American journal of perinatology | 2021
Breastfeeding Associated with Lower Prevalence of Metabolic Syndrome in Women with Gestational Diabetes in the Very Early Postpartum Period.
Abstract
OBJECTIVE\nThe 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.\n\n\nSTUDY DESIGN\nWe 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 NCEP-ATP III criteria. We defined breastfeeding as currently breastfeeding or not currently breastfeeding for the main analysis.\n\n\nRESULTS\nOf 181 women enrolled in BABI, 178 were included in this analysis (3 excluded for missing lipids). Thirty-four % 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% 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).\n\n\nCONCLUSIONS\nIn a diverse population of women with recent GDM, there was lower prevalence of MetS in women breastfeeding compared to those not breastfeeding in the very early postpartum period. This study extends the findings of an association of breastfeeding with MetS previously reported at timepoints more remote from pregnancy to the very early pp period and to an ethnically and racially diverse population.