To investigate the effects of breastfeeding (BF) on metabolic-related outcomes in women with previous gestational diabetes mellitus.
Methods:
Databases, including PubMed, Embase, Cochrane Library, and Web of Science, were searched until March 5, 2020. Finally, 14 high-quality articles were included. Relative risk (RR) and weighted mean difference (WMD) with 95% confidence interval (CI) were pooled using Stata14.0 Software.
Results:
Subjects in the BF group had a lower incidence of diabetes (RR: 0.611, 95% CI: 0.452–0.826, p < 0.001) and lower fasting plasma glucose level (WMD: −4.762, 95% CI: −5.552 to −3.973, p < 0.001), fasting insulin level (WMD: −21.513, 95% CI: −37.594 to −5.431, p = 0.009), homeostasis model assessment of insulin resistance (HOMA-IR) (WMD: −1.107, 95% CI: −1.683 to −0.532, p < 0.001), and triglyceride level (WMD: −33.951, 95% CI: −50.714 to −17.189, p < 0.001) than those in the non-BF group. The high-density lipoprotein level (WMD: 3.855, 95% CI: 2.629–5.081, p < 0.001), low-density lipoprotein level (WMD: 4.223, 95% CI: 0.6712–7.774, p = 0.020), and insulin sensitivity index (WMD: 1.503, 95% CI: 0.857–2.160, p < 0.001) in the BF group were higher than that in the non-BF group. No difference was found in the 2-hour postprandial blood glucose (WMD: −3.804, 95% CI: −8.237 to 0.630, p = 0.093), incidence of prediabetes mellitus (RR: 0.870, 95% CI: 0.750–1.009, p = 0.065), or cholesterol level (WMD: 1.377, 95% CI: −8.178 to 10.931, p = 0.778) between the two groups.
Conclusion:
BF may improve several metabolic markers and decrease the risk of developing diabetes.
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References
1.
ZhuY, ZhangC. Prevalence of gestational diabetes and risk of progression to type 2 diabetes: A global perspective. Curr Diab Rep, 2016; 16:7.
2.
LangerO, UmansJG, MiodovnikM. The proposed GDM diagnostic criteria: A difference, to be a difference, must make a difference. J Matern Fetal Neonatal Med, 2013; 26:111–115.
3.
OlsenSF, Houshmand-OeregaardA, GranströmC, et al.Diagnosing gestational diabetes mellitus in the Danish National Birth Cohort. Acta Obstet Gynecol Scand, 2017; 96:563–569.
4.
MuchD, BeyerleinA, RoßbauerM, et al.Beneficial effects of breastfeeding in women with gestational diabetes mellitus. Mol Metab, 2014; 3:284–292.
5.
ManerkarK, HardingJ, ConlonC, et al.Maternal gestational diabetes and infant feeding, nutrition and growth: A systematic review and meta-analysis. Br J Nutr, 2020; 123:1201–1215.
6.
BernsteinJ, QuinnE, AmeliO, et al.Onset of T2DM after gestational diabetes: What the prevention paradox tells us about risk. Prev Med, 2018; 113:1–6.
7.
ZhangC, OlsenSF, HinkleSN, et al.Diabetes & Women's Health (DWH) Study: An observational study of long-term health consequences of gestational diabetes, their determinants and underlying mechanisms in the USA and Denmark. BMJ Open, 2019; 9:e025517.
8.
BellamyL, CasasJP, HingoraniAD, et al.Type 2 diabetes mellitus after gestational diabetes: A systematic review and meta-analysis. Lancet, 2009; 373:1773–1779.
StuebeAM, SchwarzEB. The risks and benefits of infant feeding practices for women and their children. J Perinatol, 2010; 30:155–162.
11.
IpS, ChungM, RamanG, et al.Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (Full Rep), 2007; 153:1–186.
12.
JamesDC, LessenR, American DieteticAssociation. Position of the American Dietetic Association: Promoting and supporting breastfeeding. J Am Diet Assoc, 2009; 109:1926–1942.
13.
GundersonEP, HeddersonMM, ChiangV, et al.Lactation intensity and postpartum maternal glucose tolerance and insulin resistance in women with recent GDM: The SWIFT cohort. Diabetes Care, 2012; 35:50–56.
14.
GundersonEP, KimC, QuesenberryCPJr, et al.Lactation intensity and fasting plasma lipids, lipoproteins, non-esterified free fatty acids, leptin and adiponectin in postpartum women with recent gestational diabetes mellitus: The SWIFT cohort. Metabolism, 2014; 63:941–950.
15.
