Objective-To evaluate whether lactation duration is associated with lower prevalence of metabolic syndrome (MetSyn) in midlife, parous women.Study Design-Cross-sectional cohort analysis of 2, 516 parous, midlife women using multivariable logistic regression to determine the independent association of lactation and lactation duration on prevalence of MetSyn.Results-1,620 (64.4%) women reported a history of breastfeeding, with average lifetime duration of lactation of 1.16 (± 1.04) years. MetSyn was present in 536 (21.3%) women. Adjusting for age, smoking history, parity, ethnicity, socioeconomic status, study site, physical activity, caloric intake and high school body mass index (BMI), women with prior lactation had significantly lower odds of MetSyn (odds ratio [OR] = 0.79, 95% confidence interval [CI]= 0.63-0.99). Furthermore, increasing duration of lactation was similarly associated with lower odds of MetSyn (OR= 0.88, 95% CI= 0.77-0.99).Conclusions-Duration of lactation is associated with lower prevalence of MetSyn in a doseresponse manner in midlife, parous women.

We report a case of a fetus with shortened proximal long bones, ambiguous genitalia, intrauterine growth restriction and abnormal umbilical artery Doppler velocities observed on antenatal ultrasound exam. At 34 weeks the patient revealed methotrexate/misoprostol exposure at 6 weeks gestational age in attempted medical termination of pregnancy. On newborn exam, the baby had dysmorphic facial features, a short torso, scoliosis, a micropenis (phallus <1 cm) and shortened proximal long bones both upper and lower extremities. X-ray exam revealed a hemivertebra at T10 level, rib abnormalities, shortened proximal long bones, an absent pubic bone and bilateral knee ossification centers. With methotrexate exposure, improved counseling and surveillance could potentially avoid these significant abnormalities and prevent psychological distress.

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