Department of Obstetric Medicine, Women's and Newborn Services, Royal Brisbane and Women's Hospital, Brisbane, QLD 4029, Australia.
Faculty of Medicine, University of Queensland, Brisbane, QLD 4006, Australia.
Nutrients. 2022 Mar 22;14(7):1323. doi: 10.3390/nu14071323.
(1) Background: Breastfeeding duration may be reduced in women with type 2 diabetes. Delayed secretory activation (SA) is associated with poorer breastfeeding outcomes; however, no prior studies have examined SA in women with type 2 diabetes. This pilot study aimed to assess SA in women with type 2 diabetes by assessing breastmilk constituents. Secondary aims were to assess breastfeeding rates postpartum, and contributory factors. (2) Methods: A prospective cohort of pregnant women with type 2 diabetes ( = 18) and two control groups with age- and parity-matched nondiabetic pregnant women (body mass index (BMI)) matched ( = 18) or normal-range BMI ( = 18)) were recruited. Breastmilk constituents (citrate, lactose, protein, and fat) were measured twice daily for 5 days postpartum and compared between groups. Associations between peripartum variables, breastmilk constituents, and breastfeeding at 4 months postpartum were explored. (3) Results: Women with type 2 diabetes had a slower increase in breastmilk citrate concentration postpartum, indicative of delayed SA, compared to both control groups. Higher predelivery insulin doses in women with type 2 diabetes were associated with increasing time to SA. Both women with type 2 diabetes and BMI-matched controls were less likely to fully breastfeed at 4 months, compared with normal-BMI controls. (4) Conclusion: SA is delayed in women with type 2 diabetes when compared to BMI-matched and normal-BMI women. Women with type 2 diabetes are less likely to fully breastfeed, at hospital discharge and by 4 months postpartum, compared to women with normal-BMI.
（1）背景：患有 2 型糖尿病的女性母乳喂养时间可能会缩短。分泌延迟（SA）与较差的母乳喂养结果相关；然而，以前没有研究检查过 2 型糖尿病女性的 SA。这项初步研究旨在通过评估母乳成分来评估 2 型糖尿病女性的 SA。次要目标是评估产后母乳喂养率和促成因素。（2）方法：招募了一组前瞻性的 2 型糖尿病孕妇（n = 18）和两组年龄和产次匹配的非糖尿病孕妇（体重指数（BMI）匹配组 n = 18）或正常 BMI 组 n = 18）。在产后 5 天内每天两次测量母乳成分（柠檬酸盐、乳糖、蛋白质和脂肪），并比较组间差异。探讨了围产期变量、母乳成分与产后 4 个月母乳喂养之间的关系。（3）结果：与两组对照组相比，2 型糖尿病女性产后母乳柠檬酸盐浓度增加较慢，提示分泌延迟。2 型糖尿病女性分娩前胰岛素剂量越高，SA 时间越长。与正常 BMI 对照组相比，2 型糖尿病女性和 BMI 匹配对照组在产后 4 个月时完全母乳喂养的可能性较低。（4）结论：与 BMI 匹配和正常 BMI 的女性相比，2 型糖尿病女性的 SA 延迟。与正常 BMI 的女性相比，2 型糖尿病女性在出院时和产后 4 个月时完全母乳喂养的可能性较低。
