Postpartum Breastfeeding and Cardiovascular Risk Assessment in Women Following Pregnancy Complications

Objectives To investigate the short-term effects of breastfeeding on hypertension, metabolic syndrome, serum glucose and cholesterol profile among postpartum women 6 months after a pregnancy complicated by hypertensive disorders of pregnancy, gestational diabetes, intrauterine growth restriction, abruption, and preterm delivery. Methods Our cross-sectional analysis includes 622 women with a pregnancy complication seen at 6 months postpartum between November 2011 and December 2017 at a tertiary care centre. We compared systolic and diastolic blood pressure, serum cholesterol profile, serum glucose, and estimated cardiovascular risk in women who did not breastfeed (n=100, 16%), who breastfed for less than 6months (n=315, 51%), and who breastfed for 6 months or more (n=207, 33%) using descriptive statistics and multivariate linear and logistic regression. Results Adjusted models showed that increasing breastfeeding duration significantly decreased the odds of metabolic syndrome (Odds Ratio [95% Confidence Interval]; 0.88 [0.80, 0.98]), a high lifetime risk score (0.92 [0.80, 0.99]), elevated (0.92 [0.84, 0.99]) or hypertensive systolic blood pressure (0.90 [0.82, 0.99]), abnormal fasting glucose (0.80 [0.67, 0.95]), triglycerides (0.88 [0.79, 0.97]), and ratio of total cholesterol to HDL-C (0.86 [0.79, 0.94]). BMI, waist circumference and non-HDL-C decreased (estimated coefficients [95%CI]; of -0.11 [-0.19, -0.03], -0.32 [-0.60, -0.04], -0.04 [-0.88, -0.07]; respectively) while HDL-C increased (0.03 [-0.02, -0.04]). Conclusions Our findings suggest that breastfeeding for at least 6 months is associated with decreased indicators of cardiovascular disease risk in a cohort of women with a recent pregnancy complication and should encourage breastfeeding support and interventions in this population.