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Article

Cumulative Lactation and Clinical Metabolic Outcomes at Mid-Life among Women with a History of Gestational Diabetes

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Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA
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Department of Medicine, University of Washington, Seattle, WA 98195, USA
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Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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Department of Epidemiology, University of Washington, Seattle, WA 98195, USA
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Glotech, Rockville, MD 20850, USA
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Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70118, USA
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Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Steno Diabetes Center, 2730 Copenhagen, Denmark
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Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA
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Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institute, 2300 Copenhagen, Denmark
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Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, 2400 Frederiksberg, Denmark
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Center for Pregnant Women with Diabetes, Department of Obstetrics, 2100 Copenhagen, Denmark
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Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark
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The EMMES Corporation, Rockville, MD 20850, USA
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Department of Clinical and Preventive Nutritional Sciences, School of Health Professions, Rutgers University, Newark, NJ 08854, USA
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Division of Research, Kaiser Permanente Northern California, Oakland, CA 94611, USA
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Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94143, USA
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Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA
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Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
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Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
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NUS Bia–Echo Asia Centre for Reproductive Longevity and Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
*
Authors to whom correspondence should be addressed.
Academic Editor: Annunziata Lapolla
Nutrients 2022, 14(3), 650; https://doi.org/10.3390/nu14030650
Received: 12 January 2022 / Revised: 28 January 2022 / Accepted: 31 January 2022 / Published: 3 February 2022
Lactation is associated with a lower risk of subsequent cardiometabolic disease among parous women; however, the underlying mechanisms are unknown. Further, the potential protective effects of lactation on cardiometabolic risk markers at mid-life among high-risk women with past gestational diabetes (GDM) are not established. Using data from the Diabetes & Women’s Health Study (2012–2014; n = 577), a longitudinal cohort of women with past GDM from the Danish National Birth Cohort (1996–2002), we assessed associations of cumulative lactation duration (none, <6 months, 6–12 months, ≥12–24 months, and ≥24 months) with clinical metabolic outcomes (including type 2 diabetes [T2D], prediabetes, and obesity) and cardiometabolic biomarkers (including biomarkers of glucose/insulin metabolism, fasting lipids, inflammation, and anthropometrics) 9–16 years after enrollment when women were at mid-life. At follow-up, women were 43.9 years old (SD 4.6) with a BMI of 28.7 kg/m2 (IQR 24.6, 33.0); 28.6% of participants had T2D, 39.7% had prediabetes, and 41.2% had obesity. Relative risks (95% CI) of T2D for 0–6, 6–12, 12–24, and ≥24 months of cumulative lactation duration compared to none were 0.94 (0.62,1.44), 0.88 (0.59,1.32), 0.73 (0.46,1.17), and 0.71 (0.40,1.27), respectively. Cumulative lactation duration was not significantly associated with any other clinical outcome or continuous biomarker. In this high-risk cohort of middle-aged women with past GDM, T2D, prediabetes, and obesity were common at follow-up, but not associated with history of cumulative lactation duration 9–16 years after the index pregnancy. Further studies in diverse populations among women at mid-age are needed to understand associations of breastfeeding with T2D. View Full-Text
Keywords: lactation; breastfeeding; pregnancy; women; diabetes; obesity; biomarkers lactation; breastfeeding; pregnancy; women; diabetes; obesity; biomarkers
MDPI and ACS Style

Wander, P.L.; Hinkle, S.N.; Enquobahrie, D.A.; Wu, J.; Ley, S.H.; Grunnet, L.G.; Chavarro, J.E.; Li, M.; Bjerregaard, A.A.; Liu, A.; Damm, P.; Sherman, S.; Rawal, S.; Zhu, Y.; Chen, L.; Mills, J.L.; Hu, F.B.; Vaag, A.; Olsen, S.F.; Zhang, C. Cumulative Lactation and Clinical Metabolic Outcomes at Mid-Life among Women with a History of Gestational Diabetes. Nutrients 2022, 14, 650. https://doi.org/10.3390/nu14030650

AMA Style

Wander PL, Hinkle SN, Enquobahrie DA, Wu J, Ley SH, Grunnet LG, Chavarro JE, Li M, Bjerregaard AA, Liu A, Damm P, Sherman S, Rawal S, Zhu Y, Chen L, Mills JL, Hu FB, Vaag A, Olsen SF, Zhang C. Cumulative Lactation and Clinical Metabolic Outcomes at Mid-Life among Women with a History of Gestational Diabetes. Nutrients. 2022; 14(3):650. https://doi.org/10.3390/nu14030650

Chicago/Turabian Style

Wander, Pandora L., Stefanie N. Hinkle, Daniel A. Enquobahrie, Jing Wu, Sylvia H. Ley, Louise G. Grunnet, Jorge E. Chavarro, Mengying Li, Anne A. Bjerregaard, Aiyi Liu, Peter Damm, Seth Sherman, Shristi Rawal, Yeyi Zhu, Liwei Chen, James L. Mills, Frank B. Hu, Allan Vaag, Sjurdur F. Olsen, and Cuilin Zhang. 2022. "Cumulative Lactation and Clinical Metabolic Outcomes at Mid-Life among Women with a History of Gestational Diabetes" Nutrients 14, no. 3: 650. https://doi.org/10.3390/nu14030650

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