Am J Perinatol 2018; 35(14): 1339-1345
DOI: 10.1055/s-0038-1626713
SMFM Fellowship Series Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Association of Metabolic Dysfunction with Breastfeeding Outcomes in Gestational Diabetes

Angelica V. Glover
1  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
,
Diane C. Berry
2  School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
,
Todd A. Schwartz
2  School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
3  Department of Biostatistics, Gillings School of Global Public Health, Chapel Hill, North Carolina
,
Alison M. Stuebe
1  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
4  Carolina Global Breastfeeding Institute, Department of Maternal and Child Health, Gillings School of Global Public Health, Chapel Hill, North Carolina
› Author Affiliations
Funding This study was partially funded by the National Institutes of Health: The National Institute of Diabetes and Digestive and Kidney Disease, 1R21DK092750–01A1.
Further Information

Publication History

07 September 2017

28 December 2017

Publication Date:
02 February 2018 (online)

Abstract

Objective To evaluate the relationship between prenatal metabolic markers and breastfeeding outcomes in women with gestational diabetes mellitus (GDM).

Study Design Secondary analysis of a cluster-randomized trial of a lifestyle intervention to improve metabolic health among women with GDM. Women were enrolled between 22 and 36 weeks' gestation and followed through 10 months postpartum. Metabolic markers were measured at enrollment. Women reported when they stopped breastfeeding, whether they breastfed as long as desired, and when they introduced formula. We evaluated the association of tertiles of metabolic markers with undesired weaning and time to breastfeeding cessation using Cox proportional hazards models and Mantel–Haenszel chi-square tests, respectively.

Results Eighty-two women were eligible for analysis. There was a statistically significant difference in time to breastfeeding cessation among tertiles of fasting glucose, hemoglobin A1c (A1c), body mass index (BMI), and skinfolds (all p < 0.05). Women with higher fasting glucose, BMI, or skinfolds were also more likely to report undesired weaning; women with higher fasting glucose introduced formula earlier.

Conclusion Higher fasting glucose, A1c, BMI, and subscapular skinfolds were associated with earlier breastfeeding cessation in women with GDM. These markers may identify mothers in need of enhanced postpartum support to achieve their breastfeeding goals.

Condensation

Higher fasting glucose, glycated hemoglobin, and greater adiposity are associated with early breastfeeding cessation in mother–infant dyads affected by gestational diabetes.


Note

This study was presented as a poster at the 37th Annual Pregnancy Meeting, Society for Maternal-Fetal Medicine, January 23–28, 2017, Las Vegas, NV.