Breastfeeding Is Associated With a Reduced Maternal Cardiovascular Risk: Systematic Review and Meta‐Analysis Involving Data From 8 Studies and 1 192 700 Parous Women

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Lisa Seekircher¹  Peter Willeit¹  Lena Tschiderer¹  Setor K. Kunutsor²  Linda M. O’Keeffe³  Sanne A. E. Peters⁴ 

[1] Clinical Epidemiology Team Medical University of Innsbruck Innsbruck Austria;National Institute for Health Research Bristol Biomedical Research CentreUniversity Hospitals Bristol and Weston National Health Service Foundation Trust and the University of Bristol Bristol United Kingdom;School of Public Health, Western Gateway Building University College Cork Cork Ireland;The George Institute for Global HealthSchool of Public HealthImperial College London London United Kingdom;

关键词: breastfeeding;    cardiovascular diseases;    maternal risk;    meta‐analysis;    systematic review;   

DOI  :  10.1161/JAHA.121.022746

来源: DOAJ

【 摘 要 】

Background Breastfeeding has been robustly linked to reduced maternal risk of breast cancer, ovarian cancer, and type 2 diabetes. We herein systematically reviewed the published evidence on the association of breastfeeding with maternal risk of cardiovascular disease (CVD) outcomes. Methods and Results Our systematic search of PubMed and Web of Science of articles published up to April 16, 2021, identified 8 relevant prospective studies involving 1 192 700 parous women (weighted mean age: 51.3 years at study entry, 24.6 years at first birth; weighted mean number of births: 2.3). A total of 982 566 women (82%) reported having ever breastfed (weighted mean lifetime duration of breastfeeding: 15.6 months). During a weighted median follow‐up of 10.3 years, 54 226 CVD, 26 913 coronary heart disease, 30 843 stroke, and 10 766 fatal CVD events were recorded. In a random‐effects meta‐analysis, the pooled multivariable‐adjusted hazard ratios comparing parous women who ever breastfed to those who never breastfed were 0.89 for CVD (95% CI, 0.83–0.95; I2=79.4%), 0.86 for coronary heart disease (95% CI, 0.78–0.95; I2=79.7%), 0.88 for stroke (95% CI, 0.79–0.99; I2=79.6%), and 0.83 for fatal CVD (95% CI, 0.76–0.92; I2=47.7%). The quality of the evidence assessed with the Grading of Recommendations Assessment, Development, and Evaluation tool ranged from very low to moderate, which was mainly driven by high between‐studies heterogeneity. Strengths of associations did not differ by mean age at study entry, median follow‐up duration, mean parity, level of adjustment, study quality, or geographical region. A progressive risk reduction of all CVD outcomes with lifetime durations of breastfeeding from 0 up to 12 months was found, with some uncertainty about shapes of associations for longer durations. Conclusions Breastfeeding was associated with reduced maternal risk of CVD outcomes.

【 授权许可】

Unknown