Effects of galactopoieses on post-partum dyslipidemia among obese women

Abstract

Pregnancy is associated with atherogenic changed in lipid metabolism. We evaluated the effects of galactopoieses on dyslipidemia among obese women at 6-8 weeks postpartum. This secondary analysis of the PAWS study, a randomized clinical trial of a sleep intervention vs. usual obstetric care in participants with BMI of ≥ 25kg/m 2 was conducted May 2014-April 2015 (NCT01968330). Exclusion criteria included multiple gestations, pregestational diabetes, obstructive sleep apnea, or sleep medication use. Data was collected at 6–8-week postpartum. Exposure was galactopoieses. Our group of lactating mothers was heterogenous with their degree of lactation. Primary outcome was maternal incidence of dyslipidemia at the postpartum visit defined by cholesterol ratio (TC/HDL-c) ≥3.5, TG ≥ 150mg/dL, TC ≥ 200mg/dL, HDL-c < 40mg/dL, or LDL-c ≥ 130mg/dL. Non-parametric analyses of the results included Xηι−∑θυαρεδTεστ and Mann Whitney U Test as appropriate with P value set to < 0.05 as significant. We included 25 mothers who received care at our institution. Of those, 12 (48%) reported lactation and 13 (52%) reported non-lactation. Baseline characteristics are presented in Table 1. Lactating when compared to non-lactating participants, were more likely to demonstrate dyslipidemia by cholesterol ratio in (100 vs 66; p=0.028), and HDL-c level (41.7 vs. 7.7; p=0.047) at the postpartum visit. No significant differences were noted in other additional lipid parameters including TC, LDL, and TGs (Table 2). The current analysis demonstrated a statistically significant decrease in HDL-c and increase in the cholesterol ratio of lactating mothers. Findings may be due to heterogenous differences in the amount of lactation or obesity attenuating the benefits of lactation. Short follow up period or mobilization of lipids in early lactation could also affect our results. Our cohort included predominantly Black, obese, underserved, marginalized women at high risk of cardiovascular disease. Our findings prompt further investigation of the effects of galactopoieses on obese mothers.View Large Image Figure ViewerDownload Hi-res image Download (PPT)