Publication: Lactancia materna y calidad de vida relacionada con la salud en la población escolar
Authors
Poveda Siles, Santiago
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Escuela Internacional de Doctorado
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Gascón Cánovas, Juan José
Publisher
Universidad de Murcia
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DOI
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info:eu-repo/semantics/doctoralThesis
Description
Abstract
Introducción
La lactancia materna es un proceso fisiológico cuyos beneficios a corto, medio y largo plazo en la infancia se siguen investigando. Estos hallazgos refuerzan la importancia de iniciar y mantener la lactancia el mayor tiempo posible, tanto para madres como para profesionales sanitarios, aunque existen desafíos relacionados con los estilos de vida y la conciliación laboral. Sin embargo, aún faltan estudios que analicen la asociación entre lactancia materna y la calidad de vida relacionada con la salud (CVRS) en niños en edad escolar.
Objetivos
El objetivo principal fue analizar si haber recibido lactancia materna de cualquier tipo, lactancia exclusiva o lactancia materna durante al menos 6 meses desde el nacimiento se asocia a mejores puntuaciones en las dimensiones y subdimensiones de CVRS, así como a un menor riesgo de presentar síntomas compatibles con el diagnóstico de TDAH o sus subtipos.
Metodología
Se realizó un estudio de cohortes retrospectivas con escolares de 3º de Educación Infantil y 1º y 2º de Educación Primaria de Jumilla y Yecla (Área V de Salud), con una población total de 2.112 niños. Los progenitores completaron el cuestionario LACVA5, que incluía el instrumento CHIP-CE/PRF para medir CVRS en cinco dimensiones (Satisfacción Global, Bienestar Global, Resiliencia, Prevención de riesgos y Logros) y doce subdimensiones (como Autoestima, Bienestar físico, Rendimiento académico, entre otras). También se utilizó la escala ADHD-RS-IV.es para evaluar sintomatología de TDAH y se recogieron datos sobre lactancia materna, características sociodemográficas, antecedentes familiares y exposición al humo del tabaco.
Resultados
La tasa de respuesta fue del 58,4% (n=1234), con una distribución equilibrada entre niños y niñas. La participación fue mayor en Jumilla(74%) que en Yecla(48%). Se observaron diferencias estadísticamente significativas entre localidades en las dimensiones Satisfacción Global (mejor en Jumilla) y Bienestar Global (mejor en Yecla). En cuatro de las doce subdimensiones también hubo diferencias: Jumilla destacó en Autoestima y Prevención del riesgo individual, mientras que Yecla lo hizo en Bienestar físico y Restricción de la actividad.
Respecto a la sintomatología de TDAH, se identificaron 34 casos de TDAH inatento(2,8%), 34 de TDAH hiperactivo-impulsivo(2,8%) y 35 de TDAH combinado(2,9%), siendo más frecuentes en Jumilla. La exposición a lactancia materna de cualquier tipo fue del 82,9%, a lactancia exclusiva del 47% (duración media de 3,2 meses) y a lactancia materna posparto de al menos 6 meses del 41,8%. El 80,3% de las madres estuvieron expuestas a lactancia artificial y el 75% la recibió más de 12 meses. El 93,3% de las madres tenía expectativas prenatales de amamantar y el 86,5% mantenía la lactancia al alta hospitalaria. El 47,6% cumplió o superó el tiempo previsto de lactancia.
Se encontró una relación significativa entre haber recibido lactancia materna de cualquier tipo y mejores resultados en la dimensión Logros (OR ajustada 1,599; IC95%: 1,131-2,261;p=0,008). No se observó asociación entre lactancia exclusiva y CVRS. También se confirmó la asociación entre lactancia materna de al menos 6 meses y mejores resultados en Logros (OR ajustada 1,398; IC95%:1,058-1,848; p=0,019) y en Rendimiento académico (OR ajustada 1,619; IC95%:1,185-2,212; p=0,002).
No se halló relación entre lactancia materna y la presencia de sintomatología de TDAH global, inatento o hiperactivo-impulsivo.
