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Am J Perinatol 2024; 41(01): 072-081
DOI: 10.1055/a-1674-5724
Original Article

Breastfeeding Associated with Lower Prevalence of Metabolic Syndrome in Women with Gestational Diabetes in the Very Early Postpartum Period

Rachel A. Blair   *
1   Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham & Women's Hospital, Boston, Massachusetts
,
João Sérgio Neves   *
2   Department of Endocrinology, Diabetes and Metabolism, São João University Hospital Center, Porto, Portugal
3   Department of Surgery and Physiology, Cardiovascular Research and Development Center, Faculty of Medicine University of Porto, Porto, Portugal
,
Jacinda M. Nicklas
4   Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
,
Christine E. Horn
1   Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham & Women's Hospital, Boston, Massachusetts
,
Geraldine Skurnik
1   Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham & Women's Hospital, Boston, Massachusetts
,
Ellen W. Seely
1   Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham & Women's Hospital, Boston, Massachusetts
› Institutsangaben Funding This study was funded by the Centers of Disease Control and Prevention (grant no: HHSD2002013M53968B).
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Abstract

Objective The aim of this study is to examine the association of breastfeeding with metabolic syndrome (MetS) in women with recent gestational diabetes mellitus (GDM) in the very early postpartum (PP) period.

Study Design We performed a secondary analysis of the Balance After Baby Intervention (BABI) study which enrolled women with recent GDM. Data collected during an early (~8 weeks) PP visit were used in this analysis. At this visit, weight, height, waist circumference (WC), blood pressure (BP), fasting plasma glucose (FPG), and lipids were obtained. MetS was classified per National Cholesterol Education Program Adult Treatment Program III (NCEP-ATP III) criteria. We defined breastfeeding as currently breastfeeding or not currently breastfeeding for the main analysis.

Results Of 181 women enrolled in BABI, 178 were included in this analysis (3 excluded for missing lipids). Thirty-four percent were Hispanic. Of non-Hispanics, 31.5% were White, 18.5% Asian, and 12.9% Black/African American. The prevalence of MetS was 42.9% in women not breastfeeding versus 17.1% in women breastfeeding (p < 0.001; adjusted odds ratio [aOR] = 0.16 [95% confidence interval (CI): 0.06–0.41]). Breastfeeding women had significantly lower odds of FPG ≥100 mg/dL (aOR = 0.36 [95% CI: 0.14–0.95], p = 0.039), HDL < 50 mg/dL (aOR = 0.19 [95% CI: 0.08–0.46], p < 0.001), and triglycerides (TG) ≥ 150 mg/dL (aOR = 0.26 [95% CI: 0.10–0.66], p = 0.005). When evaluated as continuous variables, WC, FPG, and TG were significantly lower and HDL significantly higher in women breastfeeding in the very early PP period (vs. not breastfeeding).

Conclusion In a diverse population of women with recent GDM, there was lower prevalence of MetS in women breastfeeding compared with those not breastfeeding in the very early PP period. This study extends the findings of an association of breastfeeding with MetS previously reported at time points more remote from pregnancy to the very early PP period and to an ethnically and racially diverse population.

Key Points

  • MetS prevalence in women with recent GDM was lower in breastfeeding than not breastfeeding women.

  • FPG, HDL, WC, and TG were improved in the breastfeeding group.

  • This study extends prior findings to the very early PP period and to a diverse population.

Keywords

women's health - metabolic syndrome - breastfeeding - gestational diabetes mellitus - lactation - postpartum

* These authors contributed equally to the article.




Publikationsverlauf

Eingereicht: 13. April 2021

Angenommen: 03. Oktober 2021

Accepted Manuscript online:
20. Oktober 2021

Artikel online veröffentlicht:
14. Dezember 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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