Breastfeeding Duration and the Risk of Coronary Artery Disease
Open accessAbstract
BACKGROUND: Previous studies have suggested that prolonged breastfeeding has beneficial effects on the health of the mother including the reduction of long-term risk of coronary artery disease (CAD). The mechanism of this association remains unclear. METHODS: We surveyed 643 women aged 40-65 years receiving outpatient care at Stanford University Hospital on their reproductive/lactation history, including 137 women (cases) with clinically confirmed CAD. Survey data were supplemented with traditional risk factor data for CAD obtained from the participant's medical record. We then conducted logistic regression analyses to assess the relationship between breastfeeding duration and case-control status for each of the two separate definitions of duration. The first was based on the participant's single longest duration of breastfeeding considering all live births reported and the second was based on a participant's total duration of breastfeeding summed over all live births. For each of these two definitions, we ran three sequential models each with a different reference group-(1) nulliparous women, (2) parous women that never breastfed, and (3) parous women with a short duration of breastfeeding-successively excluding women in the reference group of the previous model(s). RESULTS: Just over one-half (51.6%) of the women surveyed reported a history of breastfeeding. We found nominally significant associations (p = 0.04-0.12) for our multivariate analyses that modeled maximum duration of breastfeeding. When compared with nulliparous women, parous women who either never breastfed or always breastfed for <5 months had approximately double the risk of CAD. Among parous women, women who breastfeed for ≥5 months at least once in their lifetime had a ∼30% decrease risk of CAD compared with those who did not initiate breastfeeding. Among parous women who breastfed ≥1 month, women who breastfed ≥5 months had ∼50% decreased risk of CAD. We found similar point estimates of effect for analogous analyses modeling maximum breastfeeding duration but p-values for these analyses were not significant. Unadjusted analyses demonstrated higher valued odds ratios and lower p-values suggesting the presence of some confounding by traditional risk factors. CONCLUSIONS: Parous women who breastfeed ≥5 months in at least one pregnancy seem to be at decreased risk of CAD later in their life, whereas parous women who either never breastfed or discontinued breastfeeding early seem to be at increased risk. More research is needed to more reliably quantify and determine the nature of the relationship between parity, breastfeeding duration, and risk of CAD.
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In the case-control study, a U shaped association between length of breastfeeding and morbidity from coronary heart disease was seen, with the lowest risk in women who breastfed for 16-26 months over a total lifetime.
“In the case-control study, a U shaped association between length of breastfeeding and morbidity from coronary heart disease was seen, with the lowest risk in women who breastfed for 16-26 months over a total lifetime.112”
From Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review (2020) · cites this paper as [112]
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- Authors
- Rajaei, S., Rigdon, J., Crowe, S., Tremmel, J., Tsai, S., & Assimes, T. L.
- Affiliations
- Stanford Medicine (US)
- Corresponding author
- Rajaei, Sheeva
- Venue
- Journal of Women's Health
- Publisher
- SAGE Publications
- Published
- 2019-01
- Volume
- 28
- Issue
- 1
- Pages
- 30-36
- ISSN
- 1059-7115 (ISSN-L)
- 1540-9996
- 1931-843X
- PMC
- PMC6422010
- OpenAlex
- W2904546159
- Cited by
- 43
- References
- 25
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 7 · 2023: 9 · 2022: 4 · 2021: 4 · 2020: 7 · 2019: 2 · 2018: 1
- FWCI
- 2.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Women s Health (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Heart, Lung, and Blood Institute (T32HL098049)
- Topics
- Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
- Keywords
- breastfeeding duration, coronary artery disease, cardiovascular risk, parity, postpartum women, maternal health, breastfeeding initiation
- MeSH terms
- Adult, Aged, Breast Feeding, Coronary Artery Disease, Female, Humans, Lactation, Middle Aged, Mothers, Parity, Pregnancy, Surveys and Questionnaires, Risk Factors, Time Factors, Case-Control Studies, Reproductive History
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