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Breast-Feeding Can Help
Mom's Heart Decades Later
20-year study shows it cut risk factors linked to diabetes,
cardiovascular trouble
By Serena Gordon
HealthDay Reporter
THURSDAY, Dec. 3 (HealthDay News) -- Breast-feeding,
even for just a
couple of months, can significantly lower a woman's risk of metabolic
syndrome -- a dangerous
cluster of heart disease risk factors -- years
later, reports a new study appearing online Dec. 3 in the journal
Diabetes.
In women who didn't have pregnancy-related (gestational) diabetes,
breast-feeding between
one and five months lowered a woman's risk of
developing metabolic syndrome by 39 percent, while breast-feeding
for
the same duration lowered the risk of the syndrome by 44 percent in
women with gestational diabetes.
And, the longer a woman breast-fed, the better it was for her later
health. Breast-feeding for longer than nine months
dropped the risk of
metabolic syndrome by 86 percent in women with gestational diabetes.
Women without gestational
diabetes saw a 56 percent reduction in their
risk of metabolic syndrome, according to the study.
"Breast-feeding
has favorable health benefits for women as well as for
children. Breast-feeding may help protect women from heart disease
and
diabetes in the future," said the study's lead author, Erica
Gunderson, an epidemiologist and research
scientist at the Kaiser
Permanente Division of Research in Oakland, Calif.
The benefits of breast-feeding
for infants are well-documented and
include lower risk of ear infections, stomach problems, respiratory
illnesses,
asthma, skin allergies, diabetes and sudden infant death
syndrome (SIDS). For women, breast-feeding appears to lower
the risk
of type 2 diabetes, breast cancer, ovarian cancer and postpartum
depression, according to the U.S. Department
of Health and Human
Services.
Metabolic syndrome arises when a group of cardiac risk factors occurs
in
one person. Those risk factors include: abdominal obesity, high
blood pressure, low levels of HDL ("good")
cholesterol, high levels of
LDL ("bad") cholesterol, high triglycerides, insulin resistance,
elevated
markers of inflammation and a tendency for blood to clot,
according to the American Heart Association. People with metabolic
syndrome are significantly more likely to have or progress to heart
disease and type 2 diabetes than those without
it.
For the current study, the researchers recruited almost 1,400 women
into a prospective, multi-center
study designed to assess what factors
increase the risk of coronary artery disease. At the start of the
study
in 1985, none of the women had been pregnant before, and none
had metabolic syndrome.
The women were examined
at the start of the study, and again at 7, 10,
15 and 20 years after the start of the study.
While participating
in the study, 704 of the women had babies. During
pregnancy, 84 women developed gestational diabetes. During the study
follow-up, 120 women developed metabolic syndrome.
Of those who developed metabolic syndrome, the average
duration of
breast-feeding was 2.6 months, while the average time breast-feeding
for women who didn't develop
metabolic syndrome was seven months,
according to the study.
"We found a very strong protective effect
for lactation, and longer
duration is associated with a greater risk reduction," said Gunderson.
Although
the researchers didn't study exactly how breast-feeding could
confer a benefit against heart disease so many years
later, they
suspect that women who breast-feed are benefiting from higher good
cholesterol levels and less accumulation
of belly fat. Both of these
are factors in metabolic syndrome. Additionally, Gunderson said that
breast-feeding
helps with the metabolism of blood sugar, which may
lower their levels of insulin.
And, that's probably
what's protecting these women, suggested Dr.
Jacob Warman, chief of endocrinology at the Brooklyn Hospital Center
in New York City. "I have a feeling that insulin is the culprit," he
said.
But, he noted
that this study didn't measure levels of insulin, so
it's difficult to know for sure.
Still, he said,
if women are concerned and would like to reduce their
risk even further, they should cut back on processed carbohydrates,
such as those found in sweets and in white breads, cereals and pastas.
"People with a high starch diet tend
to have high insulin levels," he
explained.
