence for promoting exclusive breastfeeding.Methods:This prospective cohort study recruited pregnant women (≤20 gestational weeks) from Maternal and Child Health Center of Gulou District from April 2019 to March 2020. Stress perception at study enrollment was evaluated using Perceived Stress Scale (PSS) and the maternal plasma serotonin level was detected. Telephone interviews were conducted 42 d after delivery to collect information on childbirth and breastfeeding. Chi-square test, two independent samples t-test, and logistic regression model were used to analyze the risk factors of non-exclusive breastfeeding. Results:A total of 366 pregnant women were enrolled and 353 (96.4%) of them completed telephone interviews, who were divided into the exclusive ( n=194) and non-exclusive breastfeeding group ( n=159). Univariate analysis showed that the PSS scores [(19.4±6.9) vs (21.1±6.9) scores, t=－2.25, P=0.026] and the proportion of high-stress perception [23.7% (46/194) vs 34.0% (54/159), χ 2=4.03, P=0.045] in the exclusive group were all significantly lower than those in non-exclusive group. In the logistic regression analysis, exclusive breastfeeding was set as the dependent variable and the independent variables included factors with P<0.200 in the univariate analysis (PSS scores or PSS rating, plasma serotonin level, age, delivery mode) and potential clinical risk factors (parity, preterm birth). The results showed that when PSS was considered as a continuous variable, total PSS scores in the first or second trimester was an independent risk factor for non-exclusive breastfeeding ( OR=1.043, 95% CI: 1.010-1.077, P=0.011) and so was the high-stress perception when PSS was considered as a categorical variable (PSS rating) ( OR=1.765, 95% CI: 1.097-2.854, P=0.020). Conclusions:Overstress in the first or second trimester will affect breastfeeding patterns. Mental health counseling may help relieve perinatal stress, which will further increase the exclusive breastfeeding rate.
