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摘要
Objective: To investigate Candida species and Staphylococcus aureus and the development of %26apos;nipple and breast thrush%26apos; among breastfeeding women. %26lt;br%26gt;Design: Prospective longitudinal cohort study. %26lt;br%26gt;Setting: Two hospitals in Melbourne, Australia (one public, one private) with follow-up in the community. %26lt;br%26gt;Participants: 360 nulliparous women recruited at %26gt;= 36 weeks%26apos; gestation from November 2009 to June 2011. Participants were followed up six times: in hospital, at home weekly until 4 weeks postpartum and by telephone at 8 weeks. %26lt;br%26gt;Main outcome measures: Case definition %26apos;nipple and breast thrush%26apos;: burning nipple pain and breast pain (not related to mastitis); detection of Candida spp (using culture and PCR) in the mother%26apos;s vagina, nipple or breast milk or in the baby%26apos;s mouth; detection of S aureus in the mother%26apos;s nipple or breast milk. %26lt;br%26gt;Results: Women with the case definition of nipple/breast thrush were more likely to have Candida spp in nipple/breast milk/baby oral samples (54%) compared to other women (36%, p=0.014). S aureus was common in nipple/breast milk/baby samples of women with these symptoms as well as women without these symptoms (82% vs 79%) (p=0.597). Time-to-event analysis examined predictors of nipple/breast thrush up to and including the time of data collection. Candida in nipple/breast milk/baby predicted incidence of the case definition (rate ratio (RR) 1.87 (95% CI 1.10 to 3.16, p=0.018). We do not have evidence that S aureus colonisation was a predictor of these symptoms (RR 1.53, 95% CI 0.88 to 2.64, p=0.13). Nipple damage was also a predictor of these symptoms, RR 2.30 (95% CI 1.19 to 4.43, p=0.012). In the multivariate model, with all three predictors, the RRs were very similar to the univariate RRs. This indicates that Candida and nipple damage are independent predictors of our case definition.
- 出版日期2013
- 单位迪肯大学
