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Determinants of mastitis in women in the CASTLE study: a cohort study

BACKGROUND: Mastitis is an acute, debilitating condition that occurs in approximately 20 % of breastfeeding women who experience a red, painful breast with fever. This paper describes the factors correlated with mastitis and investigates the presence of Staphylococcus aureus in women who participate...

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Autores principales: Cullinane, Meabh, Amir, Lisa H., Donath, Susan M., Garland, Suzanne M., Tabrizi, Sepehr N., Payne, Matthew S., Bennett, Catherine M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681172/
https://www.ncbi.nlm.nih.gov/pubmed/26674724
http://dx.doi.org/10.1186/s12875-015-0396-5
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author Cullinane, Meabh
Amir, Lisa H.
Donath, Susan M.
Garland, Suzanne M.
Tabrizi, Sepehr N.
Payne, Matthew S.
Bennett, Catherine M.
author_facet Cullinane, Meabh
Amir, Lisa H.
Donath, Susan M.
Garland, Suzanne M.
Tabrizi, Sepehr N.
Payne, Matthew S.
Bennett, Catherine M.
author_sort Cullinane, Meabh
collection PubMed
description BACKGROUND: Mastitis is an acute, debilitating condition that occurs in approximately 20 % of breastfeeding women who experience a red, painful breast with fever. This paper describes the factors correlated with mastitis and investigates the presence of Staphylococcus aureus in women who participated in the CASTLE (Candida and Staphylococcus Transmission: Longitudinal Evaluation) study. The CASTLE study was a prospective cohort study which recruited nulliparous women in late pregnancy in two maternity hospitals in Melbourne, Australia in 2009–2011. METHODS: Women completed questionnaires at recruitment and six time-points in the first eight weeks postpartum. Postpartum questionnaires asked about incidences of mastitis, nipple damage, milk supply, expressing practices and breastfeeding problems. Nasal and nipple swabs were collected from mothers and babies, as well as breast milk samples. All samples were cultured for S. aureus. “Time at risk” of mastitis was defined as days between birth and first occurrence of mastitis (for women who developed mastitis) and days between birth and the last study time-point (for women who did not develop mastitis). Risk factors for incidence of mastitis occurring during the time at risk (Incident Rate Ratios [IRR]) were investigated using a discrete version of the multivariable proportional hazards regression model. RESULTS: Twenty percent (70/346) of participants developed mastitis. Women had an increased risk of developing mastitis if they reported nipple damage (IRR 2.17, 95 % CI 1.21, 3.91), over-supply of breast milk (IRR 2.60, 95 % CI 1.58, 4.29), nipple shield use (IRR 2.93, 95 % CI 1.72, 5.01) or expressing several times a day (IRR 1.64, 95 % CI 1.01, 2.68). The presence of S. aureus on the nipple (IRR 1.72, 95 % CI 1.04, 2.85) or in milk (IRR 1.78, 95 % CI 1.08, 2.92) also increased the risk of developing mastitis. CONCLUSIONS: Nipple damage, over-supply of breast milk, use of nipple shields and the presence of S. aureus on the nipple or in breast milk increased the mastitis risk in our prospective cohort study sample. Reducing nipple damage may help reduce maternal breast infections.
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spelling pubmed-46811722015-12-17 Determinants of mastitis in women in the CASTLE study: a cohort study Cullinane, Meabh Amir, Lisa H. Donath, Susan M. Garland, Suzanne M. Tabrizi, Sepehr N. Payne, Matthew S. Bennett, Catherine M. BMC Fam Pract Research Article BACKGROUND: Mastitis is an acute, debilitating condition that occurs in approximately 20 % of breastfeeding women who experience a red, painful breast with fever. This paper describes the factors correlated with mastitis and investigates the presence of Staphylococcus aureus in women who participated in the CASTLE (Candida and Staphylococcus Transmission: Longitudinal Evaluation) study. The CASTLE study was a prospective cohort study which recruited nulliparous women in late pregnancy in two maternity hospitals in Melbourne, Australia in 2009–2011. METHODS: Women completed questionnaires at recruitment and six time-points in the first eight weeks postpartum. Postpartum questionnaires asked about incidences of mastitis, nipple damage, milk supply, expressing practices and breastfeeding problems. Nasal and nipple swabs were collected from mothers and babies, as well as breast milk samples. All samples were cultured for S. aureus. “Time at risk” of mastitis was defined as days between birth and first occurrence of mastitis (for women who developed mastitis) and days between birth and the last study time-point (for women who did not develop mastitis). Risk factors for incidence of mastitis occurring during the time at risk (Incident Rate Ratios [IRR]) were investigated using a discrete version of the multivariable proportional hazards regression model. RESULTS: Twenty percent (70/346) of participants developed mastitis. Women had an increased risk of developing mastitis if they reported nipple damage (IRR 2.17, 95 % CI 1.21, 3.91), over-supply of breast milk (IRR 2.60, 95 % CI 1.58, 4.29), nipple shield use (IRR 2.93, 95 % CI 1.72, 5.01) or expressing several times a day (IRR 1.64, 95 % CI 1.01, 2.68). The presence of S. aureus on the nipple (IRR 1.72, 95 % CI 1.04, 2.85) or in milk (IRR 1.78, 95 % CI 1.08, 2.92) also increased the risk of developing mastitis. CONCLUSIONS: Nipple damage, over-supply of breast milk, use of nipple shields and the presence of S. aureus on the nipple or in breast milk increased the mastitis risk in our prospective cohort study sample. Reducing nipple damage may help reduce maternal breast infections. BioMed Central 2015-12-16 /pmc/articles/PMC4681172/ /pubmed/26674724 http://dx.doi.org/10.1186/s12875-015-0396-5 Text en © Cullinane et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Cullinane, Meabh
Amir, Lisa H.
Donath, Susan M.
Garland, Suzanne M.
Tabrizi, Sepehr N.
Payne, Matthew S.
Bennett, Catherine M.
Determinants of mastitis in women in the CASTLE study: a cohort study
title Determinants of mastitis in women in the CASTLE study: a cohort study
title_full Determinants of mastitis in women in the CASTLE study: a cohort study
title_fullStr Determinants of mastitis in women in the CASTLE study: a cohort study
title_full_unstemmed Determinants of mastitis in women in the CASTLE study: a cohort study
title_short Determinants of mastitis in women in the CASTLE study: a cohort study
title_sort determinants of mastitis in women in the castle study: a cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681172/
https://www.ncbi.nlm.nih.gov/pubmed/26674724
http://dx.doi.org/10.1186/s12875-015-0396-5
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