Hypertensive disorders of pregnancy and breastfeeding practices: A secondary analysis of data from the All Our Families Cohort
Abstract Introduction Hypertensive disorders of pregnancy occur in approximately 7%–10% of pregnancies and are associated with adverse maternal cardiovascular health outcomes across the lifespan. In contrast, breastfeeding has been associated with a reduction in cardiovascular risk factors in a dose...
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Wiley
2022-08-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.14378 |
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| author | Kristin Horsley Kathleen Chaput Deborah Da Costa Tuong‐Vi Nguyen Natalie Dayan Lianne Tomfohr‐Madsen Suzanne Tough |
| author_facet | Kristin Horsley Kathleen Chaput Deborah Da Costa Tuong‐Vi Nguyen Natalie Dayan Lianne Tomfohr‐Madsen Suzanne Tough |
| author_sort | Kristin Horsley |
| collection | DOAJ |
| description | Abstract Introduction Hypertensive disorders of pregnancy occur in approximately 7%–10% of pregnancies and are associated with adverse maternal cardiovascular health outcomes across the lifespan. In contrast, breastfeeding has been associated with a reduction in cardiovascular risk factors in a dose‐dependent manner. Despite the potential protective effects of lactation on cardiovascular risk, how hypertensive disorders of pregnancy relate to breastfeeding practices and experiences is not well understood. The aim of this study was to investigate the association between hypertensive disorders of pregnancy and breastfeeding outcomes in the first year postpartum. Material and methods We conducted a secondary analysis of prospective data from the All Our Families Cohort, a population‐based study conducted in Calgary, Alberta, Canada. Women with a singleton pregnancy (n = 1418) who completed self‐report questionnaires at <25 weeks and 34–36 weeks of gestation, and 4 months and 12 months postpartum, and provided consent to link to electronic medical records that identified diagnoses of hypertensive disorders of pregnancy (n = 122). Logistic and multiple linear regression analyses were used to model associations between hypertensive disorders of pregnancy and breastfeeding outcomes. Outcomes included breastfeeding intention, intended duration, exclusive breastfeeding at 4 months, breastfeeding duration at 12 months and breastfeeding difficulties. Results Hypertensive disorders of pregnancy were not associated with breastfeeding intention (odds ration [OR] 1.30, 95% confidence interval [CI] 0.47–3.03, P = 0.57), intended breastfeeding duration (b = −3.28, 95% CI −7.04 to 0.48, P = 0.09), or initiation (OR = 0.64, 95% CI 0.29– 1.65, P = 0.32), but were associated with an increase in the odds of non‐exclusive breastfeeding at 4 months postpartum (OR = 2.11, 95% CI 1.39–3.22, P < 0.001). Women with hypertensive disorders breastfed for 6.26 (95% CI −10.00 to −2.51, P < 0.001) weeks less over 12 months postpartum, had significantly higher odds of reporting insufficient milk supply (OR = 1.75, 95% CI 1.19–2.46, P < 0.05) and had lower odds of breast and/or nipple pain (OR = 0.66, 95% CI 0.44–0.92, P < 0.05) compared with those without hypertensive disorders of pregnancy. Conclusions Hypertensive disorders of pregnancy are associated with altered breastfeeding practices and experiences during the first year postpartum. Further research is needed to examine biopsychosocial mechanisms through which hypertensive disorders associate with shorter breastfeeding duration, and to examine whether greater breastfeeding duration, intensity or exclusivity reduces short‐ or long‐term maternal cardiovascular risk. |
| format | Article |
| id | doaj-art-d8df005cf0a6436fa7137c93d5426041 |
| institution | DOAJ |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2022-08-01 |
| publisher | Wiley |
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| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-d8df005cf0a6436fa7137c93d54260412025-08-20T03:22:12ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122022-08-01101887187910.1111/aogs.14378Hypertensive disorders of pregnancy and breastfeeding practices: A secondary analysis of data from the All Our Families CohortKristin Horsley0Kathleen Chaput1Deborah Da Costa2Tuong‐Vi Nguyen3Natalie Dayan4Lianne Tomfohr‐Madsen5Suzanne Tough6Department of Psychology, Faculty of Science McGill University Montreal Quebec CanadaDepartment of Obstetrics and Gynecology, Cummings School of Medicine University of Calgary Calgary Alberta CanadaDepartment of Medicine, Faculty of Medicine, McGill University Montreal Quebec CanadaDepartment of Psychiatry, Faculty of Medicine McGill University