TY - JOUR
T1 - Maternal metabolic conditions as predictors of breastfeeding outcomes
T2 - Insights from an Australian cohort study
AU - Rassie, Kate
AU - Dhungana, Raja Ram
AU - Mousa, Aya
AU - Teede, Helena
AU - Joham, Anju E
N1 - Funding Information:
The research on which this paper is based was conducted as part of the ALSWH by the University of Queensland and the University of Newcastle. We are grateful to the Australian Government Department of Health and Aged Care for funding, and to the participants who provided the survey data. Open access publishing facilitated by Monash University, as part of the Wiley \u2010 Monash University agreement via the Council of Australian University Librarians.
Funding Information:
This work received no specific funding from any agency in the public, commercial, or not\u2010for\u2010profit sectors. KR is supported by a National Health and Medical Research Council (NHMRC) Scholarship. AM and HT are supported by fellowships provided by the NHMRC.
Publisher Copyright:
© 2024 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).
PY - 2024/8
Y1 - 2024/8
N2 - Introduction: Breastfeeding represents an important opportunity to optimize health outcomes for both mother and infant, particularly in the context of maternal metabolic conditions such as diabetes and polycystic ovary syndrome. However, evidence suggests that women affected by these conditions breastfeed at reduced rates and durations. Our aim was to use the large, prospective, community-based Australian Longitudinal Study on Women's Health (ALSWH) to conduct an in-depth exploratory analysis of breastfeeding outcomes in Australian women affected by key maternal metabolic conditions. Material and Methods: Data from 12 920 pregnancies to 5605 women from the 1973–1978 birth cohort of the ALSWH were examined. Univariable and multivariable regression using generalized estimating equation models were applied to assess breastfeeding initiation and duration (outcome measures) in relation to key self-reported maternal metabolic diagnoses (pre-gestational type 1 and type 2 diabetes, gestational diabetes, and polycystic ovary syndrome; main explanatory variables). Key sociodemographic and clinical covariates were also considered. Results: Results showed no significant association between specific maternal metabolic diagnoses (pre-gestational or gestational diabetes, or polycystic ovary syndrome) and breastfeeding outcomes. However, maternal body mass index emerged as a key predictor of suboptimal breastfeeding outcomes. Pregnancies affected by maternal obesity were associated with a 2.1-fold increase in the odds of not initiating breastfeeding, after adjusting for other key variables (95% CI 1.67 to 2.60, p < 0.01). Maternal overweight and obesity were, respectively, associated with an adjusted 1.4-fold (95% CI 1.20 to 1.55, p < 0.01) and 1.8-fold increase (95% CI 1.60 to 2.10, p < 0.01) in the odds of a breastfeeding duration less than 6 months. Conclusions: Maternal obesity, rather than any specific maternal metabolic condition, appears to be a key predictor of breastfeeding outcomes in Australian women.
AB - Introduction: Breastfeeding represents an important opportunity to optimize health outcomes for both mother and infant, particularly in the context of maternal metabolic conditions such as diabetes and polycystic ovary syndrome. However, evidence suggests that women affected by these conditions breastfeed at reduced rates and durations. Our aim was to use the large, prospective, community-based Australian Longitudinal Study on Women's Health (ALSWH) to conduct an in-depth exploratory analysis of breastfeeding outcomes in Australian women affected by key maternal metabolic conditions. Material and Methods: Data from 12 920 pregnancies to 5605 women from the 1973–1978 birth cohort of the ALSWH were examined. Univariable and multivariable regression using generalized estimating equation models were applied to assess breastfeeding initiation and duration (outcome measures) in relation to key self-reported maternal metabolic diagnoses (pre-gestational type 1 and type 2 diabetes, gestational diabetes, and polycystic ovary syndrome; main explanatory variables). Key sociodemographic and clinical covariates were also considered. Results: Results showed no significant association between specific maternal metabolic diagnoses (pre-gestational or gestational diabetes, or polycystic ovary syndrome) and breastfeeding outcomes. However, maternal body mass index emerged as a key predictor of suboptimal breastfeeding outcomes. Pregnancies affected by maternal obesity were associated with a 2.1-fold increase in the odds of not initiating breastfeeding, after adjusting for other key variables (95% CI 1.67 to 2.60, p < 0.01). Maternal overweight and obesity were, respectively, associated with an adjusted 1.4-fold (95% CI 1.20 to 1.55, p < 0.01) and 1.8-fold increase (95% CI 1.60 to 2.10, p < 0.01) in the odds of a breastfeeding duration less than 6 months. Conclusions: Maternal obesity, rather than any specific maternal metabolic condition, appears to be a key predictor of breastfeeding outcomes in Australian women.
KW - breastfeeding
KW - diabetes mellitus
KW - lactation
KW - obesity
KW - polycystic ovary syndrome
UR - http://www.scopus.com/inward/record.url?scp=85192234413&partnerID=8YFLogxK
U2 - 10.1111/aogs.14868
DO - 10.1111/aogs.14868
M3 - Article
C2 - 38715284
AN - SCOPUS:85192234413
SN - 0001-6349
VL - 103
SP - 1570
EP - 1583
JO - Acta Obstetricia et Gynecologica Scandinavica
JF - Acta Obstetricia et Gynecologica Scandinavica
IS - 8
ER -
