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Breastfeeding duration and development of dysglycemia in women who had gestational diabetes mellitus: evidence from the GUSTO cohort study

Breastfeeding duration and development of dysglycemia in women who had gestational diabetes mellitus: evidence from the GUSTO cohort study
Breastfeeding duration and development of dysglycemia in women who had gestational diabetes mellitus: evidence from the GUSTO cohort study
Background: breastfeeding has been shown to support glucose homeostasis in women after a pregnancy complicated by gestational diabetes mellitus (GDM) and is potentially effective at reducing long-term diabetes risk. Methods: data from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study were analyzed to understand the influence of breastfeeding duration on long-term dysglycemia (prediabetes and diabetes) risk in women who had GDM in the index pregnancy. GDM and dysglycemia four to seven years postpartum were determined by the oral glucose tolerance test (OGTT). A Poisson regression model with a robust error variance was used to estimate incidence rate ratios (IRRs) for dysglycemia four to seven years post-delivery according to groupings of the duration of any breastfeeding (<1, ≥1 to <6, and ≥6 months). Results: women who had GDM during the index pregnancy and complete breastfeeding information and OGTT four to seven years postpartum were included in this study (n = 116). Fifty-one women (44%) had postpartum dysglycemia. Unadjusted IRRs showed an inverse association between dysglycemia risk and ≥1 month to <6 months (IRR 0.91; 95% confidence interval [CI] 0.57, 1.43; p = 0.68) and ≥6 months (IRR 0.50; 95% CI 0.27, 0.91; p = 0.02) breastfeeding compared to <1 month of any breastfeeding. After adjusting for key confounders, the IRR for the ≥6 months group remained significant (IRR 0.42; 95% CI 0.22, 0.80; p = 0.008). Conclusions: our results suggest that any breastfeeding of six months or longer may reduce long-term dysglycemia risk in women with a history of GDM in an Asian setting. Breastfeeding has benefits for mothers beyond weight loss, particularly for those with GDM.
Breastfeeding, Gestational diabetes, Prediabetes risk, Type 2 diabetes risk
2072-6643
1-12
Hewage, Sumali S.
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Koh, Xin Yu Hazel
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Soh, S.E.
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Pang, Wei Wei
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Fok, Doris
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Cai, Shirong
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Müller-Riemenschneider, Falk
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Yap, Fabian
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Tan, Kok Hian
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Chua, Mei Chien
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Lim, Sok Bee
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Godfrey, Keith
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Colega, Marjorelee T.
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Chong, Yap-Seng
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Chan, Shiao-Yng
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Yoong, Joanne
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Chong, Mary F.F.
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Hewage, Sumali S.
18e1d7d2-226b-4eba-a180-f37ad6f466fd
Koh, Xin Yu Hazel
786697a8-3841-4a55-a4ca-58ecb2a33028
Soh, S.E.
00a5ad13-4c5b-4fad-aaa9-d080d9aa63e8
Pang, Wei Wei
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Fok, Doris
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Cai, Shirong
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Müller-Riemenschneider, Falk
a8e422d9-0a0f-4a08-9edf-b19e18c1fb31
Yap, Fabian
22f6b954-31fc-4696-a52b-e985a424b95b
Tan, Kok Hian
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Chua, Mei Chien
bafc2416-91c8-47b6-8301-bc1b41b1d6c1
Lim, Sok Bee
ca4c4380-5362-43d8-9782-ccdedde756a0
Godfrey, Keith
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Colega, Marjorelee T.
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Chong, Yap-Seng
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Chan, Shiao-Yng
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Yoong, Joanne
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Chong, Mary F.F.
7c540836-aa50-4fc4-81f8-36ff8e0c773c

Hewage, Sumali S., Koh, Xin Yu Hazel, Soh, S.E., Pang, Wei Wei, Fok, Doris, Cai, Shirong, Müller-Riemenschneider, Falk, Yap, Fabian, Tan, Kok Hian, Chua, Mei Chien, Lim, Sok Bee, Godfrey, Keith, Colega, Marjorelee T., Chong, Yap-Seng, Chan, Shiao-Yng, Yoong, Joanne and Chong, Mary F.F. (2021) Breastfeeding duration and development of dysglycemia in women who had gestational diabetes mellitus: evidence from the GUSTO cohort study. Nutrients, 13 (2), 1-12, [408]. (doi:10.3390/nu13020408). (In Press)

Record type: Article

Abstract

Background: breastfeeding has been shown to support glucose homeostasis in women after a pregnancy complicated by gestational diabetes mellitus (GDM) and is potentially effective at reducing long-term diabetes risk. Methods: data from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study were analyzed to understand the influence of breastfeeding duration on long-term dysglycemia (prediabetes and diabetes) risk in women who had GDM in the index pregnancy. GDM and dysglycemia four to seven years postpartum were determined by the oral glucose tolerance test (OGTT). A Poisson regression model with a robust error variance was used to estimate incidence rate ratios (IRRs) for dysglycemia four to seven years post-delivery according to groupings of the duration of any breastfeeding (<1, ≥1 to <6, and ≥6 months). Results: women who had GDM during the index pregnancy and complete breastfeeding information and OGTT four to seven years postpartum were included in this study (n = 116). Fifty-one women (44%) had postpartum dysglycemia. Unadjusted IRRs showed an inverse association between dysglycemia risk and ≥1 month to <6 months (IRR 0.91; 95% confidence interval [CI] 0.57, 1.43; p = 0.68) and ≥6 months (IRR 0.50; 95% CI 0.27, 0.91; p = 0.02) breastfeeding compared to <1 month of any breastfeeding. After adjusting for key confounders, the IRR for the ≥6 months group remained significant (IRR 0.42; 95% CI 0.22, 0.80; p = 0.008). Conclusions: our results suggest that any breastfeeding of six months or longer may reduce long-term dysglycemia risk in women with a history of GDM in an Asian setting. Breastfeeding has benefits for mothers beyond weight loss, particularly for those with GDM.

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Accepted/In Press date: 21 January 2021
Keywords: Breastfeeding, Gestational diabetes, Prediabetes risk, Type 2 diabetes risk

Identifiers

Local EPrints ID: 446915
URI: http://eprints.soton.ac.uk/id/eprint/446915
ISSN: 2072-6643
PURE UUID: a9d1d05b-6974-4ac9-8c07-f9473e8404b3
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

Catalogue record

Date deposited: 26 Feb 2021 17:31
Last modified: 26 Nov 2021 02:35

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Contributors

Author: Sumali S. Hewage
Author: Xin Yu Hazel Koh
Author: S.E. Soh
Author: Wei Wei Pang
Author: Doris Fok
Author: Shirong Cai
Author: Falk Müller-Riemenschneider
Author: Fabian Yap
Author: Kok Hian Tan
Author: Mei Chien Chua
Author: Sok Bee Lim
Author: Keith Godfrey ORCID iD
Author: Marjorelee T. Colega
Author: Yap-Seng Chong
Author: Shiao-Yng Chan
Author: Joanne Yoong
Author: Mary F.F. Chong

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