乳房植入物是否會影響哺乳?

 

許馨予醫師提供,本會常務理事康寧醫院的小兒科主任翁少萍醫師審訂與會員們分享「乳房植入物是否會影響哺乳?」

Do Breast Implants Influence Breastfeeding? A Meta-Analysis of Comparative Studies乳房植入物是否會影響哺乳?

背景:使用乳房植入物的隆乳手術是世界上最常見的整型手術。許多女性在生育年齡時選擇接受乳房植入物整型,雖然它的長期效果仍有爭議。

研究目地:我們進行整合分析以研究隆乳手術對哺乳的影響。我們也比較乳暈周和乳房下切口的純母乳哺乳率。

研究方法:

系統性收集在2018 5月前,曾發表於PubMed, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ScienceDirect, Scopus, and Web of Science ,有關乳房植入物與哺乳的比較研究。

研究結果:

共有4篇世代研究及1篇橫斷性研究包含在內。有接受乳房植入物的女性,其純母乳哺育率明顯低於沒有乳房植入物的女性(pooled relative risk = 0.63, 95%

confidence interval [0.46, 0.86],)母乳哺育率也較低( pooled relative risk = 0.88, 95% confidence interval [0.81,0.95])

並沒有証據顯示乳暈周圍切口與純母乳哺育率下降有關(pooled relative risk = 0.84, 95% confidence interval [0.45, 1.58].)

結論:有乳房植入物的女性較難建立哺乳尤其是純母乳哺育。乳暈周圍切口並無降低純母乳哺乳率。

Abstract

Background: Aesthetic breast implant augmentation surgery is the most popular plastic surgery worldwide. Many women choose to receive breast implants during their reproductive ages, although the long-term effects are still controversial.

Research aim: We conducted a meta-analysis to assess the influence of aesthetic breast augmentation on breastfeeding. We also compared the exclusive breastfeeding rates of periareolar versus inframammary incision.

Methods: A systematic search for comparative studies about breast implants and breastfeeding was performed in PubMed, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ScienceDirect, Scopus, and Web of Science through

May 2018. Meta-analysis was conducted with a random-effects model (or fixed effects, if heterogeneity was absent).

Results: Four cohorts and one cross-sectional study were included. There was a significant reduction in the exclusive breastfeeding rate for women with breast implants compared with women without implants, pooled relative risk = 0.63, 95%

confidence interval [0.46, 0.86], as well as the breastfeeding rate, pooled relative risk = 0.88, 95% confidence interval [0.81,0.95]. There was no evidence that periareolar incision was associated with a reduction in the exclusive breastfeeding rate, pooled relative risk = 0.84, 95% confidence interval [0.45, 1.58].

Conclusion: Participants with breast implants are less likely to establish breastfeeding, especially exclusive breastfeeding. Periareolar incision does not appear to reduce the exclusive breastfeeding rate.

本研究重點訊息:

  • 美容乳房植入隆胸手術是全球最受歡迎的整形手術。儘管對母乳哺育的影響仍有爭議,但許多女性在育齡期間選擇接受乳房植入。
  • 與沒有植入物的女性相比,懷孕前乳房植入的女性更不可能建立母乳哺育,特別是要達到純母乳哺育。
  • 不同的手術方式(切口)對純母乳哺育率並沒有影響。
  • 在植入隆胸後哺乳確實是可行且安全的事實背後,雖然研究顯示有植入的母親之母乳哺育率比較低,這不應成為隆胸手術的禁忌,而反而應該是要對這特定病患群作改善對其哺乳的諮詢和支持。