The BLIiNG study - Breastfeeding length and intensity in gestational diabetes and metabolic effects in a subsequent pregnancy: A cohort study.

Blood Glucose Breast Feeding Cohort Studies Diabetes Mellitus, Type 2 / epidemiology Diabetes, Gestational / epidemiology Female Humans Pilot Projects Pregnancy
Breastfeeding Cardiovascular disease Diabetes Gestational diabetes mellitus Lactation Pregnancy Type 2 diabetes mellitus

Journal

Midwifery
ISSN: 1532-3099
Titre abrégé: Midwifery
Pays: Scotland
ID NLM: 8510930

Informations de publication

Date de publication:
Apr 2022
Historique:
received: 07 06 2021
revised: 18 01 2022
accepted: 19 01 2022
pubmed: 22 2 2022
medline: 17 3 2022
entrez: 21 2 2022
Statut: ppublish

Résumé

Gestational diabetes mellitus is associated with higher risk for developing type 2 diabetes. Breastfeeding is protective against the development of type 2 diabetes after gestational diabetes. There are no data regarding the effect of breastfeeding on the development of recurrent gestational diabetes. Investigate the relationship of previous breastfeeding duration and intensity with the recurrence of gestational diabetes, and second pregnancy glucose tolerance test results. We conducted a questionnaire-based pilot cohort study, enrolling 210 women during a subsequent second pregnancy, after a gestational diabetes-affected first pregnancy. Models for length and intensity of breastfeeding as predictors of the oral glucose tolerance test and for diagnosis of gestational diabetes in second pregnancy were fitted and then adjusted for possible confounders. Recurrent gestational diabetes rate in the study cohort was 70% (n = 146). In a fully adjusted model high intensity breastfeeding was associated with a lower 2-hour glucose level on the oral glucose tolerance test (by 0.66 mmol/L, 95% CI [0.15-1.17]; p = 0.01) and breastfeeding greater than six months with a lower 1-hour glucose on the oral glucose tolerance test (by 0.67 mmol/L, 95% CI [0.16-1.19]; p = 0.01), compared to women who breastfed less intensively or for a shorter duration respectively. There was an 18% reduction in the risk of gestational diabetes if a woman breastfed for more than six months (RR 0.82, 95% CI [0.69-0.98]; p = 0.03). The association was attenuated in the fully adjusted model (RR 0.89, 95% CI [0.78-1.02]; p = 0.09). We found the risk of recurrent gestational diabetes was reduced by both increased duration and intensity of breastfeeding. Antenatal lactation education should be embedded into care pathways for women diagnosed with gestational diabetes.

Sections du résumé

BACKGROUND BACKGROUND
Gestational diabetes mellitus is associated with higher risk for developing type 2 diabetes. Breastfeeding is protective against the development of type 2 diabetes after gestational diabetes. There are no data regarding the effect of breastfeeding on the development of recurrent gestational diabetes.
OBJECTIVE OBJECTIVE
Investigate the relationship of previous breastfeeding duration and intensity with the recurrence of gestational diabetes, and second pregnancy glucose tolerance test results.
METHODS METHODS
We conducted a questionnaire-based pilot cohort study, enrolling 210 women during a subsequent second pregnancy, after a gestational diabetes-affected first pregnancy. Models for length and intensity of breastfeeding as predictors of the oral glucose tolerance test and for diagnosis of gestational diabetes in second pregnancy were fitted and then adjusted for possible confounders.
RESULTS RESULTS
Recurrent gestational diabetes rate in the study cohort was 70% (n = 146). In a fully adjusted model high intensity breastfeeding was associated with a lower 2-hour glucose level on the oral glucose tolerance test (by 0.66 mmol/L, 95% CI [0.15-1.17]; p = 0.01) and breastfeeding greater than six months with a lower 1-hour glucose on the oral glucose tolerance test (by 0.67 mmol/L, 95% CI [0.16-1.19]; p = 0.01), compared to women who breastfed less intensively or for a shorter duration respectively. There was an 18% reduction in the risk of gestational diabetes if a woman breastfed for more than six months (RR 0.82, 95% CI [0.69-0.98]; p = 0.03). The association was attenuated in the fully adjusted model (RR 0.89, 95% CI [0.78-1.02]; p = 0.09).
CONCLUSIONS AND IMPLICATIONS FOR PRACTICE CONCLUSIONS
We found the risk of recurrent gestational diabetes was reduced by both increased duration and intensity of breastfeeding. Antenatal lactation education should be embedded into care pathways for women diagnosed with gestational diabetes.

