PREVALENCIA Y FACTORES ASOCIADOS A LA LACTANCIA EN LA PRIMERA HORA DE VIDA: ESTUDIO TRANSVERSAL

Viana, Vera Alice Oliveira; Castro, Lucélia da Cunha; Rufino, Andréa Cronemberger; Madeiro, Alberto Pereira

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Original Article • Texto contexto - enferm. 33 • 2024 • https://doi.org/10.1590/1980-265X-TCE-2023-0181en copiar

PREVALENCIA Y FACTORES ASOCIADOS A LA LACTANCIA EN LA PRIMERA HORA DE VIDA: ESTUDIO TRANSVERSAL

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Analizar la prevalencia y los factores asociados a la lactancia materna en la primera hora de vida.

Método:

Estudio transversal con puérperas de maternidades públicas de Teresina, Piauí, Brasil, entre 2020 y 2021. Se evaluaron datos sociodemográficos y conductuales de la mujer y su pareja, características obstétricas, además de la violencia de pareja durante el embarazo. El análisis jerárquico se realizó mediante regresión logística múltiple, con cálculo de odds ratio ajustado (OR_aj) e intervalos de confianza del 95% (IC95%).

Resultados:

se entrevistó a 413 mujeres. Hubo una prevalencia de lactancia materna en la primera hora de vida del 66,8%. La presencia de acompañante (OR_aj=1,66; IC95% 1,34-2,29), el contacto piel con piel con el recién nacido (OR_aj=2,14; IC95% 1,04-4,38) y haber tenido un parto natural (OR_aj=2,06; IC95% 1,90-4,73) aumentaron las posibilidades de amamantamiento en la primera hora. La falta de pareja (OR_aj=0,47; IC95% 0,25-0,86) y la pareja con piel no blanca (OR_aj=0,45; IC95% 0,24-0,83) disminuyeron las posibilidades de lactancia materna.

Conclusiones:

La prevalencia de lactancia materna en la primera hora de vida se consideró buena. Los factores relacionados con la atención obstétrica y con el parto contribuyeron positivamente a la lactancia materna. Los datos refuerzan la importancia de ofrecer una asistencia de calidad durante el proceso de parto.

DESCRIPTORES:
Lactancia materna; Período posparto; Salud maternoinfantil; Hospitales de maternidad; Estudios transversales

