PMID- 35791002
OWN - NLM
STAT- MEDLINE
DCOM- 20220707
LR  - 20220910
IS  - 1746-4358 (Electronic)
IS  - 1746-4358 (Linking)
VI  - 17
IP  - 1
DP  - 2022 Jul 5
TI  - The association between intrapartum interventions and immediate and ongoing 
      breastfeeding outcomes: an Australian retrospective population-based cohort 
      study.
PG  - 48
LID - 10.1186/s13006-022-00492-7 [doi]
LID - 48
AB  - BACKGROUND: The use of intrapartum interventions is becoming increasingly common 
      globally. Interventions during birth, including caesarean section (CS), epidural 
      analgesia and synthetic oxytocin infusion, can be important in optimizing 
      obstetric care, but have the potential to impact breastfeeding. This study aimed 
      to identify whether women who have certain intrapartum interventions have greater 
      odds of unfavourable breastfeeding outcomes, both the immediate post-partum 
      period and in the months after birth. METHODS: This was a population-based cohort 
      study of singleton livebirths at >/=37 weeks' gestation between 2010 and 2018 in 
      Victoria, Australia using routinely-collected state-wide data from the Victorian 
      Perinatal Data Collection (VPDC) and the Child Development Information System 
      (CDIS). The interventions included were pre-labour CS, in-labour CS, epidural 
      analgesia, and synthetic oxytocin infusion (augmentation and/or induction of 
      labour). Outcomes were formula supplementation in hospital, method of last feed 
      before hospital discharge and breastfeeding status at 3-months and 6-months. 
      Descriptive statistics and multivariable logistic regression models adjusting for 
      potential confounders were employed. RESULTS: In total, 599,191 women initiated 
      breastfeeding. In-labour CS (aOR 1.96, 95%CI 1.93,1.99), pre-labour CS (aOR 1.75, 
      95%CI 1.72,1.77), epidural analgesia (aOR 1.45, 95%CI 1.43,1.47) and synthetic 
      oxytocin infusion (aOR 1.24, 95%CI 1.22,1.26) increased the odds of formula 
      supplementation in hospital. Long-term breastfeeding data was available for 
      105,599 infants. In-labour CS (aOR 0.79, 95%CI 0.76,0.83), pre-labour CS (aOR 
      0.73, 95%CI 0.71,0.76), epidural analgesia (aOR 0.77, 95%CI 0.75,0.80) and 
      synthetic oxytocin infusion (aOR 0.89, 95%CI 0.86-0.92) decreased the odds of 
      exclusive breastfeeding at 3-months post-partum, which was similar at 6-months. 
      There was a dose-response effect between number of interventions received and 
      odds of each unfavourable breastfeeding outcome. CONCLUSION: Common intrapartum 
      interventions are associated with less favourable breastfeeding outcomes, both in 
      hospital and in the months after birth. This confirms the importance of only 
      undertaking interventions when necessary. When interventions are used 
      intrapartum, an assessment and identification of women at increased risk of early 
      discontinuation of breastfeeding has to be performed. Targeted breastfeeding 
      support for women who have intrapartum interventions, when they wish to 
      breastfeed, is important.
CI  - (c) 2022. The Author(s).
FAU - Andrew, Madison S
AU  - Andrew MS
AD  - Department of Obstetrics and Gynaecology, Monash University, Level 5, Monash 
      Medical Centre, 246 Clayton Road, Clayton, VIC, 3168, Australia. 
      andrm3@austin.org.au.
FAU - Selvaratnam, Roshan J
AU  - Selvaratnam RJ
AD  - Department of Obstetrics and Gynaecology, Monash University, Level 5, Monash 
      Medical Centre, 246 Clayton Road, Clayton, VIC, 3168, Australia.
FAU - Davies-Tuck, Miranda
AU  - Davies-Tuck M
AD  - Department of Obstetrics and Gynaecology, Monash University, Level 5, Monash 
      Medical Centre, 246 Clayton Road, Clayton, VIC, 3168, Australia.
AD  - The Ritchie Centre, The Hudson Institute, Clayton, Victoria, Australia.
FAU - Howland, Kim
AU  - Howland K
AD  - Municipal Association of Victoria, Melbourne, Victoria, Australia.
FAU - Davey, Mary-Ann
AU  - Davey MA
AD  - Department of Obstetrics and Gynaecology, Monash University, Level 5, Monash 
      Medical Centre, 246 Clayton Road, Clayton, VIC, 3168, Australia.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220705
PL  - England
TA  - Int Breastfeed J
JT  - International breastfeeding journal
JID - 101251562
RN  - 50-56-6 (Oxytocin)
SB  - IM
MH  - Australia
MH  - *Breast Feeding
MH  - *Cesarean Section
MH  - Child
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Infant
MH  - Oxytocin
MH  - Pregnancy
MH  - Retrospective Studies
PMC - PMC9254645
OTO - NOTNLM
OT  - Analgesia, Epidural
OT  - Breast feeding
OT  - Caesarean section
OT  - Synthetic oxytocin
COIS- None declared.
EDAT- 2022/07/06 06:00
MHDA- 2022/07/08 06:00
PMCR- 2022/07/05
CRDT- 2022/07/05 23:34
PHST- 2022/02/10 00:00 [received]
PHST- 2022/06/19 00:00 [accepted]
PHST- 2022/07/05 23:34 [entrez]
PHST- 2022/07/06 06:00 [pubmed]
PHST- 2022/07/08 06:00 [medline]
PHST- 2022/07/05 00:00 [pmc-release]
AID - 10.1186/s13006-022-00492-7 [pii]
AID - 492 [pii]
AID - 10.1186/s13006-022-00492-7 [doi]
PST - epublish
SO  - Int Breastfeed J. 2022 Jul 5;17(1):48. doi: 10.1186/s13006-022-00492-7.