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The prospective associations of fetal growth-related pregnancy complications with subsequent breastfeeding duration and markers of human milk production.

The prospective associations of fetal growth-related pregnancy complications with subsequent breastfeeding duration and markers of human milk production.
The prospective associations of fetal growth-related pregnancy complications with subsequent breastfeeding duration and markers of human milk production.

Background: The development of the breast for lactation occurs throughout pregnancy. It is unknown whether pregnancy complications resulting in poor fetal growth can affect breastfeeding (BF) success. Objectives: We examined whether fetal growth-related pregnancy complications were associated with earlier BF cessation and changes in the concentrations of human milk biomarkers of low milk production. Methods: We used data from the Growing Up in Singapore Toward healthy Outcomes study (n = 954). Human milk concentrations of protein, lactose, citrate, sodium, potassium, and zinc at 3 wk postpartum were available for 180 mother-infant dyads. We examined the associations of fetal growth measures, including term infants born small-for-gestational-age (SGA) (<10th percentile), pregnancies complicated by fetal growth deceleration (second to third trimester fetal growth dropped between major centiles), elevated umbilical artery resistance (>90th percentile) or hypertensive disorders of pregnancy (HDP) with 1) risk of ceasing BF (Cox regression) and 2) concentrations of human milk components (weighted linear regression). Results: Adjusting for maternal education, smoking exposure, BF intentions, and prepregnancy BMI (in kg/m 2), individuals who delivered SGA infants and those with HDP were more likely to breastfeed for a shorter duration when compared to those with uncomplicated pregnancies {adjusted hazard ratio [95% confidence interval (CI)]: 1.45 (1.11, 1.89) and 1.61 (1.14, 2.29), respectively}; associations were nonsignificant for fetal growth deceleration and umbilical artery resistance. SGA was not associated with concentrations of human milk biomarkers, but compared to participants with uncomplicated pregnancies, milk produced by those with HDP contained lower zinc concentrations [adjusted β coefficient (95% CI): –0.56 mg/L (–1.08, –0.04) mg/L]. Conclusions: Individuals with HDP and those with SGA infants tend to breastfeed for a shorter duration; however, only HDP appear to be associated with biomarkers of compromised milk production. Further research and support are needed to help individuals with HDP and SGA achieve their BF goals. This trial was registered at clinicaltrials.gov as NCT01174875.

Asian, breastfeeding, fetal growth, human milk components, human milk zinc, hypertensive disorders of pregnancy, small-for-gestational age
0002-9165
478-487
Pang, Wei Wei
ea5e4a08-2641-485d-854d-62734f51ffe4
Geddes, Donna T.
32fb3204-4a1a-4c8a-a398-dc641abeebe6
Lai, Ching-Tat
719a7d94-4cab-4f54-bed5-3e3ab8f0fb11
Michael, Navin
fb8b79bb-696c-480c-8a52-cf5f930c4f30
Huang, Jonathan
a0a566ec-2048-46b1-89c5-555418371526
Chan, Yiong Huak
3e6bb630-bddc-4713-8a9f-3d90c6dfe712
Cheong, Clara Y.
496f5ebb-1dfb-47f4-abae-08d323ddefc4
Fok, Doris
bb0a659f-fc27-4847-b09c-c64f018dca7d
Pundir, Shikha
584231c9-dc96-4ba9-9150-77c35b2ea00c
Ng, Sharon
cb549f0f-0584-4498-8c49-6023fde1fa87
Vickers, Mark H.
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Chua, Mei Chien
bafc2416-91c8-47b6-8301-bc1b41b1d6c1
Tan, Kok Hian
4714c94d-334a-42ad-b879-f3aa3a931def
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Shek, Lynette P.
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Chong, Yap-Seng
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Eriksson, Johan G.
eb96b1c5-af07-4a52-8a73-7541451d32cd
Chan, Shiao-Yng
3c9d8970-2cc4-430a-86a7-96f6029a5293
Wlodek, Mary E.
f56b571a-c420-4bfe-b3d9-c2033e1f5495
Pang, Wei Wei
ea5e4a08-2641-485d-854d-62734f51ffe4
Geddes, Donna T.
32fb3204-4a1a-4c8a-a398-dc641abeebe6
Lai, Ching-Tat
719a7d94-4cab-4f54-bed5-3e3ab8f0fb11
Michael, Navin
fb8b79bb-696c-480c-8a52-cf5f930c4f30
Huang, Jonathan
a0a566ec-2048-46b1-89c5-555418371526
Chan, Yiong Huak
3e6bb630-bddc-4713-8a9f-3d90c6dfe712
Cheong, Clara Y.
496f5ebb-1dfb-47f4-abae-08d323ddefc4
Fok, Doris
bb0a659f-fc27-4847-b09c-c64f018dca7d
Pundir, Shikha
584231c9-dc96-4ba9-9150-77c35b2ea00c
Ng, Sharon
cb549f0f-0584-4498-8c49-6023fde1fa87
Vickers, Mark H.
6e05d089-9742-44f5-b4e1-3a505027d10c
Chua, Mei Chien
bafc2416-91c8-47b6-8301-bc1b41b1d6c1
Tan, Kok Hian
4714c94d-334a-42ad-b879-f3aa3a931def
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Shek, Lynette P.
9a77403c-0e0c-4536-a5ad-628ce94b279a
Chong, Yap-Seng
7043124b-e892-4d4b-8bb7-6d35ed94e136
Eriksson, Johan G.
eb96b1c5-af07-4a52-8a73-7541451d32cd
Chan, Shiao-Yng
3c9d8970-2cc4-430a-86a7-96f6029a5293
Wlodek, Mary E.
f56b571a-c420-4bfe-b3d9-c2033e1f5495