Gunderson said that women who'd like to reduce their
risk of metabolic
syndrome should follow health-eating guidelines, get regular exercise,
and if having a baby,
consider breast-feeding. "Lactation is
potentially something that could have a benefit to your own health,"
she said.
More information
Learn more about the benefits of breast-feeding from the National
Women's Health Information Center.
SOURCES: Erica Gunderson, Ph.D., epidemiologist and research
scientist,
Kaiser Permanente Division of Research, Oakland, Calif.;
Jacob Warman, M.D., chief of endocrinology, Brooklyn Hospital
Center,
New York City; Dec. 3, 2009, Diabetes, online
| Longer breastfeeding had a protective
effect for metabolic syndrome | Mothers who breastfeed their children were less likely to develop metabolic
syndrome, and the effect was more pronounced the longer breastfeeding continued, according to results of the CARDIA study. Researchers said breastfeeding lowered the risk for metabolic syndrome by 39% to 56% for women with gestational diabetes
and 44% to 86% for women without gestational diabetes. CARDIA included 704 women aged 18 to 30 years. At baseline,
these women had never given birth and were free of metabolic syndrome. During 20 years of follow-up, researchers reported
120 new cases of metabolic syndrome after pregnancies. The overall incidence rate for metabolic syndrome was 22.1 per 1,000
person-years for women with gestational diabetes compared with 10.8 per 1,000 person-years for women without gestational diabetes.
When evaluating women by duration of lactation, the researchers determined that women who breastfed longer had lower
incidence rates of metabolic syndrome. The protective effect was stronger among women who had gestational diabetes (relative
hazard=0.14-0.56; P=.03) compared with those who did not (relative hazard=0.44-0.61; P=.03). “The
findings indicate that breastfeeding a child may have lasting favorable effects on a woman’s risk factors for later
developing diabetes or heart disease,” Erica Gunderson, PhD, epidemiologist and research scientist
in the division of research at Kaiser Permanente Northern California, said in a press release. She added that the beneficial
effect of breastfeeding did not appear to be associated with health behaviors such as differences in weight gain or physical
activity. However, women who did not develop metabolic syndrome tended to have less abdominal fat and higher levels of HDL
cholesterol. Funded by the National Institutes of Health, the 20-year CARDIA study is the first to measure all components
of metabolic syndrome both before pregnancy and after weaning in women of childbearing age, enabling researchers to examine
breastfeeding in relation to new onset of metabolic syndrome, according to Gunderson. |
Gunderson EP. Diabetes. 2009;doi:10.2337/db09-1197.
Home Births Can Be as Safe as Hospital Births
in Low-Risk Women NEW YORK (Reuters Health) Jul 28 - In terms of
perinatal morbidity and mortality, a planned home birth is as safe as a planned hospital birth, provided that a well-trained
midwife is available, a good transportation and referral system is in place, and the mother has a low risk of developing any
complications, new research shows. "Low-risk women should
be encouraged to plan their birth at the place of their preference, provided the maternity care system is well equipped to
underpin women's choice," Dr. A. de Jonge, from TNO Quality of Life, Leiden, the Netherlands, and co-researchers
emphasize in the August issue of BJOG: An International Journal of Obstetrics and Gynaecology. Data
regarding the safety of home births in low-risk women are lacking, due in part to the fact that studies with very large sample
sizes are needed to assess relatively rare adverse outcomes. Moreover, randomized trials comparing home and hospital births
have not been done because women usually want to choose their place of birth, the authors explain. The
present study, an analysis of 529,688 low-risk planned births, was conducted in the Netherlands, the only country in the west
with a large enough data set. The group included 321,307 women who wanted to give birth at home, 163,261 who planned to give
birth in the hospital, and 45,120 with an unknown intended place of birth. All
