Nguyen Phung Thi Hoang, Binns Colin W, Nguyen Cong Luat, Ha Anh Vo Van, Chu Tan Khac, Duong Dat Van, Do Dung Van, Lee Andy H
1 Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
2 School of Public Health, Curtin University, Perth, Western Australia, Australia.
Breastfeed Med. 2019 Jan/Feb;14(1):39-45. doi: 10.1089/bfm.2018.0112. Epub 2018 Nov 1.
Gestational diabetes mellitus (GDM) and its complications are major concerns because of the negative effects of GDM during antenatal period and on the future health of mothers and infants. Breastfeeding is beneficial for GDM mothers and their babies to reduce future health risks. Little is known about the link between GDM and the duration of "any" breastfeeding. Therefore, the aim of this study was to investigate the relationship between GDM and the duration for which Vietnamese women breastfeed their babies postpartum.
A prospective cohort of 2,030 pregnant women between 24 and 28 weeks of gestation was recruited. GDM status was determined using a 75 g oral glucose tolerance test. Included mothers were then followed up from discharge after childbirth until 12 months postpartum to determine their breastfeeding duration. Kaplan-Meier estimates, log-rank tests, logistic and Cox regression models were used to examine the association between GDM and breastfeeding outcomes.
In our cohort, 94.4% of all women reported "any" breastfeeding at discharge and 72.9% of women were still breastfeeding at 12 months postpartum. The risk of early breastfeeding cessation was higher in GDM women than their non-GDM counterparts after adjustment for demographic factors (hazard ratios [HR] = 1.39, 95% confidence intervals [CI] = 1.13-1.71, p = 0.002), and all potential confounding factors (HR = 1.38, 95% CI = 1.12-1.70, p = 0.002). There were no significant differences in breastfeeding outcomes at discharge (early initiation, prelacteal feeding, and "any" breastfeeding rate) between GDM and non-GDM mothers.
GDM was associated with shorter breastfeeding duration. Women with GDM require ongoing support after hospital discharge to maintain long-term breastfeeding.
妊娠期糖尿病（GDM）及其并发症是主要关注点，因为GDM在孕期以及对母婴未来健康均有负面影响。母乳喂养对患有GDM的母亲及其婴儿有益，可降低未来健康风险。关于GDM与“任何形式”母乳喂养时长之间的关联，目前所知甚少。因此，本研究旨在调查GDM与越南女性产后母乳喂养时长之间的关系。
招募了2030名妊娠24至28周的孕妇组成前瞻性队列。采用75克口服葡萄糖耐量试验确定GDM状态。随后对纳入的母亲从产后出院至产后12个月进行随访，以确定其母乳喂养时长。使用Kaplan-Meier估计法、对数秩检验、逻辑回归和Cox回归模型来检验GDM与母乳喂养结果之间的关联。
在我们的队列中，94.4%的女性在出院时报告进行了“任何形式”的母乳喂养，72.9%的女性在产后12个月仍在母乳喂养。在调整人口统计学因素后，GDM女性早期停止母乳喂养的风险高于非GDM女性（风险比[HR]=1.39，95%置信区间[CI]=1.13 - 1.71，p = 0.002），在调整所有潜在混杂因素后也是如此（HR = 1.38，95% CI = 1.12 - 1.70，p = 0.002）。GDM母亲和非GDM母亲在出院时的母乳喂养结果（早期开始、初乳喂养和“任何形式”母乳喂养率）没有显著差异。
GDM与较短的母乳喂养时长相关。患有GDM的女性在出院后需要持续的支持以维持长期母乳喂养。
