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Diabetes Metab Res Rev. 2019 Mar;35(3):e3115. doi: 10.1002/dmrr.3115. Epub 2019 Jan 9.

Lactation intensity and duration to postpartum diabetes and prediabetes risk in women with gestational diabetes.

Author information

1
Pennington Biomedical Research Center, Baton Rouge, LA.
2
Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Six People's Hospital, Shanghai, China.
3
Tianjin Women's and Children's Health Center, Tianjin, China.
4
Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
5
Department of Epidemiology, School of Public Health, Tianjin Medical University, Tianjin, China.
6
Population Cancer Research program, Dalhousie University, Halifax, Canada.
7
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
8
Department of Public Health, University of Helsinki, Helsinki, Finland.

Abstract

OBJECTIVE:

To investigate the association of lactation intensity and duration with postpartum diabetes and prediabetes risks among Chinese women with a history of gestational diabetes (GDM).

METHODS:

We included 1260 women with a history of GDM who participated in the whole population's GDM universal screening survey by using the 1999 World Health Organization's criteria. Lactation intensity and lactation duration were collected by a standardized questionnaire. Postpartum diabetes and prediabetes risk were confirmed by an oral glucose tolerance test.

RESULTS:

During a mean postpartum period of 3.65 years, we identified 114 cases of diabetes and 417 cases of prediabetes. The multivariable-adjusted hazard ratios based on different lactation intensity (exclusive formula, mixed feeding, and exclusive lactation) were 1.00, 0.68, 0.45 for diabetes (Ptrend  = 0.008), and 1.00, 0.74, and 0.61 for prediabetes (Ptrend  = 0.006), respectively. The multivariable-adjusted hazard ratios associated with different lactation duration (none, 0-6 months, 6-12 months, 12-18 months, and ≥18 months) were 1.00, 0.66, 0.42, 0.66, and 0.25 for diabetes (Ptrend  = 0.013), and 1.00, 0.82, 0.62, 0.67, and 0.63 for prediabetes (Ptrend  = 0.021), respectively. A restricted cubic spline curve showed a graded inverse association of lactation duration with the risks of diabetes and prediabetes (Ptrend  < 0.001).

CONCLUSIONS:

Higher-lactation intensity and longer-lactation duration were significantly associated with lower risks of postpartum diabetes and prediabetes among Chinese women with a history of GDM.

KEYWORDS:

diabetes; gestational diabetes; lactation; prediabetes

PMID:
30548991
PMCID:
PMC6442676
[Available on 2020-03-01]
DOI:
10.1002/dmrr.3115
[Indexed for MEDLINE]

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