of the outcomes studied occurred with comparable frequency in the planned home and hospital birth groups. These included intrapartum
death (0.03% vs. 0.04%), intrapartum and neonatal death within 24 hours of birth (0.05% vs. 0.05%), intrapartum and neonatal
death within 7 days (0.06% vs. 0.07%), and neonatal admission to an intensive care unit (0.17% vs. 0.20%). "As
far as we know, this is the largest study into the safety of home births," the authors note. The findings, they conclude,
indicate that with proper services in place, home births are just as safe as hospital births for low-risk women. BJOG 2009;116:1177-1184. Reuters Health Information © 2009
Outcomes of planned home
birth with registered midwife versus
planned hospital birth with midwife
or physicianPatricia A. Janssen, PhD, Lee Saxell, MA, Lesley A. Page, PhD,
Michael C. Klein, MD, Robert M. Liston, MD and Shoo K. Lee, MBBS PhD From the School of Population and Public Health (Janssen), the Departments of Family Practice (Klein) and Obstetrics
and Gynecology (Janssen, Liston) and the Division of Midwifery (Saxell), Faculty of Medicine, University of British Columbia,
Vancouver, BC; the Child and Family Research Institute (Janssen, Klein, Liston), Vancouver, BC; the Nightingale School of
Nursing and Midwifery (Page), King’s College, London, UK; the Department of Pediatrics (Lee); and the Integrated Centre
for Care Advancement Through Research (Lee), University of Alberta, Edmonton, Alta. Correspondence to: Dr. Patricia A. Janssen, School of Population and Public Health, University
of British Columbia, 5804 Fairview Cres., Vancouver BC V6T 1Z3; fax 604 806-8006; pjanssen@interchange.ubc.ca Background: Studies of planned home births
attended by registered midwives have been limited by incomplete data, nonrepresentative sampling, inadequate
statistical power and the inability to exclude unplanned home births.
We compared the outcomes of planned home
births attended by midwives with
those of planned hospital births
attended by midwives or physicians. Methods: We included all planned home births attended by registered midwives from Jan. 1, 2000, to Dec. 31, 2004, in
British Columbia, Canada (n = 2889), and all planned hospital births meeting the eligibility requirements for home birth that were attended by the same cohort of midwives (n = 4752). We
also included a matched sample of physician-attended planned hospital births (n = 5331). The primary outcome measure was perinatal
mortality; secondary outcomes were obstetric interventions and adverse maternal and neonatal outcomes.
Results: The rate of perinatal death per 1000 births was 0.35 (95% confidence interval [CI] 0.00–1.03) in the
group of planned home
births; the rate in the group of
planned hospital births
was 0.57 (95% CI 0.00–1.43) among women attended by a midwife and 0.64 (95% CI 0.00–1.56) among those
attended by a physician. Women in the planned home-birth
group were significantly less likely than those who planned a midwife-attended hospital birth to have obstetric interventions (e.g., electronic
fetal monitoring, relative risk [RR] 0.32, 95% CI 0.29–0.36; assisted vaginal delivery, RR 0.41,
95% 0.33–0.52) or adverse maternal outcomes (e.g., third- or fourth-degree perineal tear, RR 0.41,
95% CI 0.28–0.59; postpartum hemorrhage, RR 0.62, 95% CI 0.49–0.77). The findings were similar
in the comparison with physician-assisted hospital births. Newborns in the home-birth
group were less likely than those in the midwife-attended hospital-birth group to require resuscitation at birth (RR 0.23, 95% CI 0.14–0.37) or oxygen therapy beyond 24 hours
(RR 0.37, 95% CI 0.24–0.59). The findings were similar in the comparison with newborns in the
physician-assisted hospital births;
in addition, newborns in the home-birth group were less likely to have
meconium aspiration (RR 0.45, 95% CI 0.21–0.93) and more likely to be admitted to hospital or readmitted
if born in hospital (RR 1.39, 95% CI 1.09–1.85). Interpretation: Planned
home birth attended by a registered midwife was associated
with very low and comparable rates of perinatal death and reduced rates of obstetric interventions and
other adverse perinatal outcomes compared with planned hospital birth attended by a midwife or physician.
CMAJ (Canadian Medical
Association Journal) September 15, 2009.
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