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Fatores associados ao desmame precoce : auto efic?cia no aleitamento materno e depress?o p?s-natal

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Previous issue date: 2013-08-28 / Objective: To determine factors associated with the length of exclusive breastfeeding at two hospitals, a baby-friendly hospital and one general hospital, and relate them to the scores of the Breastfeeding Self Efficacy Scale and the Edinburgh Postnatal Depression Scale. Methods: We conducted a descriptive and analytical cohort study of 300 binomials of mother-babies that were born in two hospitals: one at the general hospital and the other at a baby-friendly hospital. The inclusion criteria were: children with birth weight of 2,500 g or less, gestational age above 36 weeks and residents in urban areas. At the hospitals maternities, data were collected from medical records, questions to mothers were asked and the Breastfeeding Self-Efficacy Scale was applied. Every 15 days, the mother was contacted and asked if she was still exclusively breastfeeding and the Edinburgh Postnatal Depression Scale-EPDS was applied four months after giving birth. Results: Among the births, 53% were male, 52% were at a baby-friendly hospital and 55% were normal deliveries. The mothers had a mean age of 26 years and a mean gestational age of 39 weeks. The average maternal breastfeed score was 36 points while the score for the Edinburgh Scale was that 36% of the mothers had a tendency of depression. Only 34% of the mothers had up to eight years of education, 57% of them worked outside the home, 13% of them were single and 61% had 7-13 prenatal consultations. At 30 days, the frequency of exclusive breastfeeding was of 86% while only 49% of the babies were breastfed exclusively at 120 days of life. In the multivariate analysis, the variables of exclusive breastfeeding at 60 days showing risk factors were the hospital not being baby friendly (p=0,002), the mother's schooling (up to 8 years of study) (p=0,004) and a working mother (p=0,013). The highest Breastfeeding test score (p=0,016) was for the protection factor of exclusive breastfeeding. At 120 days, it was evaluated that the variables shown as protection factors were the mother's age (p=0,039) and the Breastfeed test score (p=0,046). Conclusions: The risk factors associated with exclusive breastfeeding during the 60 days at a hospital that is not baby friendly are the mother's schooling (up to 8 years) and whether she works or not. The highest Breastfeed score was the exclusive breastfeeding protection factor. At 120 days, the variables shown as exclusive breastfeeding protection factors were the mother's age and the Breastfeed test score. / Objetivo: Determinar os fatores relacionados com o tempo de aleitamento materno exclusivo em dois hospitais, um amigo da crian?a e outro hospital geral, e relacionar com os escores da Breastfeeding Self Efficacy Scale e a Edinburgh Postnatal Depression Scale. M?todos: Foi realizado um estudo de coorte descritiva e anal?tica, com 300 bin?mios m?e-beb?, cujos beb?s nasceram em dois hospitais: um hospital geral e o outro amigo da crian?a. Os crit?rios de inclus?o foram: crian?as com peso de nascimento >2.500 gramas, idade gestacional acima de 36 semanas, residentes em zonas urbanas. Na maternidade, foram coletados dados do prontu?rio foram aplicados um question?rio ?s m?es e a Breastfeeding Self Efficacy Scale. A cada 15 dias, contatava-se a m?e, perguntando-lhe se ainda estava em aleitamento materno exclusivo e, ao chegar aos quatro meses p?s-parto, foi aplicada a Edinburgh Postnatal Depression Scale. Resultados: Dentre os nascimentos, 53% era masculino, 52% foi em hospital amigo da crian?a, 55% foi parto normal. A idade m?dia das m?es era de 26 anos e a idade gestacional m?dia foi de 39 semanas. A m?dia materna de escore de Breastfeed foi de 36 pontos. Quanto ao escore de Edinburgh, 36% das m?es apresentava tend?ncia ? depress?o. Apenas 34% das m?es tinha at? oito anos de estudo, 57% trabalhava fora, 13% era solteira, 61% realizou de 7 a 13 consultas de pr?-natal. Avaliando-se a frequ?ncia de amamenta??o exclusiva (AME) aos 30 dias foi de 86%,enquanto apenas 49% das crian?as recebeu amamenta??o exclusiva aos 120 dias de vida. Na an?lise multivari?vel o aleitamento materno exclusivo aos 60 dias, as vari?veis que se mostraram como fatores de risco para a amamenta??o foram, o Hospital N?o amigo da Crian?a (p=0,002),a escolaridade (at? oito anos de estudo) (p=0,004) e a m?e que trabalha ( p= 0,013). J? a maior pontua??o no teste de Breastfeed (p=0,016) foi um fator de prote??o para amamenta??o exclusivo. Ao avaliar o aleitamento materno aos 120 dias, as vari?veis que se mostraram como fatores de prote??o para a amamenta??o foram a maior idade materna (p=0,039) e a pontua??o no teste de Breastfeed (p=0,046). Conclus?es: Os fatores de risco associados com aleitamento materno exclusivo aos 60 dias foram o Hospital N?o credenciado como amigo da Crian?a, a escolaridade (at? oito anos de estudo) e a m?e que trabalha. J? a maior pontua??o no teste de Breastfeed foi um fator de prote??o para amamenta??o exclusiva. Aos120 dias, as vari?veis que se mostraram como fatores de prote??o para a amamenta??o exclusiva foram a maior idade materna e a pontua??o no teste de Breastfeed.

Identiferoai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/1425
Date28 August 2013
CreatorsMargotti, Edficher
ContributorsStein, Renato Tetelbom
PublisherPontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina/Pediatria e Sa?de da Crian?a, PUCRS, BR, Faculdade de Medicina
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis
Formatapplication/pdf
Sourcereponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS
Rightsinfo:eu-repo/semantics/openAccess
Relation3098206005268432148, 500, 600, -8624664729441623247

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