title: The Effects of Mild Gestational Hyperglycemia on Exclusive Breastfeeding Cessation.
abstract: Gestational diabetes increases the risk of a range of adverse perinatal outcomes, including breastfeeding failure, but the best cut-off point for gestational diabetes is unknown. The purpose of this study was to evaluate the association between mild gestational glucose tolerance impairment and the early cessation of exclusive breastfeeding (EBF). This is an observational study of 768 women with full term pregnancies that were screened for gestational diabetes at 24-28 weeks gestation. Subjects were divided into two groups: those with a normal 1-h glucose challenge test and those with an elevated 1-h glucose challenge test but still did not qualify for gestational diabetes. We constructed multivariable logistic regression models using data from 616 women with normal gestational glucose tolerance and 152 women with an isolated positive 1-h glucose challenge test. The risk of early exclusive breastfeeding cessation was found to increase in women with mildly impaired glucose tolerance during pregnancy (adjusted OR, 1.65; 95% CI: 1.11, 2.45). Risks of early EBF cessation were also independently associated with the amount of neonatal weight loss and admission to the neonatal ward. Instead, parity was associated with a decreased risk for shorter EBF duration. Insulin resistance-even in the absence of gestational diabetes mellitus-may be an impeding factor for EBF.
authors.affiliation: Department of Primary Care, Balearic Health Authority, Health Sciences Research Institute IUNICS, 10 Alexandre Rosselló Ave, 07002 Palma de Mallorca, Spain. drsverd@gmail.com.|Department of Primary Care, Balearic Health Authority, 07003 Palma de Mallorca, Spain. drsverd@gmail.com.
authors.forename: Sergio
authors.initials: S
authors.lastname: Verd
authors.affiliation: Endocrinology Unit, Department of Paediatrics, Hospital Son Espases, Valldemossa Road, 79, 07010 Palma de Mallorca, Spain. diego.desotto@ssib.es.
authors.forename: Diego
authors.initials: D
authors.lastname: de Sotto
authors.affiliation: Department of Primary Care, Balearic Health Authority, 07003 Palma de Mallorca, Spain. consuelofernandez@ibsalut.caib.es.
authors.forename: Consuelo
authors.initials: C
authors.lastname: Fernández
authors.affiliation: Molecular Biology Unit, Division of Hematology, Son Espases University Hospital, Valldemossa Road, 79, 07010 Palma de Mallorca, Spain. antoniom.gutierrez@ssib.es.|Palma de Mallorca Institute of Health Research (IdISPa), Valldemossa Road, 79, 07010 Palma de Mallorca, Spain. antoniom.gutierrez@ssib.es.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gutiérrez
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D001942:Breast Feeding; D016009:Chi-Square Distribution; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000150:complications* / Q000175:diagnosis; D007333:Insulin Resistance; D007774:Lactation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000175:diagnosis; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose
keywords: breastfeeding; gestational diabetes; glucose tolerance test; insulin resistance; neonate; prediabetes; pregnancy outcomes