Metabolic effects of breastfeed in women with prior gestational diabetes mellitus: A systematic review and meta‐analysis

Ma, Shujuan; Hu, Shimin; Liang, Huiling; Xiao, Yanni; Tan, Hongzhuan

doi:10.1002/dmrr.3108

Cited by 20 publications

(20 citation statements)

References 64 publications

(225 reference statements)

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“…Compared with women with shorter duration of BF, longer BF duration was associated with improvement in glucometabolic parameters, including lower fasting glucose and enhanced insulin sensitivity, lower BMI at follow up improved lipid metabolism as demonstrated by lower triglyceride levels. Thus, BF is potentially of great value as a low cost preventative measure in preventing both T2DM and related metabolic derangements in women with a history of GDM, in addition to its other well recognized benefits ( 80 ). Evidence for prevention of CV disease in women with history of GDM through post-partum interventions is currently lacking; but logically breast feeding and improved post-partum lifestyle would be predicted to reduce the risk significantly.…”

Section: Prevention Of Future Ncd—mother and Offspringmentioning

confidence: 99%

Gestational Diabetes Mellitus—Innovative Approach to Prediction, Diagnosis, Management, and Prevention of Future NCD—Mother and Offspring

et al. 2020

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Gestational diabetes mellitus (GDM) is the commonest medical complication of pregnancy. The association of GDM with immediate pregnancy complications including excess fetal growth and adiposity with subsequent risk of birth trauma and with hypertensive disorders of pregnancy is well recognized. However, the associations with wide ranges of longer-term health outcomes for mother and baby, including the lifetime risks of obesity, pre-diabetes, and diabetes and cardiovascular disease have received less attention and few health systems address these important issues in a systematic way. This article reviews historical and recent data regarding prediction of GDM using demographic, clinical, and biochemical parameters. We evaluate current and potential future diagnostic approaches designed to most effectively identify GDM and extend this analysis into a critical evaluation of lifestyle and nutritional/pharmacologic interventions designed to prevent the development of GDM. The general approach to management of GDM during pregnancy is then discussed and the major final focus of the article revolves around the importance of a GDM diagnosis as a future marker of the risk of non-communicable disease (NCD), in particular pre-diabetes, diabetes, and cardiovascular disease, both in mother and offspring.

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Section: Prevention Of Future Ncd—mother and Offspringmentioning

confidence: 99%

Gestational Diabetes Mellitus—Innovative Approach to Prediction, Diagnosis, Management, and Prevention of Future NCD—Mother and Offspring

et al. 2020

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“…Tanase-Nakao et al (2017) reported that longer lactation (more than 4 and up to 12 weeks) of any intensity reduced diabetes risk compared to the shorter-lactation group [ 35 ]. Moreover, Ma et al reported positive effects from long-term breastfeeding of any intensity to reduce the risk of dysglycemia in women after GDM pregnancy, particularly in long-term follow-up studies [ 36 ]. However, the studies included in the analyses were primarily conducted in Western populations [ 35 , 36 ].…”

Section: Introductionmentioning

confidence: 99%

Breastfeeding Duration and Development of Dysglycemia in Women Who Had Gestational Diabetes Mellitus: Evidence from the GUSTO Cohort Study

et al. 2021

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(1) Background: Breastfeeding has been shown to support glucose homeostasis in women after a pregnancy complicated by gestational diabetes mellitus (GDM) and is potentially effective at reducing long-term diabetes risk. (2) Methods: Data from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study were analyzed to understand the influence of breastfeeding duration on long-term dysglycemia (prediabetes and diabetes) risk in women who had GDM in the index pregnancy. GDM and dysglycemia four to seven years postpartum were determined by the oral glucose tolerance test (OGTT). A Poisson regression model with a robust error variance was used to estimate incidence rate ratios (IRRs) for dysglycemia four to seven years post-delivery according to groupings of the duration of any breastfeeding (<1, ≥1 to <6, and ≥6 months). (3) Results: Women who had GDM during the index pregnancy and complete breastfeeding information and OGTT four to seven years postpartum were included in this study (n = 116). Fifty-one women (44%) had postpartum dysglycemia. Unadjusted IRRs showed an inverse association between dysglycemia risk and ≥1 month to <6 months (IRR 0.91; 95% confidence interval [CI] 0.57, 1.43; p = 0.68) and ≥6 months (IRR 0.50; 95% CI 0.27, 0.91; p = 0.02) breastfeeding compared to <1 month of any breastfeeding. After adjusting for key confounders, the IRR for the ≥6 months group remained significant (IRR 0.42; 95% CI 0.22, 0.80; p = 0.008). (4) Conclusions: Our results suggest that any breastfeeding of six months or longer may reduce long-term dysglycemia risk in women with a history of GDM in an Asian setting. Breastfeeding has benefits for mothers beyond weight loss, particularly for those with GDM.

