Lactation intensity and duration to postpartum diabetes and prediabetes risk in women with gestational diabetes

Yun Shen, Junhong Leng, Weiqin Li, Shuang Zhang, Huikun Liu, Ping Shao, Peng Wang, Leishen Wang, Huiguang Tian, Cuilin Zhang, Xilin Yang, Zhijie Yu, Lifang Hou, Jaakko Tuomilehto, Gang Hu*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Objective: To investigate the association of lactation intensity and duration with postpartum diabetes and prediabetes risks among Chinese women with a history of gestational diabetes (GDM). Methods: We included 1260 women with a history of GDM who participated in the whole population's GDM universal screening survey by using the 1999 World Health Organization's criteria. Lactation intensity and lactation duration were collected by a standardized questionnaire. Postpartum diabetes and prediabetes risk were confirmed by an oral glucose tolerance test. Results: During a mean postpartum period of 3.65 years, we identified 114 cases of diabetes and 417 cases of prediabetes. The multivariable-adjusted hazard ratios based on different lactation intensity (exclusive formula, mixed feeding, and exclusive lactation) were 1.00, 0.68, 0.45 for diabetes (Ptrend = 0.008), and 1.00, 0.74, and 0.61 for prediabetes (Ptrend = 0.006), respectively. The multivariable-adjusted hazard ratios associated with different lactation duration (none, 0-6 months, 6-12 months, 12-18 months, and ≥18 months) were 1.00, 0.66, 0.42, 0.66, and 0.25 for diabetes (Ptrend = 0.013), and 1.00, 0.82, 0.62, 0.67, and 0.63 for prediabetes (Ptrend = 0.021), respectively. A restricted cubic spline curve showed a graded inverse association of lactation duration with the risks of diabetes and prediabetes (Ptrend < 0.001). Conclusions: Higher-lactation intensity and longer-lactation duration were significantly associated with lower risks of postpartum diabetes and prediabetes among Chinese women with a history of GDM.

Original languageEnglish (US)
Article numbere3115
JournalDiabetes/Metabolism Research and Reviews
Volume35
Issue number3
DOIs
StatePublished - Mar 2019

Fingerprint

Prediabetic State
Gestational Diabetes
Lactation
Postpartum Period
Glucose Tolerance Test

Keywords

  • diabetes
  • gestational diabetes
  • lactation
  • prediabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Shen, Yun ; Leng, Junhong ; Li, Weiqin ; Zhang, Shuang ; Liu, Huikun ; Shao, Ping ; Wang, Peng ; Wang, Leishen ; Tian, Huiguang ; Zhang, Cuilin ; Yang, Xilin ; Yu, Zhijie ; Hou, Lifang ; Tuomilehto, Jaakko ; Hu, Gang. / Lactation intensity and duration to postpartum diabetes and prediabetes risk in women with gestational diabetes. In: Diabetes/Metabolism Research and Reviews. 2019 ; Vol. 35, No. 3.
@article{4b6229828b9c4cc2903187a17cc49a56,
title = "Lactation intensity and duration to postpartum diabetes and prediabetes risk in women with gestational diabetes",
abstract = "Objective: To investigate the association of lactation intensity and duration with postpartum diabetes and prediabetes risks among Chinese women with a history of gestational diabetes (GDM). Methods: We included 1260 women with a history of GDM who participated in the whole population's GDM universal screening survey by using the 1999 World Health Organization's criteria. Lactation intensity and lactation duration were collected by a standardized questionnaire. Postpartum diabetes and prediabetes risk were confirmed by an oral glucose tolerance test. Results: During a mean postpartum period of 3.65 years, we identified 114 cases of diabetes and 417 cases of prediabetes. The multivariable-adjusted hazard ratios based on different lactation intensity (exclusive formula, mixed feeding, and exclusive lactation) were 1.00, 0.68, 0.45 for diabetes (Ptrend = 0.008), and 1.00, 0.74, and 0.61 for prediabetes (Ptrend = 0.006), respectively. The multivariable-adjusted hazard ratios associated with different lactation duration (none, 0-6 months, 6-12 months, 12-18 months, and ≥18 months) were 1.00, 0.66, 0.42, 0.66, and 0.25 for diabetes (Ptrend = 0.013), and 1.00, 0.82, 0.62, 0.67, and 0.63 for prediabetes (Ptrend = 0.021), respectively. A restricted cubic spline curve showed a graded inverse association of lactation duration with the risks of diabetes and prediabetes (Ptrend < 0.001). Conclusions: Higher-lactation intensity and longer-lactation duration were significantly associated with lower risks of postpartum diabetes and prediabetes among Chinese women with a history of GDM.",
keywords = "diabetes, gestational diabetes, lactation, prediabetes",
author = "Yun Shen and Junhong Leng and Weiqin Li and Shuang Zhang and Huikun Liu and Ping Shao and Peng Wang and Leishen Wang and Huiguang Tian and Cuilin Zhang and Xilin Yang and Zhijie Yu and Lifang Hou and Jaakko Tuomilehto and Gang Hu",
year = "2019",
month = "3",
doi = "10.1002/dmrr.3115",
language = "English (US)",
volume = "35",
journal = "Diabetes/Metabolism Research and Reviews",
issn = "1520-7552",
publisher = "John Wiley and Sons Ltd",
number = "3",

