Factors associated with early weaning and spatial pattern of breastfeeding in territory in the Zona da Mata of Pernambuco, Brazil

Abstract Objectives: to assess factors associated with early weaning and the pattern of spatial distribution of breastfeeding in the ascription territory of a Basic Health Unit (BHU). Methods: analytic cross-sectional study performed with 47 mothers of children under 2 years of age in a BHU from Vitória de Santo Antão, Pernambuco. The association of independent variables and early weaning was verified using bivariate and multivariate analysis. For spatial analysis of cases of breastfeeding, we applied Kernel density estimation, proximity analysis buffers of the addresses of participants to the Health Unit and flow map. Results: the prevalence of early weaning was 61.7% (CI95% = 47.8-75.6). Factors associated with early weaning were: distance of residence to the BHU higher than 500 meters, not being primiparous, non-participation in educational groups for pregnant women during prenatal period and use of nursing bottles. Being beneficiary of welfare program Bolsa Família and residing in a home with piped water constituted a protective factor for this outcome. Two clusters of early weaning cases were found in locations further away from the BHUs. Conclusions: there was high prevalence of early weaning and association of this outcome with the home-health unit displacement, being primiparous, non-participation of pregnant women in educational activities during prenatal period and use of nursing bottles.

摘要 研究目的：评估基层卫生单元（Basic Health Unit, BHU）归属辖区内与早期断奶相关的影响因素，以及母乳喂养的空间分布模式。
方法：本研究为分析性横断面研究，研究对象为巴西伯南布哥州维多利亚-迪圣安东尼奥市某基层卫生单元的47名2岁以下儿童的母亲。采用双变量与多变量分析检验自变量与早期断奶的关联；针对母乳喂养病例的空间分析，我们运用了核密度估计、研究对象住址至卫生单元的邻近性缓冲区分析以及流向图法。
结果：早期断奶患病率为61.7%（95%置信区间：47.8~75.6）。与早期断奶相关的危险因素包括：居住地距基层卫生单元距离超过500米、非初产妇、产前未参与孕妇教育小组以及使用奶瓶。领取福利项目家庭补助金（Bolsa Família）以及家中配备管道供水则为该结局的保护因素。研究在距离基层卫生单元较远的区域发现了2个早期断奶病例聚集区。
结论：本研究显示早期断奶患病率较高，且该结局与住所-卫生单元通勤距离、初产状态、孕妇产前未参与教育活动以及使用奶瓶存在关联。