Table 3.
Determinants of exclusive breastfeeding cessation in the early postnatal period among CALD mothers in South Western Sydney and Sydney Local Health Districts, 2014–2016 (N = 25,407).
| Study Factors | Complete Case Analysis | Multiple Imputation Analysis * | ||||||
|---|---|---|---|---|---|---|---|---|
| Unadjusted OR (95% CI) | p Value | Adjusted OR (95% CI) (a) | p Value | Unadjusted OR (95% CI) | p Value | Adjusted OR (95% CI) (a) | p Value | |
| Antenatal breastfeeding intention | ||||||||
| Yes | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| No | 31.11 (25.41–38.10) | <0.001 | 23.76 (18.63–30.30) | <0.001 | 31.11 (29.90–32.37) | <0.001 | 27.13 (26.04–28.27) | <0.001 |
| Undecided | 7.01 (5.69–8.64) | <0.001 | 6.15 (4.74–7.98) | <0.001 | 7.00 (6.72–7.30) | <0.001 | 6.38 (6.11–6.66) | <0.001 |
| Sociodemographic factors | ||||||||
| Supportive partner | ||||||||
| Yes | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| No | 1.81 (1.38–2.36) | <0.001 | 1.69 (1.20–2.38) | 0.003 | 1.66 (1.58–1.74) | <0.001 | 1.60 (1.52–1.69) | <0.001 |
| Socio-economic status | ||||||||
| Low | 1.00 | 1.00 | ||||||
| Middle | 0.67 (0.61–0.75) | <0.001 | 0.85 (0.72–0.99) | 0.044 | 0.67 (0.65–0.68) | <0.001 | 0.84 (0.82–0.86) | <0.001 |
| High | 0.36 (0.28–0.47) | <0.001 | 0.48 (0.32–0.71) | <0.001 | 0.36 (0.34–0.38) | <0.001 | 0.59 (0.56–0.63) | <0.001 |
| Maternal age group | ||||||||
| 20–34 years | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| <20 years | 1.76 (1.48–2.08) | <0.001 | 1.72 (1.37–2.15) | <0.001 | 1.75 (1.69–1.81) | <0.001 | 1.75 (1.69–1.81) | <0.001 |
| ≥35 years | 1.79 (1.02–3.15) | 0.044 | 1.91 (0.93–3.93) | 0.078 | 1.78 (1.60–1.99) | <0.001 | 1.61 (1.44–1.80) | <0.001 |
| Smoking status | ||||||||
| No | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Yes | 4.29 (3.45–5.33) | <0.001 | 3.39 (2.56–4.49) | <0.001 | 4.28 (4.10–4.47) | <0.001 | 3.81 (3.65–3.99) | <0.001 |
| Major nationality group | ||||||||
| Oceania | 1.00 | 1.00 | ||||||
| North-West Europe | 0.25 (0.15–0.41) | <0.001 | 0.49 (0.25–0.97) | 0.043 | 0.25 (0.23–0.28) | <0.001 | 0.47 (0.43–0.52) | <0.001 |
| Southern-Eastern Europe | 0.57 (0.45–0.73) | <0.001 | 0.73 (0.53–1.00) | 0.051 | 0.57 (0.55–0.60) | <0.001 | 0.71 (0.68–0.74) | <0.001 |
| North Africa and The Middle East | 0.67 (0.56–0.79) | <0.001 | 0.65 (0.51–0.82) | <0.001 | 0.67 (0.65–0.69) | <0.001 | 0.64 (0.62–0.67) | <0.001 |
| South-East Asia | 0.45 (0.38–0.53) | <0.001 | 0.46 (0.36–0.58) | <0.001 | 0.45 (0.43–0.46) | <0.001 | 0.47 (0.45–0.49) | <0.001 |
| North-East Asia | 0.24 (0.19–0.31) | <0.001 | 0.41 (0.29–0.56) | <0.001 | 0.24 (0.23–0.26) | <0.001 | 0.43 (0.41–0.45) | <0.001 |
| Southern and Central Asia | 0.11 (0.09–0.14) | <0.001 | 0.18 (0.13–0.24) | <0.001 | 0.11 (0.11–0.12) | <0.001 | 0.14 (0.14–0.15) | <0.001 |
| Americas | 0.37 (0.26–0.53) | <0.001 | 0.40 (0.24–0.66) | <0.001 | 0.37 (0.35–0.40) | <0.001 | 0.41 (0.38–0.44) | <0.001 |
| Sub-Saharan Africa | 0.21 (0.14–0.31) | <0.001 | 0.25 (0.15–0.41) | <0.001 | 0.21 (0.20–0.23) | <0.001 | 0.24 (0.23–0.26) | <0.001 |
| Health factors | ||||||||
| Antenatal depressive symptoms | ||||||||
| EPDS ≤ 9 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| EPDS 10–12 | 1.03 (0.86–1.23) | 0.783 | 1.10 (0.88–1.36) | 0.398 | 1.02 (0.99–1.06) | 0.161 | 1.00 (0.97–1.04) | <0.001 |
| EPDS ≥ 13 | 1.59 (1.33–1.91) | <0.001 | 1.50 (1.20–1.89) | <0.001 | 1.59 (1.53–1.64) | <0.001 | 1.57 (1.51–1.62) | <0.001 |
| Postnatal depressive symptoms | ||||||||
| EPDS ≤ 9 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| EPDS 10–12 | 0.911 (0.73–1.13) | 0.402 | 0.97 (0.73–1.30) | 0.860 | 0.92 (0.88–0.96) | <0.001 | 1.00 (0.96–1.04) | 0.885 |
| EPDS ≥ 13 | 1.61 (1.28–2.01) | <0.001 | 2.07 (1.55–2.77) | <0.001 | 1.57 (1.50–1.63) | <0.001 | 1.66 (1.59–1.73) | <0.001 |
| Psychosocial intimate partner violence | ||||||||
| No | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Yes | 1.47 (1.02–2.12) | 0.041 | 1.66 (1.10–2.53) | 0.017 | 1.46 (1.36–1.57) | <0.001 | 1.50 (1.39–1.61) | <0.001 |
| Physical intimate partner violence | ||||||||
| No | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Yes | 1.57 (1.06–2.31) | 0.023 | 1.49 (0.94–2.38) | 0.093 | 1.56 (1.45–1.69) | <0.001 | 1.62 (1.50–1.75) | <0.001 |
| Type of delivery | ||||||||
| Normal vaginal | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Assisted vaginal | 0.79 (0.67–0.94) | 0.008 | 0.90 (0.72–1.14) | 0.386 | 0.79 (0.76–0.82) | <0.001 | 0.96 (0.88–0.92) | 0.078 |
| Caesarean section | 1.36 (1.23–1.51) | <0.001 | 1.35 (1.18–1.55) | <0.001 | 1.36 (1.33–1.39) | <0.001 | 1.48 (1.45–1.52) | <0.001 |
| Pre-existing maternal health problems | ||||||||
| No | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Yes | 0.87 (0.76–1.00) | 0.054 | 1.02 (0.83–1.07) | 0.790 | 0.87 (0.85–0.89) | <0.001 | 0.95 (0.93–0.98) | 0.004 |
(a): adjusted for maternal body mass index, gender of the baby, maternal alcohol intake, Aboriginality and birthing facility location, as well as socioeconomic and health factors. * Sensitivity analyses following multiple imputations for missing values; pre-existing maternal health problems included diabetes mellitus and/or hypertension.