Gestational Diabetes Mellitus Reduces Breastfeeding Duration: A Prospective Cohort Study.

BACKGROUND: Gestational diabetes mellitus (GDM) and its complications are major concerns because of the negative effects of GDM during antenatal period and on the future health of mothers and infants. Breastfeeding is beneficial for GDM mothers and their babies to reduce future health risks. Little is known about the link between GDM and the duration of "any" breastfeeding. Therefore, the aim of this study was to investigate the relationship between GDM and the duration for which Vietnamese women breastfeed their babies postpartum.

MATERIALS AND METHODS: A prospective cohort of 2,030 pregnant women between 24 and 28 weeks of gestation was recruited. GDM status was determined using a 75 g oral glucose tolerance test. Included mothers were then followed up from discharge after childbirth until 12 months postpartum to determine their breastfeeding duration. Kaplan-Meier estimates, log-rank tests, logistic and Cox regression models were used to examine the association between GDM and breastfeeding outcomes.

RESULTS: In our cohort, 94.4% of all women reported "any" breastfeeding at discharge and 72.9% of women were still breastfeeding at 12 months postpartum. The risk of early breastfeeding cessation was higher in GDM women than their non-GDM counterparts after adjustment for demographic factors (hazard ratios [HR] = 1.39, 95% confidence intervals [CI] = 1.13-1.71, p = 0.002), and all potential confounding factors (HR = 1.38, 95% CI = 1.12-1.70, p = 0.002). There were no significant differences in breastfeeding outcomes at discharge (early initiation, prelacteal feeding, and "any" breastfeeding rate) between GDM and non-GDM mothers.

CONCLUSIONS: GDM was associated with shorter breastfeeding duration. Women with GDM require ongoing support after hospital discharge to maintain long-term breastfeeding.