Pang, Wei Wei, Geddes, Donna T., Lai, Ching-Tat, Michael, Navin, Huang, Jonathan, Chan, Yiong Huak, Cheong, Clara Y., Fok, Doris, Pundir, Shikha, Ng, Sharon, Vickers, Mark H., Chua, Mei Chien, Tan, Kok Hian, Godfrey, Keith, Shek, Lynette P., Chong, Yap-Seng, Eriksson, Johan G., Chan, Shiao-Yng and Wlodek, Mary E. (2024) The prospective associations of fetal growth-related pregnancy complications with subsequent breastfeeding duration and markers of human milk production. American Journal of Clinical Nutrition, 121 (2), 478-487. (doi:10.1016/j.ajcnut.2024.11.008).

Record type: Article

Abstract

Background: The development of the breast for lactation occurs throughout pregnancy. It is unknown whether pregnancy complications resulting in poor fetal growth can affect breastfeeding (BF) success. Objectives: We examined whether fetal growth-related pregnancy complications were associated with earlier BF cessation and changes in the concentrations of human milk biomarkers of low milk production. Methods: We used data from the Growing Up in Singapore Toward healthy Outcomes study (n = 954). Human milk concentrations of protein, lactose, citrate, sodium, potassium, and zinc at 3 wk postpartum were available for 180 mother-infant dyads. We examined the associations of fetal growth measures, including term infants born small-for-gestational-age (SGA) (<10th percentile), pregnancies complicated by fetal growth deceleration (second to third trimester fetal growth dropped between major centiles), elevated umbilical artery resistance (>90th percentile) or hypertensive disorders of pregnancy (HDP) with 1) risk of ceasing BF (Cox regression) and 2) concentrations of human milk components (weighted linear regression). Results: Adjusting for maternal education, smoking exposure, BF intentions, and prepregnancy BMI (in kg/m 2), individuals who delivered SGA infants and those with HDP were more likely to breastfeed for a shorter duration when compared to those with uncomplicated pregnancies {adjusted hazard ratio [95% confidence interval (CI)]: 1.45 (1.11, 1.89) and 1.61 (1.14, 2.29), respectively}; associations were nonsignificant for fetal growth deceleration and umbilical artery resistance. SGA was not associated with concentrations of human milk biomarkers, but compared to participants with uncomplicated pregnancies, milk produced by those with HDP contained lower zinc concentrations [adjusted β coefficient (95% CI): –0.56 mg/L (–1.08, –0.04) mg/L]. Conclusions: Individuals with HDP and those with SGA infants tend to breastfeed for a shorter duration; however, only HDP appear to be associated with biomarkers of compromised milk production. Further research and support are needed to help individuals with HDP and SGA achieve their BF goals. This trial was registered at clinicaltrials.gov as NCT01174875.

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More information

Accepted/In Press date: 7 November 2024
e-pub ahead of print date: 13 November 2024
Keywords: Asian, breastfeeding, fetal growth, human milk components, human milk zinc, hypertensive disorders of pregnancy, small-for-gestational age

Identifiers

Local EPrints ID: 501651
URI: http://eprints.soton.ac.uk/id/eprint/501651
ISSN: 0002-9165
PURE UUID: af536bda-312a-4716-8af3-db7673d09dc4
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

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Date deposited: 04 Jun 2025 17:13
Last modified: 05 Jun 2025 01:33

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Contributors

Author: Wei Wei Pang
Author: Donna T. Geddes
Author: Ching-Tat Lai
Author: Navin Michael
Author: Jonathan Huang
Author: Yiong Huak Chan
Author: Clara Y. Cheong
Author: Doris Fok
Author: Shikha Pundir
Author: Sharon Ng
Author: Mark H. Vickers
Author: Mei Chien Chua
Author: Kok Hian Tan
Author: Keith Godfrey ORCID iD
Author: Lynette P. Shek
Author: Yap-Seng Chong
Author: Johan G. Eriksson
Author: Shiao-Yng Chan
Author: Mary E. Wlodek

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