}

Shen, Y, Leng, J, Li, W, Zhang, S, Liu, H, Shao, P, Wang, P, Wang, L, Tian, H, Zhang, C, Yang, X, Yu, Z, Hou, L, Tuomilehto, J & Hu, G 2019, 'Lactation intensity and duration to postpartum diabetes and prediabetes risk in women with gestational diabetes', Diabetes/Metabolism Research and Reviews, vol. 35, no. 3, e3115. https://doi.org/10.1002/dmrr.3115

Lactation intensity and duration to postpartum diabetes and prediabetes risk in women with gestational diabetes. / Shen, Yun; Leng, Junhong; Li, Weiqin; Zhang, Shuang; Liu, Huikun; Shao, Ping; Wang, Peng; Wang, Leishen; Tian, Huiguang; Zhang, Cuilin; Yang, Xilin; Yu, Zhijie; Hou, Lifang; Tuomilehto, Jaakko; Hu, Gang.

In: Diabetes/Metabolism Research and Reviews, Vol. 35, No. 3, e3115, 03.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Lactation intensity and duration to postpartum diabetes and prediabetes risk in women with gestational diabetes

AU - Shen, Yun

AU - Leng, Junhong

AU - Li, Weiqin

AU - Zhang, Shuang

AU - Liu, Huikun

AU - Shao, Ping

AU - Wang, Peng

AU - Wang, Leishen

AU - Tian, Huiguang

AU - Zhang, Cuilin

AU - Yang, Xilin

AU - Yu, Zhijie

AU - Hou, Lifang

AU - Tuomilehto, Jaakko

AU - Hu, Gang

PY - 2019/3

Y1 - 2019/3

N2 - Objective: To investigate the association of lactation intensity and duration with postpartum diabetes and prediabetes risks among Chinese women with a history of gestational diabetes (GDM). Methods: We included 1260 women with a history of GDM who participated in the whole population's GDM universal screening survey by using the 1999 World Health Organization's criteria. Lactation intensity and lactation duration were collected by a standardized questionnaire. Postpartum diabetes and prediabetes risk were confirmed by an oral glucose tolerance test. Results: During a mean postpartum period of 3.65 years, we identified 114 cases of diabetes and 417 cases of prediabetes. The multivariable-adjusted hazard ratios based on different lactation intensity (exclusive formula, mixed feeding, and exclusive lactation) were 1.00, 0.68, 0.45 for diabetes (Ptrend = 0.008), and 1.00, 0.74, and 0.61 for prediabetes (Ptrend = 0.006), respectively. The multivariable-adjusted hazard ratios associated with different lactation duration (none, 0-6 months, 6-12 months, 12-18 months, and ≥18 months) were 1.00, 0.66, 0.42, 0.66, and 0.25 for diabetes (Ptrend = 0.013), and 1.00, 0.82, 0.62, 0.67, and 0.63 for prediabetes (Ptrend = 0.021), respectively. A restricted cubic spline curve showed a graded inverse association of lactation duration with the risks of diabetes and prediabetes (Ptrend < 0.001). Conclusions: Higher-lactation intensity and longer-lactation duration were significantly associated with lower risks of postpartum diabetes and prediabetes among Chinese women with a history of GDM.

AB - Objective: To investigate the association of lactation intensity and duration with postpartum diabetes and prediabetes risks among Chinese women with a history of gestational diabetes (GDM). Methods: We included 1260 women with a history of GDM who participated in the whole population's GDM universal screening survey by using the 1999 World Health Organization's criteria. Lactation intensity and lactation duration were collected by a standardized questionnaire. Postpartum diabetes and prediabetes risk were confirmed by an oral glucose tolerance test. Results: During a mean postpartum period of 3.65 years, we identified 114 cases of diabetes and 417 cases of prediabetes. The multivariable-adjusted hazard ratios based on different lactation intensity (exclusive formula, mixed feeding, and exclusive lactation) were 1.00, 0.68, 0.45 for diabetes (Ptrend = 0.008), and 1.00, 0.74, and 0.61 for prediabetes (Ptrend = 0.006), respectively. The multivariable-adjusted hazard ratios associated with different lactation duration (none, 0-6 months, 6-12 months, 12-18 months, and ≥18 months) were 1.00, 0.66, 0.42, 0.66, and 0.25 for diabetes (Ptrend = 0.013), and 1.00, 0.82, 0.62, 0.67, and 0.63 for prediabetes (Ptrend = 0.021), respectively. A restricted cubic spline curve showed a graded inverse association of lactation duration with the risks of diabetes and prediabetes (Ptrend < 0.001). Conclusions: Higher-lactation intensity and longer-lactation duration were significantly associated with lower risks of postpartum diabetes and prediabetes among Chinese women with a history of GDM.

KW - diabetes

KW - gestational diabetes

KW - lactation

KW - prediabetes

UR - http://www.scopus.com/inward/record.url?scp=85059860458&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85059860458&partnerID=8YFLogxK

U2 - 10.1002/dmrr.3115

DO - 10.1002/dmrr.3115

M3 - Article

C2 - 30548991

AN - SCOPUS:85059860458

VL - 35

JO - Diabetes/Metabolism Research and Reviews

JF - Diabetes/Metabolism Research and Reviews

SN - 1520-7552

IS - 3

M1 - e3115

ER -