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Maternal Well-Being in Pregnancy and Breastfeeding Practices: Findings from the ROLO StudyFunding This study was supported by the Health Research Board Ireland, the Health Research Centre for Health and Diet Research, and the European Union's Seventh Framework Program (grant no.: FP7/2007/2013), project EarlyNutrition under grant agreement number 289346.
Objective Low mood is common during the perinatal period, which may negatively impact breastfeeding practices. Exploring predictors of successful breastfeeding is a health priority area. This study investigated if maternal well-being during pregnancy is associated with breastfeeding practices.
Study Design This is a secondary analysis of a randomized control trial of a low glycemic index diet in pregnancy. A total of 610 secundigravida women were recruited in the National Maternity Hospital, Dublin, Ireland. Data on maternal education attainment, early pregnancy body mass index (BMI), and age were collected from hospital records. Well-being was self-reported by mothers between 10 and 28 weeks' gestation using the World Health Organization 5-Item well-being index. Scores were transformed to give percentage well-being. Mothers recorded breastfeeding practices at hospital discharge and at the study follow-up appointments. Chi-squares and independent t-tests determined initial differences in breastfeeding practices. Multiple and logistic regression analyses were used to adjust for confounders.
Results Average maternal age was 32.7 years; average BMI was 26.6 kg/m2, and 56% had achieved third-level education. The average well-being score was 58.2%. In unadjusted analysis, high well-being scores were associated with exclusive breastfeeding (56.2% breastfed vs. 46%, breastfed p < 0.03). After adjusted analysis, these associations were no longer significant (odds ratio: 1.00, 95% confidence interval: 0.99–1.01). No other associations were found.
Conclusion Our findings indicated 25% of pregnant women in the first trimester reported low well-being scores. Associations between maternal well-being and breastfeeding patterns were explained by maternal age and education level, suggesting low mood may not be a barrier to breastfeeding initiation or duration. This trial is registered at: https://www.isrctn.com/ ISRCTN54392969.
Well-being during pregnancy is often diminished and the WHO 5-Item well-being index is a useful measure in clinical settings to assess maternal well-being.
Breastfeeding is a high-priority research area, particularly in an Irish setting.
Well-being was not related to breastfeeding, however age, BMI and education were the main predictors of low well-being during pregnancy.
Ethics Approval and Consent to Participate
Ethical approval was granted by the National Maternity Hospital in November 2006; the trial was performed in accordance with the Helsinki Declaration of Human Rights 1975 (revised in 1983). All participants provided informed, written consent.
C.A.Y., A.A.G., E.C.O.B., E.L., and F.M.M. were involved in the conception and design of the study. A.A.G., E.C.O.B., E.L., and M.C. were involved in the acquisition of data. C.A.Y. performed all statistical analysis. C.A.Y., A.A.G., S.L.K., and F.M.M. were involved in the interpretation of the data. J.M. was responsible for the data management. C.A.Y. drafted the manuscript. All authors revised the work critically and approved the final manuscript.
Received: 09 December 2022
Accepted: 22 May 2023
Article published online:
14 August 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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