title: Maternal pre-pregnancy BMI, gestational weight gain and breastfeeding.
abstract: OBJECTIVE
  The aims were to investigate the association of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with breastfeeding (BF) duration and BF pattern at 3 months of age.
  
  
  METHODS
  This was a prospective cohort study of 4231 children who were enrolled at birth and were followed-up at 3, 12, 24 and 48 months of age to gather information on maternal and offspring characteristics including BF patterns and BF duration. Maternal pre-pregnancy BMI was categorized according to the WHO classification and GWG according to the 2009 Institute of Medicine recommendations. Cox's proportional hazards model was used to assess whether pre-pregnancy BMI and GWG were associated with BF and exclusive breastfeeding (EBF) duration. Predicted probabilities of BF patterns at 3 months were estimated by multinomial logistic regression.
  
  
  RESULTS
  Information on BF was available to 4011 infants. The total BF and EBF median durations were 7.0 months and 1.5 months, respectively. There were no differences in duration of any BF or EBF according to pre-pregnancy BMI or GWG categories. There was an increased predicted probability for weaning before the age of 3 months among infants from obese women, compared with those from mothers with normal pre-pregnancy BMI, with margins adjusted predictions of 0.36 (95% confidence interval (CI) 0.31-0.41) and 0.23 (95% CI 0.21-0.25), respectively.
  
  
  CONCLUSIONS
  Infants from pre-pregnancy overweight/obese mothers presented higher probability of early weaning compared with infants from normal-weight mothers. Obese/overweight pregnant women need supplementary guidance about BF benefits to infant health during prenatal and postnatal care.
authors.affiliation: Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
authors.forename: H
authors.initials: H
authors.lastname: Castillo
authors.affiliation: Department of Social Medicine, Postgraduate Program in Epidemiology, School of Medicine, Federal University of Pelotas, Pelotas, Brazil.
authors.forename: I S
authors.initials: IS
authors.lastname: Santos
authors.affiliation: Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: A
authors.initials: A
authors.lastname: Matijasevich
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001938:Brazil; D001942:Breast Feeding; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology*; D011247:Pregnancy; D016016:Proportional Hazards Models; D011446:Prospective Studies; D014886:Weaning; D015430:Weight Gain; D055815:Young Adult
references.citation: Rev Saude Publica. 2000 Jun;34(3):259-65
references.pmid: 10920448
references.citation: Midwifery. 2015 May;31(5):532-9
references.pmid: 25726006
references.citation: Obstet Gynecol. 2004 Feb;103(2):219-24
references.pmid: 14754687
references.citation: J Hum Lact. 2004 Feb;20(1):18-29
references.pmid: 14974697
references.citation: Pediatrics. 2004 May;113(5):e465-71
references.pmid: 15121990
references.citation: BMC Pediatr. 2003 Dec 16;3:13
references.pmid: 14678563
references.citation: J Pediatr. 1970 Jul;77(1):1-10
references.pmid: 5430794
references.citation: Br Med J (Clin Res Ed). 1986 Aug 23;293(6545):482-3
references.pmid: 3790209
references.citation: Proc Nutr Soc. 1993 Feb;52(1):19-28
references.pmid: 8493265
references.citation: Ann Epidemiol. 1992 Sep;2(5):715-21
references.pmid: 1342323
references.citation: Bull World Health Organ. 1995;73(2):165-74
references.pmid: 7743587
references.citation: Rev Saude Publica. 1997 Jun;31(3):247-53
references.pmid: 9515261
references.citation: Reprod Fertil Dev. 1998;10(1):55-63
references.pmid: 9727593
references.citation: Am J Clin Nutr. 2004 Dec;80(6):1579-88
references.pmid: 15585772
references.citation: Natl Vital Stat Rep. 2005 Sep 8;54(2):1-116
references.pmid: 16176060
references.citation: Acta Paediatr. 2005 Sep;94(9):1310-9
references.pmid: 16278998
references.citation: BJOG. 2006 Oct;113(10):1117-25
references.pmid: 16903839
references.citation: Am J Clin Nutr. 2007 Aug;86(2):404-11
references.pmid: 17684212
references.citation: BMC Pregnancy Childbirth. 2007;7:9
references.pmid: 17608952
references.citation: Cad Saude Publica. 2008;24 Suppl 3:S409-16
references.pmid: 18797716
references.citation: J Pediatr. 2009 Oct;155(4):505-9
references.pmid: 19595369
references.citation: J Hum Lact. 2010 May;26(2):138-47
references.pmid: 19910520
references.citation: Women Birth. 2010 Dec;23(4):135-45
references.pmid: 20299299
references.citation: Arch Gynecol Obstet. 2011 Feb;283(2):249-53
references.pmid: 20098995
references.citation: BMC Public Health. 2011;11 Suppl 3:S15
references.pmid: 21501432
references.citation: Int J Epidemiol. 2011 Dec;40(6):1461-8
references.pmid: 20702597
references.citation: J Obstet Gynaecol Can. 2012 Jul;34(7):637-47
references.pmid: 22742482
references.citation: PLoS One. 2012;7(8):e39589
references.pmid: 22912663
references.citation: Breastfeed Med. 2012 Dec;7(6):448-56
references.pmid: 23215909
references.citation: Matern Child Health J. 2013 Dec;17(10):1872-8
references.pmid: 23247668
references.citation: Matern Child Nutr. 2014 Apr;10(2):166-83
references.pmid: 22905677
references.citation: Rev Saude Publica. 2014 Aug;48(4):697-708
references.pmid: 25210829
references.citation: ScientificWorldJournal. 2014;2014:964236
references.pmid: 25379554
references.citation: Int J Obes Relat Metab Disord. 2003 Jan;27(1):117-27
references.pmid: 12532163