Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Sep 5:10:100206.
doi: 10.1016/j.lanepe.2021.100206. eCollection 2021 Nov.

Association of maternal pre-pregnancy BMI and breastfeeding with NAFLD in young adults: a parental negative control study

Kushala Wm Abeysekera  1   2 , James G Orr  2 , Paul Madley-Dowd  1 , Gwen S Fernandes  1 , Luisa Zuccolo  1   3 , Fiona H Gordon  2 , Deborah A Lawlor  1   3   4 , Jon Heron  1 , Matthew Hickman  1   3
Affiliations

Association of maternal pre-pregnancy BMI and breastfeeding with NAFLD in young adults: a parental negative control study

Kushala Wm Abeysekera et al. Lancet Reg Health Eur. .

Abstract

Background: The importance of the maternal-infant dyad in the genesis of nonalcoholic fatty liver disease (NAFLD) is of increasing interest. The Avon Longitudinal Study of Parents and Children (ALSPAC) showed that at age 24, 1 in 5 had NAFLD measured by transient elastography and controlled attenuation parameter (CAP). Our aim was to investigate the association between breastfeeding duration and maternal pre-pregnancy BMI on offspring NAFLD in young adulthood.

Methods: 4021 participants attended clinic for FibroScan and CAP measurement using Echosens 502 Touch®. 440 participants with Alcohol Use Disorders were excluded. Offspring of 100 non-singleton pregnancies were excluded. 2961 valid CAP measurements for NAFLD were analysed. Exposures of interest were breastfeeding of any duration, ≥6months exclusive breastfeeding, and maternal pre-pregnancy BMI. Multivariable regression models estimated the odds of NAFLD at 24 years. We performed a paternal negative control test to explore residual confounding in the analyses of pre-pregnancy BMI.

Findings: There was a modest inverse association of exclusive and non-exclusive breastfeeding ≥6 months having a protective effect on NAFLD in offspring (OR 0·92 [95%CI 0·66-1·27] and OR 0·90 [0·67-1·21] respectively).The odds of offspring NAFLD in overweight pre-pregnancy maternal BMI and paternal BMI was OR 2·09 [1·62-2·68] and OR 1·33 [95%CI 1·07-1·65] respectively, with the ratio of effect sizes OR 1·57 [1·11-2·22]. Similarly, odds of offspring NAFLD with obese pre-pregnancy maternal BMI and paternal BMI was OR 2·66 [1·71-4·14] and OR 1·35 [0·91-2·00] respectively, with the ratio of effect sizes OR 1·98 [1·05-3·74].

Interpretation: Higher maternal pre-pregnancy BMI was associated with offspring NAFLD, having accounted for shared parental confounding. We did not replicate previous work that found a strong association between breastfeeding and NAFLD.

Funding: Medical Research Council UK, Alcohol Research UK, David Telling Charitable Trust.

Keywords: ALSPAC; Breastfeeding; Controlled attenuation parameter; Maternal pre-pregnancy BMI; Non-alcoholic fatty liver disease; Transient elastography; Young adults.

PubMed Disclaimer

Conflict of interest statement

DAL has received support from Medtronic Ltd and Roche Diagnostics for research unrelated to that presented here. MH has received lecturer honoraria from MSD and Gilead. Other authors declared no conflicts of interest.

Figures

Fig 1
Fig. 1
Flow diagram of study
See this image and copyright information in PMC

References

    1. Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012;129(3):e827–e841. - PubMed
    1. Chen A, Rogan WJ. Breastfeeding and the risk of postneonatal death in the United States. Pediatrics. 2004;113(5):e435–e439. - PubMed
    1. Owen CG, Martin RM, Whincup PH, Smith GD, Cook DG. Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence. Pediatrics. 2005;115(5):1367–1377. - PubMed
    1. Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet. 2016;387(10017):475–490. - PubMed
    1. Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, et al. Why invest, and what it will take to improve breastfeeding practices? The Lancet. 2016;387(10017):491–504. - PubMed

LinkOut - more resources