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Cited by 118Breastfeeding Practices and InfluencesCancer Risks and FactorsCardiovascular Health and Risk Factors

Breastfeeding and the Risk of Maternal Cardiovascular Disease: A Prospective Study of 300 000 Chinese Women

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Peters, Sanne A. E., Yang, Ling, Guo, Yu, Chen, Yiping, Bian, Zheng, Du, Jianwei, Yang, Jie, Li, Shanpeng +164 more·2017·Journal of the American Heart Association
DOI 10.1161/jaha.117.006081PMC PMC5669201
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Abstract

Background: Breastfeeding confers substantial benefits to child health and has also been associated with lower risk of maternal cardiovascular diseases ( CVDs ) in later life. However, the evidence on the effects of CVD is still inconsistent, especially in East Asians, in whom the frequency and duration of breastfeeding significantly differ from those in the West. Methods and Results: In 2004–2008, the nationwide China Kadoorie Biobank recruited 0.5 million individuals aged 30 to 79 years from 10 diverse regions across China. During 8 years of follow‐up, 16 671 incident cases of coronary heart disease and 23 983 cases of stroke were recorded among 289 573 women without prior CVD at baseline. Cox regression yielded adjusted hazard ratios ( HR s) and 95% CIs for incident CVD by breastfeeding. Overall, ≈99% of women had given birth, among whom 97% reported a history of breastfeeding, with a median duration of 12 months per child. Compared with parous women who had never breastfed, ever breastfeeding was associated with a significantly lower risk of CVD , with adjusted HR s of 0.91 (95% CI, 0.84–0.99) for coronary heart disease and 0.92 (95% CI, 0.85–0.99) for stroke. Women who had breastfed for ≥24 months had an 18% ( HR, 0.82; 0.77–0.87) lower risk of coronary heart disease and a 17% ( HR, 0.83; 0.79–0.87) lower risk of stroke compared with women who had never breastfed. Among women who ever breastfed, each additional 6 months of breastfeeding per child was associated with an adjusted HR of 0.96 (95% CI, 0.94–0.98) for coronary heart disease and 0.97 (95% CI, 0.96–0.98) for stroke. Conclusions: Among Chinese women, a history of breastfeeding was associated with an ≈10% lower risk of CVD in later life and the magnitude of the inverse association was stronger among those with a longer duration of breastfeeding.

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Authors
Peters, S. A. E., Yang, L., Guo, Y., Chen, Y., Bian, Z., Du, J., Yang, J., Li, S., Li, L., Woodward, M., Chen, Z., the China Kadoorie Biobank Collaboration Group, Chen, J., Collins, R., Peto, R., Bennett, D., Chang, Y., Clarke, R., Du, H., Fan, X., Gilbert, S., Hacker, A., Holmes, M., Iona, A., Kartsonaki, C., Kerosi, R., Kong, L., Kurmi, O., Lancaster, G., Lewington, S., McDonnell, J., Millwood, I., Nie, Q., Radhakrishnan, J., Rafiq, S., Ryder, P., Sansome, S., Schmidt, D., Sherliker, P., Sohoni, R., Turnbull, I., Walters, R., Wang, J., Wang, L., Yang, X., Chen, G., Han, B., Hou, C., Lv, J., Pei, P., Qu, S., Tan, Y., Yu, C., Zhou, H., Pang, Z., Gao, R., Wang, S., Liu, Y., Du, R., Zang, Y., Cheng, L., Tian, X., Zhang, H., Lv, S., Wang, J., Hou, W., Yin, J., Jiang, G., Liu, S., Pang, Z., Zhou, X., Yang, L., He, H., Yu, B., Li, Y., Mu, H., Xu, Q., Dou, M., Ren, J., Wang, S., Hu, X., Wang, H., Chen, J., Fu, Y., Fu, Z., Wang, X., Dong, H., Weng, M., Zheng, X., Li, Y., Li, H., Li, C., Wu, M., Zhou, J., Tao, R., Shen, J., Hu, Y., Lu, Y., Gao, Y., Ma, L., Zhou, R., Tang, A., Zhang, S., Jin, J., Tang, Z., Chen, N., Huang, Y., Li, M., Meng, J., Pan, R., Jiang, Q., Qing, J., Zhang, W., Liu, Y., Wei, L., Zhou, L., Chen, N., Yang, J., Guan, H., Wu, X., Zhang, N., Chen, X., Tang, X., Luo, G., Li, J., Chen, X., Wang, J., Liu, J., Sun, Q., Ge, P., Ren, X., Dong, C., Zhang, H., Mao, E., Wang, X., Wang, T., Liu, G., Zhu, B., Zhou, G., Feng, S., Chang, L., Fan, L., Gao, Y., He, T., Jiang, L., Sun, H., He, P., Hu, C., Lv, Q., Zhang, X., Yu, M., Hu, R., Fang, L., Wang, H., Qian, Y., Wang, C., Xie, K., Chen, L., Pan, Y., Pan, D., Huang, Y., Chen, B., Jin, D., Liu, H., Fu, Z., Xu, Q., Xu, X., g, Y., Jia, W., Li, X., Zhang, L., & Qiu, Z.
Affiliations
  • The George Institute for Global Health (GB)
  • University of Oxford (GB)
  • Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
  • Hainan CDC, Haikou, Hainan, China
  • Jiangsu CDC NCDs Prevention and Control Department, Nanjing, Jiangsu, China
  • Qingdao CDC, Qingdao, China
  • Johns Hopkins University (US)
  • Huazhong University of Science and Technology (CN)
  • Guizhou University (CN)
  • Fuzhou University (CN)
  • Hunan University (CN)
Corresponding author
  • Woodward, Mark
  • Chen, Zhengming
ORCID
Venue
Journal of the American Heart Association
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2017-11-06
Volume
6
Issue
6
ISSN
2047-9980 (ISSN-L)
DOI
10.1161/jaha.117.006081
PMC
PMC5669201
OpenAlex
W2695710583
Cited by
118
References
31
Citations by year
2026: 1 · 2025: 15 · 2024: 13 · 2023: 9 · 2022: 14 · 2021: 11 · 2020: 9 · 2019: 36 · 2018: 7 · 2017: 3
FWCI
11.78
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of the American Heart Association (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • UNSWorks (UNSW Sydney) (submittedVersion, cc-by)
Funders
  • Wellcome Trust (088158/Z/09/Z, 104085/Z/14/Z)
  • Centers for Disease Control and Prevention
Topics
  • Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
  • Health Sciences › Medicine › Oncology › Cancer Risks and Factors
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Keywords
breastfeeding, maternal cardiovascular disease, coronary artery disease, stroke, breastfeeding duration, Chinese women, China Kadoorie Biobank, East Asian women, postpartum cardiovascular risk
MeSH terms
Adult, Age Factors, Aged, Breast Feeding, Cardiovascular Diseases, China, Female, Humans, Middle Aged, Prognosis, Prospective Studies, Risk Factors, Sex Factors, Time Factors, Incidence, Proportional Hazards Models, Risk Assessment, Protective Factors

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