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1. Breastfeeding and infant growth in offspring of mothers with hyperglycaemia in pregnancy: The pregnancy and neonatal diabetes outcomes in remote Australia study

Author

Danielle K. Longmore, Angela Titmuss, Elizabeth Barr, Federica Barzi, Alison Simmonds, I‐Lynn Lee, Eyvette Hawthorne, Ruth Derkenne, Christine Connors, Jacqueline Boyle, Paul Zimmet, Kerin O'Dea, Jeremy Oats, Harold D. McIntyre, Alex Brown, Jonathan Shaw, Louise J. Maple‐Brown, Longmore, Danielle K, Titmuss, Angela, Barr, Elizabeth, Barzi, Federica, Simmonds, Alison, Lee, I-Lynn, Hawthorne, Eyvette, Derkenne, Ruth, Connors, Christine, Boyle, Jacqueline, Zimmet, Paul, O'Dea, Kerin, Oats, Jeremy, McIntyre, Harold D, Brown, Alex, Shaw, Jonathan, and Maple-Brown, Louise J

Subjects
infant growth, Nutrition and Dietetics, breastfeeding, Health Policy, Infant, Newborn, Public Health, Environmental and Occupational Health, Infant, Mothers, gestational diabetes mellitus, Body Mass Index, Obesity, Maternal, Prediabetic State, Diabetes, Gestational, Breast Feeding, Diabetes Mellitus, Type 2, Pregnancy, Hyperglycemia, Pediatrics, Perinatology and Child Health, Birth Weight, Humans, Female, neonatal diabetes, Child
Abstract

Refereed/Peer-reviewed Background: Benefits of breastfeeding on infant growth in children born to mothers with gestational diabetes mellitus (GDM) are uncertain. Objectives: To describe growth trajectories between birth and 14 months according to breastfeeding and maternal hyperglycaemia in pregnancy, and assess associations between breastfeeding and 14 month growth outcomes among children born to mothers with GDM. Subjects/methods: Data on 258 Aboriginal and Torres Strait Islander infants from the PANDORA study born to mothers with normoglycaemia (n = 73), GDM (n = 122), or with pre-existing type 2 diabetes (n = 63) in pregnancy were assessed. Infant weight and BMI growth trajectories according to predominant breastfeeding at 6 months and hyperglycaemia in pregnancy were developed using mixed-effect models and cubic splines. Associations between breastfeeding and 14-month growth outcomes (z-scores: weight-for-age, weight-for-length and BMI) were evaluated using linear regression in a subgroup of infants born to mothers with GDM. Results: Predominantly breastfed infants had lower BMI trajectories compared to those not predominantly breastfed, irrespective of maternal hyperglycaemia in pregnancy status (p

Published
2022
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2. Associations of gestational diabetes and type 2 diabetes during pregnancy with breastfeeding at hospital discharge and up to 6 months: the PANDORA study

Author

Paul Zimmet, Eyvette Hawthorne, Elizabeth L M Barr, Kerin O'Dea, Jeremy Oats, Marie Kirkwood, Harold David McIntyre, Jonathan E. Shaw, Alyce N. Wilson, Federica Barzi, I-Lynn Lee, Alex Brown, Alison Simmonds, Christine Connors, Louise J. Maple-Brown, Danielle K. Longmore, Jacqueline Boyle, Paula van Dokkum, Longmore, Danielle K, Barr, Elizabeth LM, Wilson, Alyce N, Barzi, Federica, Kirkwood, Marie, Simmonds, Alison, Lee, I Lynn, Hawthorne, Eyvette, Van Dokkum, Paula, Connors, Christine, Boyle, Jacqueline A, Zimmet, Paul, O'Dea, Kerin, Oats, Jeremy, McIntyre, Harold D, Brown, Alex DH, Shaw, Jonathan E, and Maple-Brown, Louise J

Subjects
0301 basic medicine, medicine.medical_specialty, breastfeeding, Endocrinology, Diabetes and Metabolism, Breastfeeding, 030209 endocrinology & metabolism, Type 2 diabetes, diabetes associated with pregnancy, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Diabetes mellitus, Internal Medicine, medicine, Humans, diabetes, Obstetrics, business.industry, medicine.disease, Obesity, Indigenous, Hospitals, Gestational diabetes, Diabetes, Gestational, 030104 developmental biology, Breast Feeding, Diabetes Mellitus, Type 2, Hyperglycemia, Cohort, intergenerational, Female, business, Breast feeding
Abstract

Aims/hypothesis: Women with gestational diabetes mellitus (GDM) and obesity experience lower rates of breastfeeding. Little is known about breastfeeding among mothers with type 2 diabetes. Australian Indigenous women have a high prevalence of type 2 diabetes in pregnancy. We aimed to evaluate the association of hyperglycaemia, including type 2 diabetes, with breastfeeding outcomes. Methods: Indigenous (n = 495) and non-Indigenous (n = 555) participants of the Pregnancy And Neonatal Diabetes Outcomes in Remote Australia (PANDORA) cohort included women without hyperglycaemia in pregnancy (n = 222), with GDM (n = 684) and with type 2 diabetes (n = 144). The associations of hyperglycaemia in pregnancy and breastfeeding at hospital discharge, 6 weeks and 6 months post-partum were evaluated with logistic regression, after adjustment for maternal obesity, ethnicity, maternal and neonatal characteristics. Results: Indigenous women were more likely to predominantly breastfeed at 6 weeks across all levels of hyperglycaemia. Compared with women with no hyperglycaemia in pregnancy, women with type 2 diabetes had lower odds for exclusive breastfeeding at discharge (adjusted OR for exclusive breastfeeding 0.4 [95% CI 0.2, 0.8] p = 0.006). At 6 weeks and 6 months, the relationship between type 2 diabetes and predominant breastfeeding was not statistically significant (6 weeks 0.7 [0.3, 1.6] p = 0.40, 6 months 0.8 [0.4, 1.6] p = 0.60). Women with gestational diabetes were as likely to achieve predominant breastfeeding at 6 weeks and 6 months as women without hyperglycaemia in pregnancy. Conclusions/interpretation: Indigenous women had high rates of breastfeeding. Women with type 2 diabetes had difficulty establishing exclusive breastfeeding at hospital discharge. Further research is needed to assess the impact on long-term breastfeeding outcomes Refereed/Peer-reviewed

Published
2020

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