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The BLIiNG study - Breastfeeding length and intensity in gestational diabetes and metabolic effects in a subsequent pregnancy: a cohort study
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  • Sarah J Melov,
  • Lisa White,
  • Michelle Simmons,
  • Adrienne Kirby,
  • Virginia Stulz,
  • Suja Padmanabhan,
  • Thushari Alahakoon,
  • Dharmintra Pasupathy,
  • N Cheung
Sarah J Melov
Westmead Hospital
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Lisa White
Blacktown and Mount Druitt Hospital
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Michelle Simmons
Westmead Hospital
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Adrienne Kirby
The University of Sydney
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Virginia Stulz
Western Sydney University
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Suja Padmanabhan
The University of Sydney Faculty of Medicine and Health
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Thushari Alahakoon
Westmead Hospital
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Dharmintra Pasupathy
The University of Sydney
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N Cheung
The University of Sydney
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Abstract

Objective To investigate if increased length and intensity of breastfeeding mediates gestational diabetes mellitus (GDM) risk in a subsequent pregnancy. Design Multisite cohort study. Setting Western Sydney, Australia, March 2017–April 2019. Population Women with a second subsequent pregnancy after a GDM-affected first pregnancy. Methods Information on breastfeeding experience, intensity and GDM management in the first pregnancy was collected by questionnaire. The results of the oral glucose tolerance test (OGTT) in the second pregnancy were also recorded. Multivariable models for OGTT and for diagnosis of GDM were fitted and then adjusted for medical treatment of GDM in the first pregnancy, BMI, age at current pregnancy and ethnicity. Main outcome measures Second pregnancy oral glucose tolerance test (OGTT) blood glucose results and diagnosis of GDM. Results We recruited 227 women with 210 eligible for analysis. Of these women, 146 (70%) were diagnosed with recurrent GDM. We found a 19% reduction in the risk of GDM in a subsequent pregnancy if a woman breastfed for more than six months (RR 0.81, 95% CI 0.68–0.96) after adjusting for both age and BMI. In a fully adjusted model, the association was attenuated (RR 0.89, 95% CI 0.78–1.02). With the same adjusted confounders, however, both high intensity breastfeeding (2 h OGTT, P = 0.01) and breastfeeding for greater than six months (1 h OGTT, P = 0.01) were associated with a mean blood glucose decrease of 0.7mmol/L. Conclusion We found the risk of recurrent GDM was reduced by both increased duration and intensity of breastfeeding.

Peer review status:UNDER REVIEW

29 Aug 2020Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
01 Sep 2020Assigned to Editor
01 Sep 2020Submission Checks Completed
08 Sep 2020Reviewer(s) Assigned