Variables	All		Breastfeeding in the first hour YES		COR^*	CI95%^†	P
Variables	n	%	n	%	COR^*	CI95%^†	P
Woman
Age group (years old)
10-19	72	17.4	52	72.2	1		0.446^‡
20-29	206	49.9	141	68.4	0.83	0.46-1.51
30-39	124	30.0	76	61.3	0.61	0.32-1.14
≥40	11	2.7	7	63.6	0.67	0.18-2.55
Skin color
White	39	9.4	26	66.7	1	-	0.982^‡
Non-white	374	90.6	250	66.8	1.01	0.50-2.03	0.982^‡
Schooling (years of study)
0-4	13	3.1	11	84.6	2.32	0.48-11.12	0.406^‡
5-8	101	24.5	71	70.3	1	-
9-11	259	62.7	169	65.3	0.79	0.48-1.31
≥12	40	9.7	25	62.5	0.70	0.33-1.52
Occupation
Occupied	75	18.2	51	68.0	1.07	0.62-1.82	0.812^§
Unoccupied	338	81.8	225	66.6	1	-	0.812^§
Income
Yes	75	18.2	51	68.0	1.07	0.62-1.82	0.812^§
No	338	81.8	225	66.6	1	-	0.812^§
Marital status
With partner	355	86.0	246	69.3	1	-	0.008^§
Without partner	58	14.0	30	51.7	0.47	0.27-0.83	0.008^§
Alcohol consumption
Yes	25	6.1	19	76.0	1.61	0.63-4.14	0.315^§
No	388	93.9	257	66.2	1	-	0.315^§
Tobacco use
Yes	9	2.2	7	77.8	1.76	0.36-8.57	0.724^§
No	404	97.8	169	66.6	1	-	0.724^§
Use of illicit drugs
Yes	2	0.5	2	100.0	-	-	-
No	411	99.5	274	66.7	-	-	-
Intimate Partner
Age group (years old) (n=406)^\|\|
15-19	19	4.6	15	78.9	1	-	0.266^§
20-29	188	45.5	128	68.1	0.57	0.18-1.79
30-39	146	35.4	99	67.8	0.56	0.18-1.78
≥40	53	12.8	30	56.6	0.35	0.10-1.19
Skin color (n=409)^\|\|
White	82	19.9	66	80.5	1	-	0.003^§
Non-white	327	79.1	207	63.3	0.42	0.23-0.76	0.003^§
Schooling (years of study) (n=355)^\|\|
0-4	23	5.6	13	56.5	1	-	0.511^§
5-8	98	23.7	67	68.4	1.66	0.66-4.21
9-11	207	50.1	146	70.5	1.84	0.77-4.42
≥12	27	6.5	17	63.0	1.31	0.42-4.07
Occupation (n=411)^\|\|
Occupied	335	81.1	224	66.9	0.99	0.58-1.68	0.968^§
Unoccupied	76	18.4	51	67.1	1	-	0.968^§
Family provider (n=411)^\|\|
Yes	281	68.0	189	67.3	1.05	0.67-1.63	0.825^§
No	130	31.5	86	66.2	1	-	0.825^§
Alcohol use (n=411)^\|\|
Yes	239	57.9	156	65.3	0.84	0.55-1.27	0.405^§
No	172	41.6	119	69.2	1	-	0.405^§
Tobacco use (n=411)^\|\|
Yes	61	14.8	47	77.0	1.80	0.95-3.39	0.068^§
No	350	84.7	228	65.1	1	-	0.068^§
Use of illicit drugs (n=407)^\|\|
Yes	18	4.4	14	77.8	1.80	0.58-5.57	0.303^§
No	389	94.2	257	66.1	1	-	0.303^§

Variables	All		Breastfeeding in the first hour YES		COR^*	CI95%^†	P
Variables	n	%	n	%	COR^*	CI95%^†	P
Number of pregnancies
1	154	37.3	101	65.6	1	-	0.679^‡
>1	259	62.7	71	67.6	1.09	0.72-1.67	0.679^‡
Number of abortions
0	336	81.4	225	67.0	0.96	0.54-1.72	0.897^§
1	62	15.0	42	67.7	1	-
2	13	3.1	8	61.5	0.76	0.22-2.63
3	2	0.5	1	50.0	0.48	0.03-8.01
Number of deliveries
1	171	41.4	113	66.1	1.39	0.67-2.90	0.563^‡
2	116	28.1	80	69.0	1.59	0.74-3.43
3	74	17.9	49	66.2	1.40	0.62-3.17
4	36	8.7	21	58.3	1	-
≥5	16	3.9	13	81.3	3.09	0.75-12.80
Planned pregnancy
Yes	144	34.9	94	65.3	0.90	0.58-1.38	0.624^‡
No	269	65.1	182	67.7	1	-
Feelings regarding unplanned pregnancy (n=269)
Unwanted	21	7.8	14	66.7	1	-		0.919^‡
Wanted	248	92.2	168	67.7	1.05	0.41-2.70		0.919^‡
Number of prenatal care appointments
None	2	0.5	-	-			0.861^‡
<6	82	19.9	54	65.9	1	-
>6	329	79.7	220	66.9	1.05	0.63-1.74
Received guidance on breastfeeding
Yes	150	36.3	94	62.7	0.75	0.49-1.15	0.183^‡
No	263	63.7	181	69.1	1	-	0.183^‡
Received guidance on physical activity
Yes	231	55.9	149	64.5	0.79	0.52-1.20	0.274^‡
No	182	44.1	126	69.6	1	-	0.274^‡
Companion during labor
Yes	178	43.1	134	75.3	1.99	1.30-3.06	0.001^‡
No	235	56.9	142	60.4	1	-	0.001^‡
Skin-to-skin contact with the newborn
Yes	194	47.0	153	78.9	2.91	1.88-4.50	0.001^‡
No	219	53.0	123	56.2	1	-	0.001^‡
Type of delivery
Natural birth	158	38.3	128	81.0	3.08	1.93-4.93	0.001^‡
Cesarean Section	255	61.7	148	58.0	1		0.001^‡
Gestational age (weeks)
<37	37	9.0	21	56.8	1	-	0.374^‡
37-40	263	63.7	177	67.3	1.57	0.78-3.16
>40	113	27.4	78	69.0	1.70	0.79-3.64
Birth weight (grams)
<2000	-	-					0.342^‡
2000-2500	35	8.5	20	57.1	1	-
2501-4000	351	85.0	236	67.2	1.54	0.76-3.12
>4000	27	6.5	20	74.1	2.14	0.72-6.38
Gender of the Newborn
Male	203	49.2	131	64.5	0.82	0.541-1.23	0.330^‡
Female	210	50.8	145	69.0	1	-	0.330^‡
5-Minute Apgar score
<7	3	0.7	-	-	-	-	-
≥7	410	99.3	276	67.3	-	-
Breastfeeding in the first hour of life
Yes	276	66.8	-	-	-	-	-
No	137	33.2	-	-	-	-

