Breast‐feeding and the onset of rheumatoid arthritis

Abstract

Objective. In a recent study we demonstrated that the postpartum period, particularly after the first pregnancy, is a time of increased risk for the development of rheumatoid arthritis (RA). The present study was undertaken to investigate whether this risk might be explained by breast-feeding. Methods. Through a nationwide media campaign, we identified 187 women who had developed RA within 12 months of a pregnancy, and we compared their breast-feeding histories with those of 149 similarly aged women chosen from the patient registers of a nationwide group of general practitioners.Results. In all, 88 of the women with RA developed the disease after their first pregnancy. Eighty-one percent of these 88 women had breast-fed. This was higher than the breast-feeding prevalence of 50% in the 129 controls whose first pregnancy had resulted in a live birth (adjusted odds ratio [OR] 5.4, 95% confidence interval 2.5-11.4). There was a smaller increased risk of breast-feeding after a second pregnancy in the RA cases (OR 2.0) and no increase after a third pregnancy (OR 0.6). The increase in risk was greatest in those cases whose disease was erosive and who were rheumatoid factor positive.Conclusion. In a small group of susceptible women, exposure to breast-feeding after the first pregnancy is associated with a significant increase in risk for RA development. We postulate that this may reflect hormonal influences, specifically the high level of the proinflammatory hormone prolactin.Premenopausal women are approximately 3 times more likely to develop rheumatoid arthritis (RA) than are men (l), and thus much effort in understand-

Atypical Presentations of Rheumatoid Arthritis

“…In a recent study we demonstrated that the postpartum period, particularly after the first pregnancy, is a time of increased risk for the development of rheumatoid arthritis (RA) which may reflect hormonal influences, specifically the high level of the proinflammatory hormone prolactin 29 . The onset of RA symptoms is reduced during pregnancy and increased in the postpartum period.…”

Os benefícios da amamentação para a saúde da mulher

“…24 In another case control study with 88 English women who developed rheumatoid arthritis after their first child was born, the incidence of the disease was five times more frequent among those who breastfed. 25 …”

“…10,[18][19][20][21][22] There are also evidences that breastfeeding reduces the risk of death from rheumatoid arthritis. [23][24][25][26][27] Many studies have presented the relationship between breastfeeding and postnatal amenorrhea, and the occurrence of a consequent longer intergestational period. 10,[28][29][30][31][32][33][34][35][36][37][38][39][40][41] Other benefits for lactating women are the faster loss of weight gained during the pregnancy, [38][39][40][42][43][44][45] and the reduced postnatal uterine bleeding, which leads to less anemia 10 due to the faster uterus involution caused by the greater oxytocin release.…”

Focusing on arthritis and parenting

“…Some evidence links the onset and prognosis of rheumatoid arthritis with exposure to breastfeeding in susceptible women (Brennan and Silman, 1994;Jorgensen et al, 1994). Clearly, this study has underlined the urgent need for further information to be made available.…”