Duration of Lactation and Risk Factors for Maternal Cardiovascular Disease
Open accessAbstract
OBJECTIVE: To examine dose-response relationships between the cumulative number of months women lactated and postmenopausal risk factors for cardiovascular disease. METHODS: We examined data from 139,681 postmenopausal women (median age 63 years) who reported at least one live birth on enrolling in the Women's Health Initiative observational study or controlled trials. Multivariable models were used to control for sociodemographic (age, parity, race, education, income, age at menopause), lifestyle, and family history variables when examining the effect of duration of lactation on risk factors for cardiovascular disease, including obesity (body mass index [BMI] at or above 30), hypertension, self-reported diabetes, hyperlipidemia, and prevalent and incident cardiovascular disease. RESULTS: Dose-response relationships were seen; in fully adjusted models, women who reported a lifetime history of more than 12 months of lactation were less likely to have hypertension (odds ratio [OR] 0.88, P<.001), diabetes (OR 0.80, P<.001), hyperlipidemia (OR 0.81, P<.001), or cardiovascular disease (OR 0.91, P=.008) than women who never breast-fed, but they were not less likely to be obese. In models adjusted for all above variables and BMI, similar relationships were seen. Using multivariate adjusted prevalence ratios from generalized linear models, we estimate that among parous women who did not breast-feed compared with those who breast-fed for more than 12 months, 42.1% versus 38.6% would have hypertension, 5.3% versus 4.3% would have diabetes, 14.8% versus 12.3% would have hyperlipidemia, and 9.9% versus 9.1% would have developed cardiovascular disease when postmenopausal. Over an average of 7.9 years of postmenopausal participation in the Women's Health Initiative, women with a single live birth who breast-fed for 7-12 months were significantly less likely to develop cardiovascular disease (hazard ratio 0.72, 95% confidence interval 0.53-0.97) than women who never breast-fed. CONCLUSION: Among postmenopausal women, increased duration of lactation was associated with a lower prevalence of hypertension, diabetes, hyperlipidemia, and cardiovascular disease.
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Compared with women who did not breastfeed, two US cohort studies found that morbidity from composite cardiovascular disease is lower in women with a lifetime length of lactation of more than 12 months.
“Compared with women who did not breastfeed, two US cohort studies found that morbidity from myocardial infarction92 and composite cardiovascular disease93 was lower in women with a lifetime length of lactation of more than 12 months.”
From Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review (2020) · cites this paper as [93]
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- Authors
- Schwarz, E. B., Ray, R. M., Stuebe, A. M., Allison, M. A., Ness, R. B., Freiberg, M. S., & Cauley, J. A.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Fred Hutch Cancer Center (US)
- University of California San Diego (US)
- University of Pittsburgh (US)
- ORCID
- Venue
- Obstetrics & Gynecology
- Published
- 2009-05
- Volume
- 113
- Issue
- 5
- Pages
- 974-982
- ISSN
- 0029-7844 (ISSN-L)
- PMC
- PMC2714700
- OpenAlex
- W2080803671
- Cited by
- 436
- References
- 28
- Citations by year
- 2026: 8 · 2025: 19 · 2024: 21 · 2023: 31 · 2022: 28 · 2021: 27 · 2020: 28 · 2019: 34 · 2018: 31 · 2017: 32 · 2016: 28 · 2015: 24 · 2014: 19 · 2013: 31 · 2012: 25
- FWCI
- 16.56
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (n01wh32105-27-0-1, n01wh32108-30-0-1, n01wh32100-28-0-1, n01wh32118-27-0-1, n01wh32111-28-0-1, n01wh32115-26-0-1, n01wh22110-38-0-0, N01-WH-3-2115, N01WH24152, n01wh24152-12-0-0, n01wh32122-31-0-1, N01-WH-3-2122, n01wh42107-22-0-1, N01-WH-32108-9, N01WH 32111-13, N01 WH 32105-6, N01 WH022110, N01WH32118-9, N01-WH-32100-2, N01-WH-42107-26)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD051585)
- Topics
- Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- lactation length, breastfeeding, postmenopausal women, cardiovascular disease, hypertension, diabetes mellitus, hyperlipidemia, obesity, cardiovascular risk factors, dose-response relationship, Women's Health Initiative
- MeSH terms
- Adult, Aged, Breast Feeding, Cardiovascular Diseases, Diabetes Mellitus, Female, Humans, Lactation, Life Style, Middle Aged, Obesity, Risk Factors, Socioeconomic Factors, Cohort Studies, Prevalence, Postmenopause, Young Adult
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