Variables	All		Breastfeeding in the first hour YES		COR^*	CI95%^†	p
Variables	N	%	n	%	COR^*	CI95%^†	p
Physical violence during pregnancy
Yes	6	1.5	4	66.7	0.99	0.18-5.49	1.000^‡
No	407	98.5	272	66.8	1	-
Psychological violence during pregnancy
Yes	15	3.6	11	73.3	1.38	0.43-4.42	0.782^§
No	398	96.4	265	66.6	1
Sexual violence during pregnancy
Yes	-	-	-	-	-	-	-
No	413	100.0	276	66.8	-	-
Any sort of violence during pregnancy
Yes	15	3.6	11	68.8	1.09	0.37-3.22	0.868^‡
No	398	96.4	265	66.8	1	-
Physical violence at some point in life
Yes	29	7.0	23	79.3	1.99	0.79-4.99	0.139^‡
No	384	93.0	253	65.9	1	-
Sexual violence at some point in life
Yes	3	0.7	3	100.0	-	-	-
No	410	99.3	273	66.6	-	-
Psychological violence at some point in life
Yes	44	10.7	33	75.0	1.56	0.76-3.18	0.223^‡
No	369	89.3	243	65.9	1	-
Any sort of violence at some point in life
Yes	104	25.2	73	70.2	1.23	0.76-1.99	0.400^‡
No	309	74.8	203	65.7	1	-

Variables	Model 1		Model 2		Model 3
Variables	AOR^*	CI95%^†	AOR^*	CI95%^†	AOR^*	CI95%^†
Marital status
With partner	1
Without partner	0.50	0.28-0,89^‡
Skin color (partner)
White	1
Non-white	0.43	0.24-0,78^‡
Tobacco use
Yes	1.79	0.94-3.42
No	1
Physical violence at some point in life
Yes			1.93	0.75-4.99
No			1
Received guidance on breastfeeding
Yes					0.73	0.46-1.15
No					1
Had a companion during labor
Yes					1.66	1.34-2,29^‡
No					1
Skin-to-skin contact with the newborn
Yes					2.14	1,04 - 4,38^‡
No					1
Type of delivery
Natural birth					2.06	1.90-4,73^‡
Cesarean section					1

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[1] CORRESPONDING AUTHOR
Vera Alice Oliveira Viana veraalice75@hotmail.com