Christensen Sophie Hilario, Aarestrup Julie, Rasmussen Kathleen M, Baker Jennifer L, Pedersen Dorthe C, Bjerregaard Lise G
Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark; Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.
Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark.
Am J Clin Nutr. 2025 Aug;122(2):433-440. doi: 10.1016/j.ajcnut.2025.05.028. Epub 2025 May 29.
Although lactation may reduce maternal risk of breast cancer, other potential long-term health benefits of lactation for mothers are largely unknown.
We examined whether the durations of predominant and any lactation were associated with maternal risks of coronary artery disease (CAD) and stroke.
In this prospective cohort study, we followed up 6857 mothers from the Copenhagen Perinatal Cohort who gave birth during 1959-1961 at median age 24 y (IQR, 20-30 y). Durations of predominant and any lactation were assessed at the infant's 1-y examination. Diagnoses of CAD (n = 701 at 45-70 y; n = 593 at >70 y) and stroke (n = 410 at 45-70 y; n = 535 at >70 y) were obtained from national health registers during 1977-2022. Hazard ratios (HRs) and 95% CIs were estimated by Cox regressions without and with adjustment for demographics, metabolic risk during pregnancy, pregnancy complications, and reproductive history.
Durations of predominant and any lactation were inversely associated with risk of CAD, but not with stroke, when using lactation as a continuous variable. In categorical analyses, mothers who lactated for >4 months had 41% (HR: 0.59; 95% CI: 0.46, 0.75) and 34% (HR: 0.66; 95% CI: 0.48, 0.92) lower risk of CAD and stroke, respectively, at ages 45-70 y, compared with mothers who lactated ≤0.5 months. After adjustment for demographic, metabolic, and reproductive risk factors during pregnancy, these associations attenuated (HR: 0.78; 95% CI: 0.60, 1.01 for CAD; HR: 0.90; 95% CI: 0.64, 1.27 for stroke). No associations were observed with CAD or stroke diagnosed after age 70 y.
Limited evidence exists for an association between lactation and maternal risk of stroke. Longer durations of lactation are associated with lower risks of maternal CAD diagnosed before age 70 y. Adjustment for risk factors attenuate the associations, which suggests these factors may partly confound the benefits of lactation on maternal risks of CAD.
尽管哺乳可能降低母亲患乳腺癌的风险，但哺乳对母亲其他潜在的长期健康益处在很大程度上尚不清楚。
我们研究了纯母乳喂养和任何母乳喂养的持续时间是否与母亲患冠状动脉疾病（CAD）和中风的风险相关。
在这项前瞻性队列研究中，我们对哥本哈根围产期队列中的6857名母亲进行了随访，这些母亲于1959年至1961年分娩，中位年龄为24岁（四分位间距，20 - 30岁）。在婴儿1岁检查时评估纯母乳喂养和任何母乳喂养的持续时间。1977年至2022年期间从国家健康登记处获取CAD（45 - 70岁时n = 701；>70岁时n = 593）和中风（45 - 70岁时n = 410；>70岁时n = 535）的诊断信息。通过Cox回归估计风险比（HRs）和95%置信区间（CIs），未调整和调整了人口统计学、孕期代谢风险、妊娠并发症和生育史。
当将母乳喂养作为连续变量时，纯母乳喂养和任何母乳喂养的持续时间与CAD风险呈负相关，但与中风风险无关。在分类分析中，与母乳喂养≤0.5个月的母亲相比，母乳喂养>4个月的母亲在45 - 70岁时患CAD和中风的风险分别降低41%（HR：0.59；95%CI：0.46，0.75）和34%（HR：0.66；95%CI：0.48，0.92）。在调整孕期的人口统计学、代谢和生育风险因素后，这些关联减弱（CAD的HR：0.78；95%CI：0.60，1.01；中风的HR：0.90；95%CI：0.64，1.27）。在70岁以后诊断的CAD或中风未观察到关联。
关于母乳喂养与母亲中风风险之间的关联证据有限。较长时间的母乳喂养与70岁之前诊断的母亲CAD风险较低相关。对风险因素的调整减弱了这种关联，这表明这些因素可能部分混淆了母乳喂养对母亲CAD风险的益处。