Identifiants

DOI: 10.1016/j.midw.2022.103262 PMID: 35189450
pubmed: 35189450
pii: S0266-6138(22)00014-6
doi: 10.1016/j.midw.2022.103262
pii:
doi:

Substances chimiques

Blood Glucose 0

Types de publication

Journal Article

Langues

eng

Pagination

103262

Informations de copyright

Copyright © 2022. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of competing interest None declared.

Auteurs

Sarah J Melov (SJ)

Reproduction and Perinatal Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Westmead Institute for Maternal and Fetal Medicine, Women's and Newborn Health, Westmead Hospital, Westmead, NSW, Australia. Electronic address: sarah.melov@health.nsw.gov.au.

Lisa White (L)

Division of Women's and Children's, Blacktown and Mount Druitt Hospitals, Blacktown, NSW, Australia. Electronic address: lisa.white@health.nsw.gov.au.

Michelle Simmons (M)

Women's and Newborn Health, Westmead Hospital, Westmead, NSW, Australia. Electronic address: michelle.simmons@health.nsw.gov.au.

Adrienne Kirby (A)

NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia. Electronic address: adrienne.kirby@sydney.edu.au.

Virginia Stulz (V)

Western Sydney University, Nepean Hospital, Centre for Nursing & Midwifery Research, Nepean Hospital, Penrith, NSW, Australia. Electronic address: v.stulz@westernsydney.edu.au.

Suja Padmanabhan (S)

Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, NSW, Australia. Electronic address: suja.padmanabhan@sydney.edu.au.

Thushari I Alahakoon (TI)

Westmead Institute for Maternal and Fetal Medicine, Women's and Newborn Health, Westmead Hospital, Westmead, NSW, Australia; Discipline of Obstetrics Gynaecology and Neonatology, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. Electronic address: indika.alahakoon@health.nsw.gov.au.

Dharmintra Pasupathy (D)

Reproduction and Perinatal Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. Electronic address: dharmintra.pasupathy@sydney.edu.au.

N Wah Cheung (NW)

Reproduction and Perinatal Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, NSW, Australia; Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia. Electronic address: wah.cheung@sydney.edu.au.

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Classifications MeSH

questionsmedicales.fr › Glucides › Sucres › Oses › Hexose › Glucose › Glycémie › The BLIiNG study - Breastfeeding length and...
questionsmedicales.fr › Phénomènes physiologiques › Alimentation et nutrition › Phénomènes physiologiques nutritionnels › Comportement alimentaire › Allaitement naturel › The BLIiNG study - Breastfeeding length and...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › The BLIiNG study - Breastfeeding length and...
questionsmedicales.fr › Maladies endocriniennes › Diabète › Diabète de type 2 › The BLIiNG study - Breastfeeding length and...
questionsmedicales.fr › Maladies endocriniennes › Diabète › Diabète gestationnel › The BLIiNG study - Breastfeeding length and...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › The BLIiNG study - Breastfeeding length and...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Projets pilotes › The BLIiNG study - Breastfeeding length and...
questionsmedicales.fr › Phénomènes physiologiques des appareils urinaire et reproducteur › Phénomènes physiologiques de la reproduction › Reproduction › Grossesse › The BLIiNG study - Breastfeeding length and...