Background The World Health Organization recommends mothers and infants be in direct skin-to-skin contact immediately after birth and initiate breastfeeding as soon as possible. Little is known in women with schizophrenia. Methods We conducted a population-based cohort study using administrative health data from Ontario, Canada (2012–2014), comparing women with (n = 471) and without schizophrenia (n = 218 435), and their infants, on the primary outcomes of any skin-to-skin contact and opportunity to initiate breastfeeding within the first 2 h after birth. For dyads with available data, secondary outcomes of intention to breastfeed, breastfeeding support, any breastmilk, and exclusive breastmilk at discharge were assessed. Modified Poisson regression was used to generate relative risks (aRR) and 95% confidence intervals (CI), adjusted for maternal age, parity, neighbourhood income, region of residence, smoking in pregnancy, and maternal medical and non-psychotic psychiatric comorbidity for all outcomes. Results Maternal schizophrenia was associated with lower likelihood of skin-to-skin contact (65.2% vs 78.1%; aRR 0.88, 95% CI: 0.82–0.94), and breastfeeding initiation post-delivery (38.9% vs 52.6% aRR 0.80, CI: 0.71–0.90) compared to dyads unexposed to maternal schizophrenia. Secondary outcomes followed a similar pattern. The magnitude of the effect was slightly less when restricting the cohort to full-term, vaginal deliveries, not admitted to NICU, and infant not discharged to social services. Conclusions Reduced maternal-infant skin-to-skin contact and breastfeeding initiation immediately after birth may significantly impact maternal–child bonding and the establishment breastfeeding in this population. Mothers with schizophrenia may require individualized support to promote these WHO recommended hospital practices in the early post-natal period.

中文翻译：

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母体精神分裂症、皮肤接触和婴儿喂养开始

背景 世界卫生组织建议母亲和婴儿在出生后立即进行直接的皮肤接触，并尽快开始母乳喂养。对患有精神分裂症的女性知之甚少。方法 我们使用加拿大安大略省 (2012-2014) 的行政健康数据进行了一项基于人群的队列研究，比较了患有 (n = 471) 和非精神分裂症的女性 (n = 218 435) 及其婴儿的主要结局出生后 2 小时内的任何皮肤接触和开始母乳喂养的机会。对于有可用数据的二元组，评估了母乳喂养意向、母乳喂养支持、任何母乳和出院时纯母乳的次要结果。修正泊松回归用于生成相对风险 (aRR) 和 95% 置信区间 (CI)，对所有结局的孕产妇年龄、胎次、邻里收入、居住地区、怀孕期间吸烟以及孕产妇内科和非精神病性精神病合并症进行了调整。结果 孕产妇精神分裂症与皮肤接触的可能性较低（65.2% vs 78.1%；aRR 0.88, 95% CI: 0.82–0.94）和分娩后开始母乳喂养（38.9% vs 52.6% aRR 0.80, CI : 0.71–0.90) 与未暴露于母体精神分裂症的二元组相比。次要结果遵循类似的模式。当将队列限制为足月、阴道分娩、未入住 NICU 和未出院接受社会服务的婴儿时，影响的幅度略小。结论 减少母婴皮肤接触和出生后立即开始母乳喂养可能会显着影响该人群的母婴关系和母乳喂养的建立。患有精神分裂症的母亲可能需要个性化的支持，以在产后早期推广这些 WHO 推荐的医院做法。