Premium
Lactation intensity and duration to postpartum diabetes and prediabetes risk in women with gestational diabetes
Author(s) -
Shen Yun,
Leng Junhong,
Li Weiqin,
Zhang Shuang,
Liu Huikun,
Shao Ping,
Wang Peng,
Wang Leishen,
Tian Huiguang,
Zhang Cuilin,
Yang Xilin,
Yu Zhijie,
Hou Lifang,
Tuomilehto Jaakko,
Hu Gang
Publication year - 2019
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.3115
Subject(s) - prediabetes , medicine , gestational diabetes , lactation , diabetes mellitus , obstetrics , pregnancy , population , postpartum period , type 2 diabetes , endocrinology , gestation , environmental health , biology , genetics
Objective To investigate the association of lactation intensity and duration with postpartum diabetes and prediabetes risks among Chinese women with a history of gestational diabetes (GDM). Methods We included 1260 women with a history of GDM who participated in the whole population's GDM universal screening survey by using the 1999 World Health Organization's criteria. Lactation intensity and lactation duration were collected by a standardized questionnaire. Postpartum diabetes and prediabetes risk were confirmed by an oral glucose tolerance test. Results During a mean postpartum period of 3.65 years, we identified 114 cases of diabetes and 417 cases of prediabetes. The multivariable‐adjusted hazard ratios based on different lactation intensity (exclusive formula, mixed feeding, and exclusive lactation) were 1.00, 0.68, 0.45 for diabetes ( P trend = 0.008), and 1.00, 0.74, and 0.61 for prediabetes ( P trend = 0.006), respectively. The multivariable‐adjusted hazard ratios associated with different lactation duration (none, 0‐6 months, 6‐12 months, 12‐18 months, and ≥18 months) were 1.00, 0.66, 0.42, 0.66, and 0.25 for diabetes ( P trend = 0.013), and 1.00, 0.82, 0.62, 0.67, and 0.63 for prediabetes ( P trend = 0.021), respectively. A restricted cubic spline curve showed a graded inverse association of lactation duration with the risks of diabetes and prediabetes ( P trend < 0.001). Conclusions Higher‐lactation intensity and longer‐lactation duration were significantly associated with lower risks of postpartum diabetes and prediabetes among Chinese women with a history of GDM.