Medical College of Wisconsin Milwaukee, WI, United States
Objective: To examine the association between breastfeeding and maternal and child cardiometabolic health 10-14 years after delivery in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Follow-up Study.
Study Design: Secondary analysis of maternal-child dyads from HAPO Follow-up Study. The primary exposure was self-reported breastfeeding. Cardiometabolic outcomes included maternal measures of prediabetes, diabetes, hypertension, and hyperlipidemia, and child measures of glucose metabolism disorders, defined as either type 2 diabetes or impaired glucose tolerance, increased body fat defined as >85%tile, and increased body mass index (BMI) defined as BMI >85%tile. Multivariate logistic regression was used and adjusted for baseline maternal covariates at HAPO enrollment.
Results: Of 4,685 assessed maternal-child dyads, 79.7% reported breastfeeding. Mothers who breastfed were older at the time of follow-up (42.4y [38.8, 45.9] vs. 41.4y [37.1, 45.4], p=0.012), less likely to smoke (5.9% vs. 15.4%, p< 0.001), and more likely to use alcohol (35.0% vs. 22.9%, p< 0.001). When looking at the outcomes, mothers who breastfed had lower HOMA insulin resistance (1.8 [1.2, 2.8] vs. 1.9 [1.3, 3.0], p=0.001) and body fat percentage (34.9% vs. 35.9%, p=0.013). In multivariate analysis, breastfeeding was not associated with maternal cardiometabolic outcomes (Table). However, breastfeeding was associated with improved child cardiometabolic health, including lower rates of glucose metabolism disorders (10.7% vs. 13.7%; aOR 0.77, 95% CI 0.62, 0.96), impaired fasting glucose (6.1% vs. 9.4%; aOR 0.67, 95% CI 0.51, 0.88), HOMA insulin resistance >85% (13.0% vs. 15.6%; aOR 0.79, 95% CI 0.64, 0.98), body fat >85%, (13.6% vs. 17.5%; aOR 0.79, 95% CI 0.65, 0.97), and BMI >85% (26.6% vs. 30.0%; aOR 0.81, 95% CI 0.69, 0.96) (Table).
Conclusion: Breastfeeding was associated with improved child but not maternal cardiometabolic health 10-14 years postpartum, including lower rates of glucose metabolism disorders and lower rates of body fat and BMI being >85%tile.