Montreal Quebec CanadaDepartment of Medicine, Faculty of Medicine, McGill University Montreal Quebec CanadaDepartment of Psychology, Faculty of Arts University of Calgary Calgary Alberta CanadaDepartment of Pediatrics and Community Health Sciences, Cummings School of Medicine University of Calgary Calgary Alberta CanadaAbstract Introduction Hypertensive disorders of pregnancy occur in approximately 7%–10% of pregnancies and are associated with adverse maternal cardiovascular health outcomes across the lifespan. In contrast, breastfeeding has been associated with a reduction in cardiovascular risk factors in a dose‐dependent manner. Despite the potential protective effects of lactation on cardiovascular risk, how hypertensive disorders of pregnancy relate to breastfeeding practices and experiences is not well understood. The aim of this study was to investigate the association between hypertensive disorders of pregnancy and breastfeeding outcomes in the first year postpartum. Material and methods We conducted a secondary analysis of prospective data from the All Our Families Cohort, a population‐based study conducted in Calgary, Alberta, Canada. Women with a singleton pregnancy (n = 1418) who completed self‐report questionnaires at <25 weeks and 34–36 weeks of gestation, and 4 months and 12 months postpartum, and provided consent to link to electronic medical records that identified diagnoses of hypertensive disorders of pregnancy (n = 122). Logistic and multiple linear regression analyses were used to model associations between hypertensive disorders of pregnancy and breastfeeding outcomes. Outcomes included breastfeeding intention, intended duration, exclusive breastfeeding at 4 months, breastfeeding duration at 12 months and breastfeeding difficulties. Results Hypertensive disorders of pregnancy were not associated with breastfeeding intention (odds ration [OR] 1.30, 95% confidence interval [CI] 0.47–3.03, P = 0.57), intended breastfeeding duration (b = −3.28, 95% CI −7.04 to 0.48, P = 0.09), or initiation (OR = 0.64, 95% CI 0.29– 1.65, P = 0.32), but were associated with an increase in the odds of non‐exclusive breastfeeding at 4 months postpartum (OR = 2.11, 95% CI 1.39–3.22, P < 0.001). Women with hypertensive disorders breastfed for 6.26 (95% CI −10.00 to −2.51, P < 0.001) weeks less over 12 months postpartum, had significantly higher odds of reporting insufficient milk supply (OR = 1.75, 95% CI 1.19–2.46, P < 0.05) and had lower odds of breast and/or nipple pain (OR = 0.66, 95% CI 0.44–0.92, P < 0.05) compared with those without hypertensive disorders of pregnancy. Conclusions Hypertensive disorders of pregnancy are associated with altered breastfeeding practices and experiences during the first year postpartum. Further research is needed to examine biopsychosocial mechanisms through which hypertensive disorders associate with shorter breastfeeding duration, and to examine whether greater breastfeeding duration, intensity or exclusivity reduces short‐ or long‐term maternal cardiovascular risk.https://doi.org/10.1111/aogs.14378exclusive breastfeedinghigh‐riskhypertension in pregnancypreeclampsiapregnancypregnancy breastfeeding |
| spellingShingle | Kristin Horsley Kathleen Chaput Deborah Da Costa Tuong‐Vi Nguyen Natalie Dayan Lianne Tomfohr‐Madsen Suzanne Tough Hypertensive disorders of pregnancy and breastfeeding practices: A secondary analysis of data from the All Our Families Cohort Acta Obstetricia et Gynecologica Scandinavica exclusive breastfeeding high‐risk hypertension in pregnancy preeclampsia pregnancy pregnancy breastfeeding |
| title | Hypertensive disorders of pregnancy and breastfeeding practices: A secondary analysis of data from the All Our Families Cohort |
| title_full | Hypertensive disorders of pregnancy and breastfeeding practices: A secondary analysis of data from the All Our Families Cohort |
| title_fullStr | Hypertensive disorders of pregnancy and breastfeeding practices: A secondary analysis of data from the All Our Families Cohort |
| title_full_unstemmed | Hypertensive disorders of pregnancy and breastfeeding practices: A secondary analysis of data from the All Our Families Cohort |
| title_short | Hypertensive disorders of pregnancy and breastfeeding practices: A secondary analysis of data from the All Our Families Cohort |
| title_sort | hypertensive disorders of pregnancy and breastfeeding practices a secondary analysis of data from the all our families cohort |
| topic | exclusive breastfeeding high‐risk hypertension in pregnancy preeclampsia pregnancy pregnancy breastfeeding |
| url | https://doi.org/10.1111/aogs.14378 |
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