Vai trò trung gian của việc sinh tại bệnh viện thân thiện với trẻ em trong mối liên hệ giữa tình trạng kinh tế - xã hội của cha mẹ và việc cho trẻ sơ sinh bú sữa mẹ hoàn toàn lúc sáu tháng tuổi

BMC Public Health - Tập 24 - Trang 1-10 - 2024
Hong Mei1, Yuanyuan Zhang2, Ruixia Chang2, Ke Xu2, Jianduan Zhang2, Fang Wang3
1Institute of Maternal and Child Health, Tongji Medical College, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital, Huazhong University of Science and Technology, Wuhan, China
2Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
3Department of Obstetrics, Tongji Medical College, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital, Huazhong University of Science and Technology, Wuhan, China

Tóm tắt

Bằng chứng hiện tại cho thấy tỷ lệ bú sữa mẹ hoàn toàn (EBF) tại Trung Quốc ở tháng thứ sáu sau sinh thấp hơn đáng kể so với các mục tiêu được Tổ chức Y tế Thế giới (WHO) khuyến nghị. Chênh lệch về kinh tế - xã hội trong tỷ lệ EBF đã được quan sát thấy ở các quốc gia đang phát triển, với sự không đồng nhất đáng kể giữa các nghiên cứu. Mặc dù đã triển khai Sáng kiến Bệnh viện Thân thiện với Bà mẹ và Trẻ em (BFHI) tại Trung Quốc từ những năm 1990 nhằm thúc đẩy việc bú sữa mẹ, nhưng vẫn thiếu đánh giá về sự khác biệt giữa các trẻ sơ sinh từ các nền tảng kinh tế - xã hội khác nhau. Nghiên cứu này nhằm điều tra mối liên hệ giữa tình trạng kinh tế - xã hội (SES) và EBF, đồng thời khám phá tác động tiềm năng của việc sinh tại một Bệnh viện Thân thiện với Trẻ em (BFH) đến mối liên hệ này. Chúng tôi đã phân tích dữ liệu từ 98.469 cặp mẹ - con được chọn từ Hệ thống Thông tin Quản lý Sức khỏe Bà mẹ và Trẻ em. Chúng tôi đã sử dụng mô hình log-binomial để xem xét mối quan hệ giữa SES và EBF, SES và việc sinh tại BFH, cũng như việc sinh tại BFH và EBF. Thêm vào đó, chúng tôi đã khám phá một phương pháp trung gian phản chứng để đánh giá vai trò trung gian của việc sinh tại BFH trong mối liên hệ giữa SES và EBF. Chúng tôi phát hiện có một mối liên hệ đáng kể giữa SES và EBF (RRMedium so với Thấp = 1.47, 95% CI 1.39–1.55; RRHigh so với Thấp = 1.40, 95% CI 1.32–1.49). Những bà mẹ có SES cao hơn có xu hướng sinh tại BFH (RRMedium so với Thấp = 1.85, 95% CI 1.81–1.88; RRHigh so với Thấp = 2.29, 95% CI 2.25–2.33). Tính chất quan trọng của mối liên hệ SES-EBF đã giảm khi xem xét loại bệnh viện sinh, cho thấy hiệu ứng trung gian đáng kể của việc sinh tại BFH trong mối liên hệ SES-EBF. Chênh lệch về kinh tế - xã hội liên quan đến tỷ lệ EBF ở trẻ sơ sinh, với việc sinh tại BFH có vai trò trung gian trong mối liên hệ này, đặc biệt là đối với các trường hợp có SES thấp tại vùng nông thôn.

Từ khóa

#EBF #SES #Baby-Friendly Hospital #Infant Nutrition #Socioeconomic Disparities

Tài liệu tham khảo

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