Breastfeeding History and Risk of Stroke Among Parous Postmenopausal Women in the Women's Health Initiative
Open accessAbstract
Background: Stroke is the third leading cause of death among US Hispanic and non‐Hispanic black women aged 65 and older. One factor that may protect against stroke is breastfeeding. Few studies have assessed the association between breastfeeding and stroke and whether this association differs by race and ethnicity. Methods and Results: Data were taken from the Women's Health Initiative Observational Study with follow‐up through 2010; adjusted hazard ratios for stroke subsequent to childbirth were estimated with Cox regression models accounting for left and right censoring, overall and stratified by race/ethnicity. Of the 80 191 parous women in the Women's Health Initiative Observational Study, 2699 (3.4%) had experienced a stroke within a follow‐up period of 12.6 years. The average age was 63.7 years at baseline. Fifty‐eight percent (n=46 699) reported ever breastfeeding; 83% were non‐Hispanic white, 8% were non‐Hispanic black, 4% were Hispanic, and 5% were of other race/ethnicity. After adjustment for nonmodifiable potential confounders, compared with women who had never breastfed, women who reported ever breastfeeding had a 23% lower risk of stroke (adjusted hazard ratio=0.77; 95% confidence interval 0.70‐0.83). This association was strongest for non‐Hispanic black women (adjusted hazard ratio=0.52; 95% confidence interval 0.37‐0.71). Further, breastfeeding for a relatively short duration (1‐6 months) was associated with a 19% lower risk of stroke (adjusted hazard ratios=0.81; 95% confidence interval 0.74‐0.89). This association appeared stronger with longer breastfeeding duration and among non‐Hispanic white and non‐Hispanic black women (test for trend P< 0.01). Conclusions: Study results show an association and dose‐response relationship between breastfeeding and lower risk of stroke among postmenopausal women after adjustment for multiple stroke risk factors and lifestyle variables. Further investigation is warranted.
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Longer length of breastfeeding versus never breastfed is associated with reduced morbidity from stroke in two cohort studies.
“Longer length of breastfeeding versus never breastfed was associated with reduced morbidity from stroke in two cohort studies.113 116”
From Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review (2020) · cites this paper as [113]
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- Authors
- Jacobson, L. T., Hade, E. M., Collins, T. C., Margolis, K. L., Waring, M. E., Van Horn, L. V., Silver, B., Sattari, M., Bird, C. E., Kimminau, K., Wambach, K., & Stefanick, M. L.
- Affiliations
- Department of Preventive Medicine and Public Health School of Medicine‐Wichita University of Kansas Wichita KS
- The Ohio State University (US)
- HealthPartners (US)
- University of Connecticut (US)
- Northwestern University Chicago IL
- University of Massachusetts Chan Medical School (US)
- University of Florida Health (US)
- RAND Corporation (US)
- University of Kansas Medical Center (US)
- Stanford University (US)
- Corresponding author
- Jacobson, Lisette T.
- ORCID
- Venue
- Journal of the American Heart Association
- Published
- 2018-09-04
- Volume
- 7
- Issue
- 17
- Pages
- e008739-e008739
- ISSN
- 2047-9980 (ISSN-L)
- PMC
- PMC6201437
- OpenAlex
- W2888635470
- Cited by
- 44
- References
- 80
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 3 · 2023: 5 · 2022: 7 · 2021: 4 · 2020: 8 · 2019: 7 · 2018: 3
- FWCI
- 4.29
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- Journal of the American Heart Association (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- The Journal of the American Medical Association (JAMA) Network (American Medical Association) (submittedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Heart, Lung, and Blood Institute (HHSN268201600018C, HHSN268201600004C, HHSN268201600001C, HHSN268201600003C, HHSN268201600002C)
- 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
- breastfeeding, stroke risk, postmenopausal women, parous women, breastfeeding duration, racial and ethnic differences, non-Hispanic Black women, Hispanic women, Women's Health Initiative Observational Study, stroke prevention
- MeSH terms
- Aged, Aged, 80 and over, Black or African American, Breast Feeding, Ethnicity, Female, Hispanic or Latino, Humans, Middle Aged, Time Factors, United States, Proportional Hazards Models, Postmenopause, Stroke, White People
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