The number of pregnant women with congenital heart disease (CHD) is rising, and the disease poses increased risks of cardiovascular and obstetric complications during pregnancy, potentially impacting breastfeeding success. This study aimed to investigate breastfeeding in primiparous women with CHD compared to primiparous women without CHD, and to examine potential hindering factors for breastfeeding in women with CHD. The data were gathered between 2014 and 2019 and obtained by merging the Swedish Congenital Heart Disease Register (SWEDCON) with the Swedish Pregnancy Register. Primiparous women ≥ 18 years of age with CHD (n = 578) were matched by age and municipality to 3049 women without CHD, giving birth after 22 gestational weeks. Multivariable logistic regression analysis was used to identify factors associated with non-breastfeeding in women with CHD. Fewer women with CHD breastfed than women without CHD two days (94% vs. 97%, p = 0.001) and four weeks after birth (84% vs. 89%, p = 0.006). When all women were analysed, having CHD was associated with non-breastfeeding at both two days and four weeks after birth. For women with CHD, body mass index (BMI) ≥ 30 (OR 3.1; 95% CI 1.4, 7.3), preterm birth (OR 6.4; 95% CI 2.1, 19.0), self-reported history of psychiatric illness (OR 2.4; 95% CI 1.2, 5.1), small for gestational age (OR 4.2; 95% CI 1.4, 12.2), and New York Heart Association Stages of Heart Failure class II − III (OR 6.0; 95% CI 1.4, 26.7) were associated with non-breastfeeding two days after birth. Four weeks after birth, factors associated with non-breastfeeding were BMI ≥ 30 (OR 4.3; 95% CI 2.1, 9.0), self-reported history of psychiatric illness (OR 2.2; 95% CI 1.2, 4.2), and preterm birth (OR 8.9; 95% CI 2.8, 27.9). The study shows that most women with CHD breastfeed, however, at a slightly lower proportion compared to women without CHD. In addition, factors related to the heart disease were not associated with non-breastfeeding four weeks after birth. Since preterm birth, BMI ≥ 30, and psychiatric illness are associated with non-breastfeeding, healthcare professionals should provide greater support to women with CHD having these conditions.

中文翻译：

---

患有先天性心脏病的初产妇的母乳喂养——一项登记研究

患有先天性心脏病 (CHD) 的孕妇人数正在增加，这种疾病会增加怀孕期间发生心血管和产科并发症的风险，可能会影响母乳喂养的成功。本研究旨在比较患有先心病的初产妇女与没有先心病的初产妇女的母乳喂养情况，并探讨患有先心病的初产妇女母乳喂养的潜在阻碍因素。这些数据是在 2014 年至 2019 年期间收集的，是通过将瑞典先天性心脏病登记处 (SWEDCON) 与瑞典妊娠登记处合并而获得的。将 ≥ 18 岁患有 CHD 的初产妇女 (n = 578) 按年龄和城市与 3049 名无 CHD 的妇女进行匹配，在 22 孕周后分娩。使用多变量逻辑回归分析来确定与先心病女性非母乳喂养相关的因素。出生后两天（94% vs. 97%，p = 0.001）和四周（84% vs. 89%，p = 0.006），患有 CHD 的女性接受母乳喂养的人数少于无 CHD 的女性。对所有女性进行分析后发现，患有先天性心脏病与出生后两天和四周内的非母乳喂养有关。对于患有 CHD 的女性，体重指数 (BMI) ≥ 30（OR 3.1；95% CI 1.4，7.3）、早产（OR 6.4；95% CI 2.1，19.0）、自我报告的精神疾病史（OR 2.4；95% CI 1.4，19.0）。 95% CI 1.2, 5.1）、小于胎龄（OR 4.2；95% CI 1.4, 12.2）和纽约心脏协会心力衰竭分期 II – III 级（OR 6.0；95% CI 1.4, 26.7）相关出生后两天非母乳喂养。出生后 4 周，与非母乳喂养相关的因素包括 BMI ≥ 30（OR 4.3；95% CI 2.1，9.0）、自我报告的精神疾病史（OR 2.2；95% CI 1.2，4.2）和早产（ OR 8.9；95% CI 2.8, 27.9)。研究表明，大多数患有先心病的女性母乳喂养的比例略低于没有先心病的女性。此外，与心脏病相关的因素与出生后4周非母乳喂养无关。由于早产、BMI ≥ 30 和精神疾病与非母乳喂养有关，医疗保健专业人员应该为患有这些疾病的先心病女性提供更多支持。