Lactation intensity and duration to postpartum diabetes and prediabetes risk in women with gestational diabetes.

Abstract

To investigate the association of lactation intensity and duration with postpartum diabetes and prediabetes risks among Chinese women with a history of gestational diabetes (GDM). We included 1260 women with a history of GDM who participated in the whole population's GDM universal screening survey by using the 1999 World Health Organization's criteria. Lactation intensity and lactation duration were collected by a standardized questionnaire. Postpartum diabetes and prediabetes risk were confirmed by an oral glucose tolerance test. During a mean postpartum period of 3.65years, we identified 114 cases of diabetes and 417 cases of prediabetes. The multivariable-adjusted hazard ratios based on different lactation intensity (exclusive formula, mixed feeding, and exclusive lactation) were 1.00, 0.68, 0.45 for diabetes (Ptrend =0.008), and 1.00, 0.74, and 0.61 for prediabetes (Ptrend =0.006), respectively. The multivariable-adjusted hazard ratios associated with different lactation duration (none, 0-6months, 6-12months, 12-18months, and ≥18months) were 1.00, 0.66, 0.42, 0.66, and 0.25 for diabetes (Ptrend =0.013), and 1.00, 0.82, 0.62, 0.67, and 0.63 for prediabetes (Ptrend =0.021), respectively. A restricted cubic spline curve showed a graded inverse association of lactation duration with the risks of diabetes and prediabetes (Ptrend <0.001). Higher-lactation intensity and longer-lactation duration were significantly associated with lower risks of postpartum diabetes and prediabetes among Chinese women with a history of GDM.