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Cited by 72Breastfeeding Practices and InfluencesCardiovascular Health and Disease PreventionCancer Risks and Factors

Lactation Duration and Midlife Atherosclerosis

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Gunderson, Erica P., Quesenberry, Charles P., Ning, Xian, Jacobs, David R., Gross, Myron, Goff, David C., Pletcher, Mark J., Lewis, Cora E.·2015·Obstetrics & Gynecology
DOI 10.1097/aog.0000000000000919PMC PMC5193138
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Abstract

OBJECTIVE: To evaluate lactation duration in relation to subsequent atherosclerosis in women during midlife. METHODS: The Coronary Artery Risk Development in Young Adults study is a multicenter prospective cohort that enrolled 2,787 women in 1985-1986 (ages 18-30 years, 52% black, 48% white), of whom 2,014 (72%) attended the 20-year follow-up examination in 2005-2006. We selected 846 women (46% black) without heart disease or diabetes at baseline who delivered one or more times after the baseline evaluation, had cardiometabolic risk factors measured at baseline, and had maximum common carotid intima-media thickness (mm) measured at the 20-year follow-up examination in 2005-2006. Lactation duration was summed across all postbaseline births for each woman and (n, women) categorized as: 0 to less than 1 month (n=262), 1 to less than 6 months (n=210), 6 to less than 10 months (n=169), and 10 months or greater (n=205). Multiple linear regression models estimated mean common carotid intima-media thickness (95% confidence interval) and mean differences among lactation duration groups compared with the 0 to less than 1-month group adjusted for prepregnancy obesity, cardiometabolic status, parity, and other risk factors. RESULTS: Lactation duration had a graded inverse association with common carotid intima-media thickness; mean differences between 10 months or greater compared with 0 to less than 1 month ranged from -0.062 mm for unadjusted models (P trend <.001) to -0.029 mm for models fully adjusted for prepregnancy body mass index (BMI) and cardiometabolic risk factors, parity, smoking, and sociodemographics (P trend=.010). Stepwise addition of potential mediators (BMI, systolic blood pressure at the 20-year follow-up examination) modestly attenuated the lactation and common carotid intima-media thickness association to -0.027 and -0.023 mm (P trend=.019 and .054). CONCLUSION: Shorter lactation duration is associated with subclinical atherosclerosis independent of prepregnancy cardiometabolic risk factors and traditional risk factors. The magnitude of differences in carotid artery intima-media thickness may represent greater vascular aging. Lactation may have long-term benefits that lower cardiovascular disease risk in women. LEVEL OF EVIDENCE: II.

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  • Never breastfed was associated with vascular characteristics (larger arterial lumen and adventitial diameters) linked to a higher risk of cardiovascular disease independent of sociodemographic characteristics, health related behaviour, family history, and body mass index.

    “never breastfed was associated with vascular characteristics (larger arterial lumen and adventitial diameters) linked to a higher risk of cardiovascular disease independent of sociodemographic characteristics, health related behaviour, family history, and body mass index”

    From Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review (2020) · cites this paper as [118]

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Authors
Gunderson, E. P., Quesenberry, C. P., Ning, X., Jacobs, D. R., Gross, M., Goff, D. C., Pletcher, M. J., & Lewis, C. E.
Affiliations
Northwestern University (US)
ORCID
Venue
Obstetrics & Gynecology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2015-08
Volume
126
Issue
2
Pages
381-390
ISSN
0029-7844 (ISSN-L)
DOI
10.1097/aog.0000000000000919
PMC
PMC5193138
OpenAlex
W2170166614
Cited by
72
References
32
Citations by year
2026: 2 · 2025: 7 · 2024: 9 · 2023: 13 · 2022: 6 · 2021: 7 · 2020: 10 · 2019: 7 · 2018: 5 · 2017: 2 · 2016: 3 · 2015: 1
FWCI
2.87
Type
journal article
Language
en
Open access
Locations
  • Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Institutes of Health (n01hc48050-59-0-1)
  • National Institute on Aging (AG 0005)
  • National Heart, Lung, and Blood Institute (HHSN268201300028C, HHS-N2-68201300029C, HHSN268201300027C, HHSN268200900041C, HHSN268201300026C, HHS-N2-68201300025C, N01 HC048050)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01DK090047, K01DK059944)
Topics
  • Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
  • Health Sciences › Medicine › Oncology › Cancer Risks and Factors
Keywords
lactation length, atherosclerosis, subclinical atherosclerosis, carotid intima-media thickness, middle-aged women, postpartum period, pre-pregnancy body mass index, cardiometabolic risk factors, systolic blood pressure, Coronary Artery Risk Development in Young Adults Study, cardiovascular risk factors, parity, smoking, Black women
MeSH terms
Adult, Breast Feeding, Coronary Artery Disease, Ethnicity, Female, Humans, Lactation, Longitudinal Studies, Pregnancy, Prospective Studies, Risk Factors, Time Factors, United States, Multivariate Analysis, Linear Models, Risk Assessment, Carotid Intima-Media Thickness

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