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Table 3 Characteristics of the included studies investigating associations between breastfeeding and depressive disorders

From: Association of breastfeeding with mental disorders in mother and child: a systematic review and meta-analysis

Studyc

Country

Sample size (cases)

Outcome criteria

Age at outcome assessment, years

Exposure

Reference

Crude OR (95% CI)

Adjusted OR (95% CI)

Adjusted variables

NOS scorea

Cohort studies

 Zhong 2013 [33]

China

3582 (86)

MINI-KID 5.0

6–14

Neverb

Everb

2.07 (1.39–3.09)

1.88 (1.28–2.49)

Age, school attendance, parental marital status, family type, dominant caregivers

6

 De Mola 2016 [45]

Brazil

3542 (272)

MINI-KID 5.0

30

1–2.9 months

< 1 month

0.71 (0.51–0.97)

0.79 (0.53–1.16)

Sex, ancestry, birth weight, maternal age, maternal education, marital status, previous gestations, income at birth, smoking during pregnancy, type of delivery, assets index, mother nerve problems, father living together and father history of psychiatric illness

4

3–5.9 months

< 1 month

0.78 (0.57–1.08)

0.93 (0.63–1.38)

≥ 6 months

< 1 month

0.69 (0.51–0.95)

0.77 (0.53–1.12)

 Allen 1998 [36]

USA

579 (141)

K-SADS

16.4 ± 1.2

Never

Ever

1.66 (1.13–2.45)

A: 1.68 (1.13–2.47); B: 1.71 (1.14–2.56); C: 1.64 (1.07–2.51)

MA: prenatal variables that were significantly associated with adolescent psychiatric disorder; MB: maternal depression, family cohesion, family conflict, adolescent physical symptoms; MC: other adolescent psychiatric disorders

5

 Kwok 2013 [40]

China

5797 (261)

PHQ-9

11

Never

Mixed BF or EBFb < 3 months

NR

1.14 (0.87–1.49)

Sex, age, survey mode, SEP (parents’ education, parents’ occupation, household income), mother’s birthplace, birth weight-for-gestational age z-score, birth order, second hand smoke exposure and parents’ age at birth

7

     

Never

EBF ≥ 3 months

NR

0.77 (0.43–1.40)

 

 Huang 2019 [34]

China

1979 (227)

CBCL

6–11

< 6 months

Never

NR

0.79 (0.37–1.67)

Educational attainment of mothers, maternal medicine use during pregnancy, parents upbringing style, maternal alcohol drinking during pregnancy

6

     

≥ 6 months

Never

NR

0.45 (0.23–0.91)

 

Cross-sectional

 Liu 2023 [47]

United Kingdom

110,948 (53,690)

PHQ-9

> 50

Ever

Never

0.73 (0.71–0.75)

MSDP

0.86 (0.82–0.91)

NMSDP

0.82 (0.79–0.84)

Sex, age, 10 principle components of population structure, smoking, alcohol use, and Townsend deprivation index

6

  1. K-SADS Schedule for Affective Disorders and Schizophrenia for School-Age Children, MINI-KID Mini International Neuropsychiatric Interview for Children and Adolescents, MSDP maternal smoking during pregnancy, NMSDP no maternal smoking during pregnancy, NR not reported
  2. aNewcastle Ottawa (NOS) score: very good = 9–10, good = 7–8, satisfactory = 5–6, unsatisfactory = 0–4
  3. bAuthors defined breastfeeding exposure as whether child was breastfed before the age of 1 year or not
  4. cHayatbakhsh et al. (n = 4502, NOS = 6) did not report odds/risk ratios, providing comparisons of continuous variables within each subscale of The Youth Self Report (YSR) of the Child Behavior Check List (CBCL) only. Authors reported statistically significant association between breastfeeding and “Anxiety/depression” domain for ≥ 4 months vs. “never” regression coefficient (95% CI) − 0.43 (− 0.78, − 0.09) and − 0.36 (− 0.70, − 0.01), respectively in adjusted models; Oddy et al. (n = 2366, NOS = 8) used a composite outcome “internalising complaints” that includes withdrawn, somatic complaints, anxiety, and depression. BF < 6 months vs. ≥ 6 months OR 1.21 (95% CI 1.0–1.46)
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BMC Medicine

ISSN: 1741-7015

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