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. 2019 Apr;28(4):462-472.
doi: 10.1089/jwh.2018.7393. Epub 2018 Dec 11.

Breastfeeding Greater Than 6 Months Is Associated with Smaller Maternal Waist Circumference Up to One Decade After Delivery

Gabrielle G Snyder  1 , Claudia Holzman  2 , Tao Sun  3 , Bertha Bullen  2 , Marnie Bertolet  1   3 , Janet M Catov  1
Affiliations

Breastfeeding Greater Than 6 Months Is Associated with Smaller Maternal Waist Circumference Up to One Decade After Delivery

Gabrielle G Snyder et al. J Womens Health (Larchmt). 2019 Apr.

Abstract

Background: Abdominal obesity is an important indicator of cardiometabolic dysfunction in later life. Prior studies have observed an inverse association between breastfeeding and maternal waist circumference (WC) in the years after pregnancy, but this may be due to bias resulting from systematic differences in women who do and do not breastfeed.

Materials and methods: A total of 678 women enrolled in the Pregnancy Outcomes and Community Health (POUCH) cohort also participated in the POUCHmoms Study 7-15 years after delivery. Multivariable linear regression models and propensity scores were used to assess the relationship between WC measured at follow-up and self-reported history of breastfeeding duration of >6 months versus ≤6 months.

Results: After a mean follow-up period of 11.0 (standard deviation = 1.4) years, breastfeeding was significantly associated with smaller WC. A threshold effect was detected for women who reported breastfeeding >6 months; their adjusted mean WC was 3.5 cm (95% confidence interval [CI]: -5.7 to -1.2) smaller compared with women who breastfed ≤6 months. The use of two propensity score approaches, weighted and matched, produced similar results; adjusted mean WC difference was -3.6 cm (95% CI: -5.6 to -1.6) and -3.1 cm (95% CI: -5.5 to -0.7), respectively.

Conclusions: This study extends conventional observational study methods to incorporate propensity score approaches that make it possible to separate the study design from the study analysis to account for systematic differences in women who did and did not breastfeed. After reducing potential bias, breastfeeding for greater than 6 months was independently associated with smaller WC in the decade after delivery.

Keywords: breastfeeding; maternal obesity; propensity score; waist circumference.

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Conflict of interest statement

No competing financial interests exist.

Figures

<b>FIG. 1.</b>
FIG. 1.
Flow chart of participants in POUCHmoms Study, 2011–2014. POUCH, Pregnancy Outcomes and Community Health.
<b>FIG. 2.</b>
FIG. 2.
Comparative waist circumference (cm) according to breastfeeding duration. Line indicates central obesity cutoff point for women at 88 cm.
<b>FIG. 3.</b>
FIG. 3.
Group balance for breastfeeding before and after applying propensity score matching and weighting methods.
See this image and copyright information in PMC

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