Postpartum Breastfeeding and Cardiovascular Risk Assessment in Women Following Pregnancy Complications

Breastfeeding is associated with lower cardiovascular (CV) risk over the long-term, however, less is known about its immediate effects among women with a recent complicated pregnancy. The objective of this study is to investigate the short-term effects of breastfeeding on markers of cardiovascular disease risk among women ∼6 months after a pregnancy complicated by a hypertensive disorder, gestational diabetes, intrauterine growth restriction, abruption, or preterm birth. Our cross-sectional analysis includes 622 women seen at 6 months postpartum (interquartile range: 5.7-6.7) between November 2011 and December 2017 at a tertiary care center. Self-reported breastfeeding status and measured CV risk factors were assessed at the same visit. CV risk factors were compared between women who did not breastfeed (n = 100, 16%), those who breastfed for less than 6 months (n = 315, 51%), and those who breastfed for 6 months or more (n = 207, 33%) using multivariate logistic and linear regression. Increased breastfeeding duration significantly decreased the likelihood of metabolic syndrome (adjusted odds ratio [95% confidence interval; CI]: 0.89 [0.79-0.99]), abnormal fasting glucose (0.79 [0.64-0.96]), and ratio of total cholesterol to high-density lipoprotein-cholesterol (HDL-C) (0.86 [0.78-0.95]). Furthermore, body mass index (estimated beta coefficients [95% CI] -0.10 [-0.18 to -0.02]), fasting glucose (-0.05 [-0.08 to -0.02]), triglycerides (-0.07 [-0.10 to -0.04]), and ratio of total cholesterol to HDL-C (-0.06 [-0.10 to -0.03]) also decreased with increased breastfeeding duration, while HDL-C increased (0.02 [-0.01 to -0.04]). Our findings suggest that breastfeeding is associated with decreased indicators of CV risk in a cohort of women with recent pregnancy complication.