Association Between Breastfeeding and Long-Term Risk of Cardiovascular Disease.

Area of Science:

• Cardiovascular Health
• Maternal-Child Health
• Epidemiology

Background:

• Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of mortality globally.
• Gestational diabetes mellitus (GDM) is a known risk factor for future maternal ASCVD.
• The long-term health implications of breastfeeding, particularly concerning cardiovascular outcomes in mothers with a history of GDM, require further investigation.

Purpose of the Study:

• To determine if breastfeeding is associated with a reduced risk of long-term ASCVD.
• To investigate whether this association is modified by a history of gestational diabetes mellitus (GDM).

Main Methods:

• Secondary analysis of the prospective Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Follow-Up Study.
• Exposure: Any breastfeeding (yes/no).
• Outcomes: Estimated ASCVD risk (10- and 30-year) using Framingham Risk Score, assessed 10-14 years postpartum. Multivariable linear regression adjusted for covariates. Effect modification by GDM status was examined.

Main Results:

• Breastfeeding was associated with a lower estimated 10-year ASCVD risk (adjusted β -0.13) and 30-year ASCVD risk (adjusted β -0.36).
• The protective association of breastfeeding against ASCVD was significantly stronger in individuals with a history of GDM compared to those without.
• Interaction P-values for GDM status were .004 for 10-year ASCVD risk and .003 for 30-year ASCVD risk.

Conclusions:

• Breastfeeding is associated with a reduced long-term risk of atherosclerotic cardiovascular disease.
• This protective effect is particularly pronounced for women with a history of gestational diabetes mellitus.
• Promoting breastfeeding may be a beneficial strategy for improving long-term cardiovascular health in women, especially those with GDM.