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Effect of lactation on the recurrence rate of gestational diabetes mellitus: a retrospective cohort study

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To examine the impact of lactation on the recurrence rate of gestational diabetes mellitus (GDM).

Methods

Retrospective cohort study performed in a single teaching hospital on data between 2009 and 2016. The study group consisted of women who had a diagnosis of GDM and breastfed exclusively for ≥ 1 month. The control group consisted of women who had a diagnosis of GDM and did not breastfeed or added formula < 1 month postpartum. Data regarding breastfeeding duration, timing and amount of formula supplementation were obtained by a telephone questionnaire. We hypothesized that the recurrence of GDM would be lower in women who breastfed exclusively for ≥ 1 month. Therefore, to detect a decrease from 50 to 30% in the recurrence rate of GDM with alpha (one-sided) of 0.05 and 80% power, a sample size of 168 (84 per group) was needed.

Results

Overall, 229 women were found eligible; 139 and 90 in the study and control groups, respectively. Except for parity, baseline demographic and obstetric variables were not different between the two groups. After adjusting for parity, the incidence of GDM in subsequent pregnancy was significantly lower among the study compared to the control group [48 (34.5%) and 41 (45.6%), respectively; one-tailed p = 0.043; RR 0.56; 95% CI 0.35–0.90)]. The cesarean delivery (CD) rate was significantly lower as well [28 (20.1%) and 31 (34.4%), respectively; two-tailed p = 0.02; RR 0.48, 95% CI 0.26–0.89)].

Conclusion

Exclusive lactation for ≥ 1 month reduced the recurrence rate of GDM and possibly the risk of CD in the subsequent pregnancy.

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Acknowledgements

The authors thank Paula S. Herer, biostatistician, MSc, MPH, for statistical guidance and assistance.

Funding

The study was not funded.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Emek Medical Center, 18101, Afula, Israel

    Sivan Zuarez-Easton, Ilanit Berkovich, Alon Tal, Raja Zoabi & Raed Salim

  2. The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel

    Daphna Birenbaum-Carmeli

  3. Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel

    Sivan Zuarez-Easton, Alon Tal & Raed Salim

Authors
  1. Sivan Zuarez-Easton
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  2. Ilanit Berkovich
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  3. Daphna Birenbaum-Carmeli
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  4. Alon Tal
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  5. Raja Zoabi
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  6. Raed Salim
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Contributions

All the authors have read the manuscript and agreed to its being submitted for publication. All listed authors meet the appropriate authorship criteria. Nobody who qualifies for authorship has been omitted from the list. All authors have approved the acknowledgment of their contribution. SZE Protocol development, Data collection or management, Data analysis, Manuscript writing/editing. IB Data collection or management, Data analysis, Manuscript editing. DBC Protocol development, Data collection or management, Data analysis, Manuscript editing. AT Data collection or management, Data analysis. RZ Data collection or management, Data analysis, Manuscript editing. RS conceived the study, Protocol development, Data collection or management, Data analysis, Manuscript writing/editing.

Corresponding author

Correspondence to Raed Salim.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the local institutional review board, Emek Medical Center, Afula, Israel (registration number 0014–17-EMC) in March 2017. Oral consent was obtained from all women before completing the telephone questionnaire. This article does not contain any studies with human participants or animals performed by any of the authors.

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Zuarez-Easton, S., Berkovich, I., Birenbaum-Carmeli, D. et al. Effect of lactation on the recurrence rate of gestational diabetes mellitus: a retrospective cohort study. Arch Gynecol Obstet 301, 973–979 (2020). https://doi.org/10.1007/s00404-020-05497-3

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  • DOI: https://doi.org/10.1007/s00404-020-05497-3

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