Lactation duration and ischemic heart disease among parous postmenopausal females from a prospective cohort study

Abstract Background This study aimed to evaluate the association of lactation duration with incident ischemic heart disease (IHD) and to determine the potential health gains from scaling up breastfeeding practice. Methods 130,147 parous postmenopausal females without IHD were included at baseline (2...

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Main Authors: Leying Hou, Shiyi Shan, Keyao Lu, Weidi Sun, Wen Liu, Xue Li, Changzheng Yuan, Peige Song
Format: Article
Language:English
Published: Nature Portfolio 2025-03-01
Series:Communications Medicine
Online Access:https://doi.org/10.1038/s43856-025-00806-w
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author Leying Hou
Shiyi Shan
Keyao Lu
Weidi Sun
Wen Liu
Xue Li
Changzheng Yuan
Peige Song
author_facet Leying Hou
Shiyi Shan
Keyao Lu
Weidi Sun
Wen Liu
Xue Li
Changzheng Yuan
Peige Song
author_sort Leying Hou
collection DOAJ
description Abstract Background This study aimed to evaluate the association of lactation duration with incident ischemic heart disease (IHD) and to determine the potential health gains from scaling up breastfeeding practice. Methods 130,147 parous postmenopausal females without IHD were included at baseline (2004–2008) from the China Kadoorie Biobank study. Lactation duration was self-reported and measured as lifetime, per child, and first child, respectively. Incident IHD was identified during follow-up (2004–2015). The dose-response associations between lactation duration and IHD were examined using Cox models with restricted cubic splines. Stratification analyses were conducted by socioeconomic status (SES) and residence. The number of preventable IHD cases was estimated using the population attributable fraction and potential impact fraction in various scenarios. Results The study shows that parous postmenopausal females who ever lactated have significantly lower risks of IHD, with adjusted hazard ratios (aHRs) varying from 0.71 (95%CI: 0.63–0.80) to 0.85 (95%CI: 0.75–0.96) for a lifetime, from 0.70 (0.63–0.78) to 0.82 (0.72–0.93) for per-child, and from 0.80 (0.74–0.87) to 0.92 (0.85–0.99) for the first-child, appearing as U-shaped associations. Similar associations are found in females with low SES and urban residence. The scaling up of breastfeeding to near-universal levels could have prevented up to 115,000 new IHD cases among Chinese females aged over 40 years in 2019. Conclusions Lactation demonstrates potential benefits in reducing IHD risk, appearing as U-shaped associations among Chinese parous postmenopausal females, especially for those with low SES in urban areas. Scaling up breastfeeding practices serves as a promising strategy for reducing the IHD burden in China.
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spelling doaj-art-73bf69ee6d7744b9b921b9720ff443602025-08-20T03:40:50ZengNature PortfolioCommunications Medicine2730-664X2025-03-015111110.1038/s43856-025-00806-wLactation duration and ischemic heart disease among parous postmenopausal females from a prospective cohort studyLeying Hou0Shiyi Shan1Keyao Lu2Weidi Sun3Wen Liu4Xue Li5Changzheng Yuan6Peige Song7Center for Clinical Big Data and Statistics of the Second Affiliated Hospital, Zhejiang University School of MedicineCenter for Clinical Big Data and Statistics of the Second Affiliated Hospital, Zhejiang University School of MedicineSchool of Public Health, Zhejiang University School of MedicineCenter for Clinical Big Data and Statistics of the Second Affiliated Hospital, Zhejiang University School of MedicineSchool of Public Health, Zhejiang University School of MedicineSchool of Public Health and the Second Affiliated Hospital, Zhejiang University School of MedicineSchool of Public Health and the Second Affiliated Hospital, Zhejiang University School of MedicineCenter for Clinical Big Data and Statistics of the Second Affiliated Hospital, Zhejiang University School of MedicineAbstract Background This study aimed to evaluate the association of lactation duration with incident ischemic heart disease (IHD) and to determine the potential health gains from scaling up breastfeeding practice. Methods 130,147 parous postmenopausal females without IHD were included at baseline (2004–2008) from the China Kadoorie Biobank study. Lactation duration was self-reported and measured as lifetime, per child, and first child, respectively. Incident IHD was identified during follow-up (2004–2015). The dose-response associations between lactation duration and IHD were examined using Cox models with restricted cubic splines. Stratification analyses were conducted by socioeconomic status (SES) and residence. The number of preventable IHD cases was estimated using the population attributable fraction and potential impact fraction in various scenarios. Results The study shows that parous postmenopausal females who ever lactated have significantly lower risks of IHD, with adjusted hazard ratios (aHRs) varying from 0.71 (95%CI: 0.63–0.80) to 0.85 (95%CI: 0.75–0.96) for a lifetime, from 0.70 (0.63–0.78) to 0.82 (0.72–0.93) for per-child, and from 0.80 (0.74–0.87) to 0.92 (0.85–0.99) for the first-child, appearing as U-shaped associations. Similar associations are found in females with low SES and urban residence. The scaling up of breastfeeding to near-universal levels could have prevented up to 115,000 new IHD cases among Chinese females aged over 40 years in 2019. Conclusions Lactation demonstrates potential benefits in reducing IHD risk, appearing as U-shaped associations among Chinese parous postmenopausal females, especially for those with low SES in urban areas. Scaling up breastfeeding practices serves as a promising strategy for reducing the IHD burden in China.https://doi.org/10.1038/s43856-025-00806-w
spellingShingle Leying Hou
Shiyi Shan
Keyao Lu
Weidi Sun
Wen Liu
Xue Li
Changzheng Yuan
Peige Song
Lactation duration and ischemic heart disease among parous postmenopausal females from a prospective cohort study
Communications Medicine
title Lactation duration and ischemic heart disease among parous postmenopausal females from a prospective cohort study
title_full Lactation duration and ischemic heart disease among parous postmenopausal females from a prospective cohort study
title_fullStr Lactation duration and ischemic heart disease among parous postmenopausal females from a prospective cohort study
title_full_unstemmed Lactation duration and ischemic heart disease among parous postmenopausal females from a prospective cohort study
title_short Lactation duration and ischemic heart disease among parous postmenopausal females from a prospective cohort study
title_sort lactation duration and ischemic heart disease among parous postmenopausal females from a prospective cohort study
url https://doi.org/10.1038/s43856-025-00806-w
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