Effect of Lactation on Maternal Hypertension: A Systematic Review.

INTRODUCTION

Hypertension is relatively common in pregnancy, and pregnancy may unmask hypertension among women who are predisposed to it. Lactation may be a means through which to mitigate pregnancy-related vascular risk. The impact of lactation on maternal blood pressure, and the duration of any effect, remains unclear. This study aimed at systematically reviewing the literature evaluating the impact of lactation on the development of hypertension.

MATERIALS AND METHODS

We searched PubMed, including EMBASE and MEDLINE, for studies that reported on the association between breastfeeding and maternal risk of hypertension that were published in a peer-reviewed source. The quality of the studies included was assessed by using the Newcastle-Ottawa Scale.

RESULTS

Nineteen studies met all inclusion criteria for this review. Of the four studies with short-term follow-up, 50% showed a protective association. The fifteen studies with longer-term follow-up were stratified by outcome assessed. Sixty-seven percent of the studies that evaluated for elevated blood pressure and 100% of the studies evaluating for an outcome of hypertension showed a protective association. The minimum duration of lactation associated with a benefit was 1 month. This association was demonstrated in follow-up periods as long as two to three decades. Studies that showed a protective association had overall higher quality ratings.

DISCUSSION

Lactation is associated with a beneficial effect on maternal blood pressure that persists for decades. These results add to the growing body of literature demonstrating the protective association of lactation on maternal cardiovascular risk. Providers may incorporate the decreased risk of hypertension into their counseling on the maternal benefits of lactation.