Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Folkhälsan Research Center, Helsinki, Finland.
Int Breastfeed J. 2021 Feb 16;16(1):19. doi: 10.1186/s13006-021-00369-1.
The impact of gestational diabetes mellitus (GDM) on the duration of breastfeeding varies between shortening and no impact. Breastfeeding seems to reduce both maternal and offspring risk for type 2 diabetes and offspring risk for overweight or obesity later in life. The aim of our study was to evaluate in primiparous women whether GDM had an influence on the duration of breastfeeding, and further, to evaluate the factors that influenced on the duration of breastfeeding.
The study cohort (N = 1089) consisted of all primiparous women with a Finnish background excluding women with pre-existing diabetes mellitus who lived in the city of Vantaa, Finland, gave birth to a singleton living child between 2009 and 2015, and with valid data on breastfeeding available. The diagnosis of GDM was based on a standard 75 g 2-h oral glucose tolerance test. Data were obtained from Finnish national registers and from the medical records of the city of Vantaa.
No differences were observed in the duration of breastfeeding between women diagnosed with GDM and without GDM, 7.5 (Standard Deviation [SD] 3.7) months versus 7.9 (SD 3.5) months (p = 0.17). Women diagnosed with GDM breastfed boys for a longer duration than girls (maternal age, pre-pregnancy body mass index, marital status, educational attainment, duration of pregnancy, and smoking habits adjusted p = 0.042). Women who breastfed < 6 months were younger, were more likely smokers, had shorter education, and higher pre-pregnancy body mass index than women who breastfed over 6 months (p < 0.001 for linearity).
In primiparous women GDM did not influence breastfeeding duration. The positive health effects of breastfeeding should be emphasized especially in young, overweight and less educated women in order to minimize the risk of obesity and type 2 diabetes for themselves and their offspring.
妊娠糖尿病（GDM）对母乳喂养持续时间的影响既有缩短的，也有没有影响的。母乳喂养似乎可以降低母婴患 2 型糖尿病的风险，降低后代成年后患超重或肥胖的风险。我们的研究目的是评估初产妇中 GDM 是否会影响母乳喂养的持续时间，并进一步评估影响母乳喂养持续时间的因素。
研究队列（N=1089）包括所有芬兰背景的初产妇，不包括患有既往糖尿病的妇女，她们居住在芬兰万塔市，在 2009 年至 2015 年间分娩了一名单胎活产子女，并且母乳喂养数据有效。GDM 的诊断基于标准的 75g 2 小时口服葡萄糖耐量试验。数据来自芬兰国家登记处和万塔市的医疗记录。
在母乳喂养持续时间方面，患有 GDM 和没有 GDM 的妇女之间没有差异，分别为 7.5 个月（标准差 [SD] 3.7）和 7.9 个月（SD 3.5）（p=0.17）。患有 GDM 的妇女母乳喂养男孩的时间长于女孩（母亲年龄、孕前体重指数、婚姻状况、教育程度、妊娠持续时间和吸烟习惯调整后 p=0.042）。母乳喂养 <6 个月的妇女比母乳喂养超过 6 个月的妇女年龄更小，更有可能吸烟，受教育程度更低，孕前体重指数更高（线性性 p<0.001）。
在初产妇中，GDM 并未影响母乳喂养的持续时间。应特别强调母乳喂养的积极健康影响，尤其是针对年轻、超重和受教育程度较低的妇女，以最大程度地降低肥胖和 2 型糖尿病的风险，既为她们自己，也为她们的后代。
