Filardi Tiziana, Bleve Enrico, Gorini Stefania, Caprio Massimiliano, Morano Susanna
Department for the Promotion of Human Sciences and Quality of Life, San Raffaele Roma Open University, Via di Val Cannuta, 247, 00166 Rome, Italy.
Department of Experimental Medicine, "Sapienza" University, Viale Regina Elena 324, 00161 Rome, Italy.
J Clin Med. 2025 Apr 29;14(9):3065. doi: 10.3390/jcm14093065.
Gestational diabetes mellitus (GDM) leads to increased lifelong cardiometabolic risk in both mothers and their offspring. The identification of effective strategies to contain the future risk of type 2 diabetes (T2D) and cardiovascular disease (CVD) is of utmost importance to reduce the burden of the disease. Breastfeeding (BF) is effective in reducing short- and long-term child morbidity. In recent years, BF has emerged as a candidate low-cost intervention to prevent future cardiometabolic complications both in mothers and infants exposed to GDM. The aim of this review is to provide an overview of the evidence about the possible metabolic benefits of BF for both mothers with a history of GDM and their offspring. Increasing evidence supports the positive effects of exclusive BF over formula feeding (FF) or mixed feeding on glucose homeostasis and the lipid profile in women with previous GDM in the early postpartum period. Studies with a longer observation suggest clear benefits of intensive and longer BF on the risk of diabetes and prediabetes in mothers after adjustment for confounders. In regards to infants, in most studies, the intensity and duration of BF are positively associated with slower infant growth curves compared with FF, indicating that the positive effect of BF on growth trends might contrast the increased risk of obesity and metabolic diseases observed in infants exposed to GDM. Considering these findings, a global effort should be made to support BF practice to possibly reduce cardiometabolic morbidity after GDM.
妊娠期糖尿病（GDM）会增加母亲及其后代一生中患心脏代谢疾病的风险。确定有效的策略以控制未来患2型糖尿病（T2D）和心血管疾病（CVD）的风险对于减轻疾病负担至关重要。母乳喂养（BF）在降低儿童短期和长期发病率方面是有效的。近年来，母乳喂养已成为一种低成本的干预措施，有望预防患有GDM的母亲及其婴儿未来出现心脏代谢并发症。这篇综述的目的是概述母乳喂养对有GDM病史的母亲及其后代可能产生的代谢益处的相关证据。越来越多的证据支持，在产后早期，纯母乳喂养比配方奶喂养（FF）或混合喂养对既往患有GDM的女性的血糖稳态和血脂状况有积极影响。观察期更长的研究表明，在调整混杂因素后，强化和延长母乳喂养对母亲患糖尿病和糖尿病前期的风险有明显益处。对于婴儿，在大多数研究中，与配方奶喂养相比，母乳喂养的强度和持续时间与婴儿生长曲线较慢呈正相关，这表明母乳喂养对生长趋势的积极影响可能会抵消GDM患儿患肥胖症和代谢性疾病风险增加的影响。考虑到这些发现，应做出全球努力来支持母乳喂养，以可能降低GDM后的心脏代谢发病率。
