Breastfeeding and Post-perinatal Infant Deaths in the United States, A National Prospective Cohort Analysis

Summary: Background: Reducing infant mortality is a major public health goal. The potential impact of breastfeeding on infant deaths is not well studied in the United States (US). Methods: We analyzed linked birth−death certificates for 3,230,500 US births that occurred in 2017, including 6,969 pos...

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Autores principales:	Ruowei Li, Julie Ware, Aimin Chen, Jennifer M. Nelson, Jennifer M. Kmet, Sharyn E. Parks, Ardythe L. Morrow, Jian Chen, Cria G. Perrine
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2022
Materias:	Breastfeeding Infant mortality Racial/ethnic disparity Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/cec55feb72354cf1bb8c315c991a3930
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spelling	oai:doaj.org-article:cec55feb72354cf1bb8c315c991a39302021-12-02T05:04:39ZBreastfeeding and Post-perinatal Infant Deaths in the United States, A National Prospective Cohort Analysis2667-193X10.1016/j.lana.2021.100094https://doaj.org/article/cec55feb72354cf1bb8c315c991a39302022-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2667193X21000909https://doaj.org/toc/2667-193XSummary: Background: Reducing infant mortality is a major public health goal. The potential impact of breastfeeding on infant deaths is not well studied in the United States (US). Methods: We analyzed linked birth−death certificates for 3,230,500 US births that occurred in 2017, including 6,969 post-perinatal deaths from 7−364 days of age as the primary outcome, further specified as late-neonatal (7−27 days) or post-neonatal (28−364 days) deaths. The primary exposure was ‘ever breastfed’ obtained from birth certificates. Multiple logistic regression examined associations of ever breastfeeding with post-perinatal deaths and specific causes of deaths, controlling for maternal and infant factors. Findings: We observed an adjusted reduced odds ratio (AOR)=0·74 with 95% confidence intervals (CI)=0·70–0·79 for the association of breastfeeding initiation with overall infant deaths (7−364 days), AOR=0·60 (0·54–0·67) for late-neonatal deaths, and AOR=0·81 (0·76–0·87) for post-neonatal deaths. In race/ethnicity-stratified analysis, significant associations of breastfeeding initiation with reduced odds of overall infant deaths were observed for Hispanics [AOR=0·64 (0·55−0·74)], non-Hispanic Whites [AOR=0·75 (0·69−0·81)], non-Hispanic Blacks [AOR=0·83 (0·75−0·91)], and non-Hispanic Asians [AOR=0·51 (0·36−0·72)]. Across racial/ethnic groups, effect sizes for late-neonatal deaths were consistently larger than those for post-neonatal deaths. Significant effects of breastfeeding initiation were observed for deaths due to infection [AOR=0·81(0·69–0·94)], Sudden Unexpected Infant Death [AOR=0·85 (0·78–0·92)], and necrotizing enterocolitis [AOR=0·67 (0·49−0·90)]. Interpretation: Breastfeeding initiation is significantly associated with reduced odds of post-perinatal infant deaths in multiple racial and ethnic groups within the US population. These findings support efforts to improve breastfeeding in infant mortality reduction initiatives.Ruowei LiJulie WareAimin ChenJennifer M. NelsonJennifer M. KmetSharyn E. ParksArdythe L. MorrowJian ChenCria G. PerrineElsevierarticleBreastfeedingInfant mortalityRacial/ethnic disparityPublic aspects of medicineRA1-1270ENThe Lancet Regional Health. Americas, Vol 5, Iss , Pp 100094- (2022)
institution	DOAJ
collection	DOAJ
language	EN
topic	Breastfeeding Infant mortality Racial/ethnic disparity Public aspects of medicine RA1-1270
spellingShingle	Breastfeeding Infant mortality Racial/ethnic disparity Public aspects of medicine RA1-1270 Ruowei Li Julie Ware Aimin Chen Jennifer M. Nelson Jennifer M. Kmet Sharyn E. Parks Ardythe L. Morrow Jian Chen Cria G. Perrine Breastfeeding and Post-perinatal Infant Deaths in the United States, A National Prospective Cohort Analysis
description	Summary: Background: Reducing infant mortality is a major public health goal. The potential impact of breastfeeding on infant deaths is not well studied in the United States (US). Methods: We analyzed linked birth−death certificates for 3,230,500 US births that occurred in 2017, including 6,969 post-perinatal deaths from 7−364 days of age as the primary outcome, further specified as late-neonatal (7−27 days) or post-neonatal (28−364 days) deaths. The primary exposure was ‘ever breastfed’ obtained from birth certificates. Multiple logistic regression examined associations of ever breastfeeding with post-perinatal deaths and specific causes of deaths, controlling for maternal and infant factors. Findings: We observed an adjusted reduced odds ratio (AOR)=0·74 with 95% confidence intervals (CI)=0·70–0·79 for the association of breastfeeding initiation with overall infant deaths (7−364 days), AOR=0·60 (0·54–0·67) for late-neonatal deaths, and AOR=0·81 (0·76–0·87) for post-neonatal deaths. In race/ethnicity-stratified analysis, significant associations of breastfeeding initiation with reduced odds of overall infant deaths were observed for Hispanics [AOR=0·64 (0·55−0·74)], non-Hispanic Whites [AOR=0·75 (0·69−0·81)], non-Hispanic Blacks [AOR=0·83 (0·75−0·91)], and non-Hispanic Asians [AOR=0·51 (0·36−0·72)]. Across racial/ethnic groups, effect sizes for late-neonatal deaths were consistently larger than those for post-neonatal deaths. Significant effects of breastfeeding initiation were observed for deaths due to infection [AOR=0·81(0·69–0·94)], Sudden Unexpected Infant Death [AOR=0·85 (0·78–0·92)], and necrotizing enterocolitis [AOR=0·67 (0·49−0·90)]. Interpretation: Breastfeeding initiation is significantly associated with reduced odds of post-perinatal infant deaths in multiple racial and ethnic groups within the US population. These findings support efforts to improve breastfeeding in infant mortality reduction initiatives.
format	article
author	Ruowei Li Julie Ware Aimin Chen Jennifer M. Nelson Jennifer M. Kmet Sharyn E. Parks Ardythe L. Morrow Jian Chen Cria G. Perrine
author_facet	Ruowei Li Julie Ware Aimin Chen Jennifer M. Nelson Jennifer M. Kmet Sharyn E. Parks Ardythe L. Morrow Jian Chen Cria G. Perrine
author_sort	Ruowei Li
title	Breastfeeding and Post-perinatal Infant Deaths in the United States, A National Prospective Cohort Analysis
title_short	Breastfeeding and Post-perinatal Infant Deaths in the United States, A National Prospective Cohort Analysis
title_full	Breastfeeding and Post-perinatal Infant Deaths in the United States, A National Prospective Cohort Analysis
title_fullStr	Breastfeeding and Post-perinatal Infant Deaths in the United States, A National Prospective Cohort Analysis
title_full_unstemmed	Breastfeeding and Post-perinatal Infant Deaths in the United States, A National Prospective Cohort Analysis
title_sort	breastfeeding and post-perinatal infant deaths in the united states, a national prospective cohort analysis
publisher	Elsevier
publishDate	2022
url	https://doaj.org/article/cec55feb72354cf1bb8c315c991a3930
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Breastfeeding and Post-perinatal Infant Deaths in the United States, A National Prospective Cohort Analysis

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