GundersonEP, JacobsDRJr, ChiangV, et al.Duration of lactation and incidence of the metabolic syndrome in women of reproductive age according to gestational diabetes mellitus status: A 20-Year prospective study in CARDIA (Coronary Artery Risk Development in Young Adults). Diabetes, 2010; 59:495–504.
16.
ZieglerAG, WallnerM, KaiserI, et al.Long-term protective effect of lactation on the development of type 2 diabetes in women with recent gestational diabetes mellitus. Diabetes, 2012; 61:3167–3171.
17.
MartensPJ, ShaferLA, DeanHJ, et al.Breastfeeding initiation associated with reduced incidence of diabetes in mothers and offspring. Obstet Gynecol, 2016; 128:1095–1104.
18.
KjosSL, PetersRK, XiangA, et al.Contraception and the risk of type 2 diabetes mellitus in Latina women with prior gestational diabetes mellitus. JAMA, 1998; 280:533–538.
19.
BuchananTA, XiangAH, KjosSL, et al.Antepartum predictors of the development of type 2 diabetes in Latino women 11–26 months after pregnancies complicated by gestational diabetes. Diabetes, 1999; 48:2430–2436.
20.
WellsGA, SheaB, O'ConnellD, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality if nonrandomized studies in meta-analyses. 2012; Available at http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp (accessed April10, 2020).
21.
KjosSL, HenryO, LeeRM, et al.The effect of lactation on glucose and lipid metabolism in women with recent gestational diabetes. Obstet Gynecol, 1993; 82:451–455.
22.
BuchananTA, XiangA, KjosSL, et al.Gestational diabetes: Antepartum characteristics that predict postpartum glucose intolerance and type 2 diabetes in Latino women. Diabetes, 1998; 47:1302–1310.
23.
McManusRM, CunninghamI, WatsonA, et al.Beta-cell function and visceral fat in lactating women with a history of gestational diabetes. Metabolism, 2001; 50:715–719.
24.
Chouinard-CastonguayS, WeisnagelSJ, TchernofA, et al.Relationship between lactation duration and insulin and glucose response among women with prior gestational diabetes. Eur J Endocrinol, 2013; 168:515–523.
25.
MatteiL, ColatrellaA, BittermanO, et al.Long lasting effects of breastfeeding on metabolism in women with prior gestational diabetes. J Diab Mellitus, 2014; 4:257–263.
26.
CapulaC, ChiefariE, VeroA, et al.Prevalence and predictors of postpartum glucose intolerance in Italian women with gestational diabetes mellitus. Diabetes Res Clin Pract, 2014; 105:223–230.
27.
Bentley-LewisR, XiongG, LeeH, et al.Metabolomic analysis reveals amino acid responses to an oral glucose tolerance test in women with prior history of gestational diabetes mellitus. J Clin Transl Endocrinol, 2014; 1:38–43.
28.
BenhalimaK, LeuridanL, CalewaertP, et al.Glucose intolerance after a recent history of gestational diabetes. Int J Endocrinol, 2014; 2014:727652.
29.
GundersonEP, HurstonSR, NingX, et al.Lactation and progression to type 2 diabetes mellitus after gestational diabetes mellitus: A prospective cohort study. Ann Intern Med, 2015; 163:889–898.
30.
YasuhiI, SodaT, YamashitaH, et al.The effect of high-intensity breastfeeding on postpartum glucose tolerance in women with recent gestational diabetes. Int Breastfeed J, 2017; 12:32.
31.
CorradoF, GiuntaL, GraneseR, et al.Metabolic effects of breastfeeding in women with previous gestational diabetes diagnosed according to the IADPSG criteria. J Matern Fetal Neonatal Med, 2019; 32:225–228.
32.
ShenY, LengJ, LiW, et al.Lactation intensity and duration to postpartum diabetes and prediabetes risk in women with gestational diabetes. Diabetes Metab Res Rev, 2019; 35:e3115.
33.
YasuhiI, YamashitaH, MaedaK, et al.High-intensity breastfeeding improves insulin sensitivity during early post-partum period in obese women with gestational diabetes. Diabetes Metab Res Rev, 2019; 35:e3127.
34.
MaS, HuS, LiangH, et al.Metabolic effects of breastfeed in women with prior gestational diabetes mellitus: A systematic review and meta-analysis. Diabetes Metab Res Rev, 2019; 35:e3108.
35.
ButteNF, HopkinsonJM, MehtaN, et al.Adjustments in energy expenditure and substrate utilization during late pregnancy and lactation. Am J Clin Nutr, 1999; 69:299–307.
36.
GundersonEP, LewisCE, WeiGS, et al.Lactation and changes in maternal metabolic risk factors. Obstet Gynecol, 2007; 109:729–738.