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“…GDM is associated with significant maternal and fetal morbidities. Mothers with GDM are at increased risks of preeclampsia, polyhydramnios, preterm birth, and cesarean delivery, while fetal and neonatal complications include macrosomia, shoulder dystocia, neonatal jaundice, and hypoglycemia [ 2 ]. Studies have shown that rising maternal glucose leads to a graded increase in the risk of complications, even within the accepted normal plasma glucose range [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…The documented prevalence of GDM worldwide varied substantially from 1% to more than 30%. The lack of universally accepted screening and diagnostic criteria for GDM has made international comparisons difficult [ 2 ]. Various international bodies, including the World Health Organization (WHO), advocate screening all pregnant women for diabetes, while the British National Institute for Health and Care Excellence (NICE) supports risk-based screening [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Although fasting plasma glucose values demonstrated a stronger link to poor pregnancy outcomes than the 1 h and 2 h values [ 2 ], the exact relationship between different characteristics of the oral glucose tolerance test (OGTT) and pregnancy outcomes remain unclear [ 12 ]. The degree of association between maternal glycemia and pregnancy outcomes in different populations could vary, for example, by ethnicity [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Correlation between Oral Glucose Tolerance Test Abnormalities and Adverse Pregnancy Outcomes in Gestational Diabetes: A Cross-Sectional Study

Kalok

Ong

Hasrori

et al. 2020

IJERPH

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Gestational diabetes mellitus (GDM) is associated with maternal and neonatal complications. We aimed to evaluate the relationship between the abnormalities of the oral glucose tolerance test (OGTT) and adverse pregnancy outcomes. This was a retrospective study of GDM patients over a five-year period in a Malaysian tertiary center. The diagnosis of GDM was based on the National Institute for Health and Care Excellence (NICE) guideline. The data on patients’ demographics, OGTT results, GDM treatment, and pregnancy outcomes were analyzed. A total of 1105 women were included in the final analysis. The percentage of women with isolated abnormal fasting glucose, isolated two-hour abnormality, and both abnormal values were 4.8%, 87.1%, and 8.1%, respectively. Women with both OGTT abnormalities had a higher risk of preeclampsia (odds ratio (OR) 4.73; 95% confidence interval (CI) 1.45–15.41) and neonatal hypoglycemia (OR 8.78; 95% CI 1.93–39.88). Isolated postprandial abnormality was associated with an 80% lesser risk of neonatal hypoglycemia (OR 0.19; 95% CI 0.04–0.87). Both isolated fasting and multiple OGTT abnormalities were associated with insulin therapy. Multiple OGTT abnormalities were a positive predictor of adverse pregnancy outcomes, while isolated postprandial abnormality was associated with a lesser risk of neonatal complication. Further prospective study is essential to validate these findings.

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Metabolic effects of breastfeed in women with prior gestational diabetes mellitus: A systematic review and meta‐analysis

Cited by 20 publications

References 64 publications

Gestational Diabetes Mellitus—Innovative Approach to Prediction, Diagnosis, Management, and Prevention of Future NCD—Mother and Offspring

Gestational Diabetes Mellitus—Innovative Approach to Prediction, Diagnosis, Management, and Prevention of Future NCD—Mother and Offspring

Breastfeeding Duration and Development of Dysglycemia in Women Who Had Gestational Diabetes Mellitus: Evidence from the GUSTO Cohort Study

Correlation between Oral Glucose Tolerance Test Abnormalities and Adverse Pregnancy Outcomes in Gestational Diabetes: A Cross-Sectional Study

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