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Lactation Duration and Midlife Atherosclerosis.

Erica P Gunderson1, Charles P Quesenberry, Xian Ning

  • 1Division of Research, Kaiser Permanente Northern California, Oakland, and the Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; the Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota; Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado; and the Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama.

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Shorter lactation duration is linked to increased atherosclerosis in midlife women. Longer breastfeeding may reduce cardiovascular disease risk, indicating long-term vascular benefits.

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Area of Science:

  • Cardiovascular disease research
  • Women's health
  • Epidemiology

Background:

  • Atherosclerosis is a major cause of cardiovascular disease in women.
  • Lactation is a unique physiological state in women with potential long-term health implications.
  • Understanding factors influencing atherosclerosis development in midlife women is crucial for preventive strategies.

Purpose of the Study:

  • To investigate the association between lactation duration and subclinical atherosclerosis in midlife women.
  • To determine if this association is independent of prepregnancy cardiometabolic and traditional risk factors.

Main Methods:

  • Prospective cohort study (Coronary Artery Risk Development in Young Adults) with 2,014 women followed for 20 years.
  • Analysis included 846 women with measured common carotid intima-media thickness (a marker of atherosclerosis) at follow-up.
  • Lactation duration was categorized, and associations with intima-media thickness were assessed using multiple linear regression.

Main Results:

  • A graded inverse association was observed between lactation duration and common carotid intima-media thickness.
  • Women with 10 months or more of lactation had significantly lower intima-media thickness compared to those with less than 1 month, even after adjusting for multiple risk factors.
  • The association was modestly attenuated by mediators like BMI and systolic blood pressure.

Conclusions:

  • Shorter lactation duration is independently associated with subclinical atherosclerosis in midlife women.
  • The observed differences in carotid artery intima-media thickness suggest potential accelerated vascular aging with shorter lactation.
  • Lactation may confer long-term cardiovascular disease risk reduction benefits for women.