Conclusiones
Este estudio, uno de los pocos que analiza la relación entre lactancia materna y CVRS usando instrumentos validados, confirma que la exposición a lactancia materna de cualquier tipo y mantenida al menos 6 meses se asocia a mejores resultados en salud en la dimensión Logros y en el Rendimiento académico. No se encontró asociación entre lactancia y sintomatología de TDAH o sus subtipos
Introduction Breastfeeding is a physiological process whhose short-, medium-, and long-term benefits in childhood continue to be investigated. These findings reinforce the importance of initiating and maintaining breastfeeding for as long as possible, both for mothers and health care professionals, although there are challenges related to lifestyle and work-life balance. However, studies analyzing the association between breastfeeding and healthrelated quality of life (HRQoL) in school-aged children are still lacking. Objectives The main objective was to analyze whether having received any type of breastfeeding, exclusive breastfeeding, or breastfeeding for at least 6 months from birth is associated with better scores on the dimensions and subdimensions of HRQoL, as well as a lower risk of presenting symptoms compatible with a diagnosis of ADHD or its subtypes. Methodology A retrospective cohort study was conducted with 2,112 children in the third year of Early Childhood Education and First and Second years of Primary Education in Jumilla and Yecla (Health Area V). Parents completed the LACVA5 questionnaire, which included the CHIP-CE/PRF instrument to measure HRQoL in five dimensions (Global Satisfaction, Global Well-being, Resilience, Risk Revention, an Achievement) and twelve subdimensions (such as Self-Esteem, Physical Well-being, Academic Performance, among others). The ADHD-RS-IV.es scale was also used to assess ADHD symptons, and data were collected on breastfeeding, sociodemographic characteristics, family history, and tobacco smoke exposure. Results The response rate was 58.4% (n=1234), with a balanced distribution between boys and girls. Participation was higher in Jumilla (74%) than in Yecla (48%). Statistically significant differences were observed between localities in the dimensions of Global Satisfaction (best in Jumilla) and Global Well-being (best in Yecla). Differences also occurred in four of the twelve subdimensions: Jumilla excelled in Self-Esteem and Individual Risk Prevention, while Yecla excelled in Physical Well-being and Activity Restriction. Regarding ADHD symptoms, 34 cases of Inattentive ADHD (2.8%), 34 of Hyperactive-Impulsive ADHD (2.8%), and 35 of Combined ADHD (2.9%) were identified, with the latter being more frequent in Jumilla. Exposure to any type of breastfeeding was 82.9% to exclusive breastfeeding 47% (average duration of 3.2 months), and to postpartum breastfeeding of al least 6 months 41.8%. 80.3% of mothers were exposed to bottle feeding, and 75% received it for more than 12 months. Ninety-three point three percent of mothers had prenatal expectations of breastfeeding, and 86.5% were breastfeeding at hospital discharge. 47.6% met or exceeded their expected breastfeeding duration. A significant relationship was found between haing received any type of breastfeeding and better outcomes in the Achievement dimension (adjusted OR 1.599;95% CI: 1.131-2.261; p=0,008). No association was observed between exclusive breastfeeding and HRQoL. An association was also confirmed between breastfeeding for at least 6 months and better outcomes in Achievement (adjusted OR 1.398; 95% CI: 1.058-1.848; p=0,019) and Academic Performance (adjusted OR 1.619;95% CI: 1.185-2.212;p=0,002). No relationship was found between breastfeeding and the presence of ADHD symptonms overall, inattentive, or hyperactive-impulsive. Conclusions This study, one of the few to analyze the relationshio between breastfeeding and HRQoL using validated instruments, confirms that exposure to breastfeeding of any type and maintained for at least 6 months is associated with better health outcomes in the Achievement and Academic Performance dimensions. No association was found between breastfeeding and ADHD symptoms or its subtypes.
Introduction Breastfeeding is a physiological process whhose short-, medium-, and long-term benefits in childhood continue to be investigated. These findings reinforce the importance of initiating and maintaining breastfeeding for as long as possible, both for mothers and health care professionals, although there are challenges related to lifestyle and work-life balance. However, studies analyzing the association between breastfeeding and healthrelated quality of life (HRQoL) in school-aged children are still lacking. Objectives The main objective was to analyze whether having received any type of breastfeeding, exclusive breastfeeding, or breastfeeding for at least 6 months from birth is associated with better scores on the dimensions and subdimensions of HRQoL, as well as a lower risk of presenting symptoms compatible with a diagnosis of ADHD or its subtypes. Methodology A retrospective cohort study was conducted with 2,112 children in the third year of Early Childhood Education and First and Second years of Primary Education in Jumilla and Yecla (Health Area V). Parents completed the LACVA5 questionnaire, which included the CHIP-CE/PRF instrument to measure HRQoL in five dimensions (Global Satisfaction, Global Well-being, Resilience, Risk Revention, an Achievement) and twelve subdimensions (such as Self-Esteem, Physical Well-being, Academic Performance, among others). The ADHD-RS-IV.es scale was also used to assess ADHD symptons, and data were collected on breastfeeding, sociodemographic characteristics, family history, and tobacco smoke exposure. Results The response rate was 58.4% (n=1234), with a balanced distribution between boys and girls. Participation was higher in Jumilla (74%) than in Yecla (48%). Statistically significant differences were observed between localities in the dimensions of Global Satisfaction (best in Jumilla) and Global Well-being (best in Yecla). Differences also occurred in four of the twelve subdimensions: Jumilla excelled in Self-Esteem and Individual Risk Prevention, while Yecla excelled in Physical Well-being and Activity Restriction. Regarding ADHD symptoms, 34 cases of Inattentive ADHD (2.8%), 34 of Hyperactive-Impulsive ADHD (2.8%), and 35 of Combined ADHD (2.9%) were identified, with the latter being more frequent in Jumilla. Exposure to any type of breastfeeding was 82.9% to exclusive breastfeeding 47% (average duration of 3.2 months), and to postpartum breastfeeding of al least 6 months 41.8%. 80.3% of mothers were exposed to bottle feeding, and 75% received it for more than 12 months. Ninety-three point three percent of mothers had prenatal expectations of breastfeeding, and 86.5% were breastfeeding at hospital discharge. 47.6% met or exceeded their expected breastfeeding duration. A significant relationship was found between haing received any type of breastfeeding and better outcomes in the Achievement dimension (adjusted OR 1.599;95% CI: 1.131-2.261; p=0,008). No association was observed between exclusive breastfeeding and HRQoL. An association was also confirmed between breastfeeding for at least 6 months and better outcomes in Achievement (adjusted OR 1.398; 95% CI: 1.058-1.848; p=0,019) and Academic Performance (adjusted OR 1.619;95% CI: 1.185-2.212;p=0,002). No relationship was found between breastfeeding and the presence of ADHD symptonms overall, inattentive, or hyperactive-impulsive. Conclusions This study, one of the few to analyze the relationshio between breastfeeding and HRQoL using validated instruments, confirms that exposure to breastfeeding of any type and maintained for at least 6 months is associated with better health outcomes in the Achievement and Academic Performance dimensions. No association was found between breastfeeding and ADHD symptoms or its subtypes.
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