Breastfeeding Is Associated With a Reduced Maternal Cardiovascular Risk: Systematic Review and Meta-Analysis Involving Data From 8 Studies and 1 192 700 Parous Women

Lena Tschiderer, Lisa Seekircher, Setor K Kunutsor, Sanne Peters, Linda M O'Keeffe, Peter Willeit*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

18 Citations (Scopus)
28 Downloads (Pure)

Abstract

Background: Breastfeeding has been robustly linked to reduced maternal risk of breast cancer, ovarian cancer, and type-2 diabetes mellitus. We herein systematically reviewed the published evidence on the association of breastfeeding with maternal risk of cardiovascular disease (CVD) outcomes.
Methods and Results: Our systematic search of PubMed and Web of Science of articles published up to 16 April 2021 identified eight relevant prospective studies involving 1,192,700 parous women (weighted mean age: 51.3 years at study entry, 24.6 years at first birth; weighted mean number of births: 2.3). 982,566 women (82%) reported having ever breastfed (weighted mean lifetime duration of breastfeeding: 15.6 months). Over a weighted median follow-up of 10.3 years, 54,226 CVD, 26,913 coronary heart disease, 30,843 stroke, and 10,766 fatal CVD events were recorded. In a random-effects meta-analysis, the pooled multivariable adjusted hazard ratios comparing parous women who ever to those who never breastfed were: 0.89 for CVD (95% CI: 0.83-0.95; I2=79.4%); 0.86 for coronary heart disease (0.78-0.95; I2=79.7%); 0.88 for stroke (0.79-0.99; I2=79.6%); and 0.83 for fatal CVD (0.76-0.92; I2=47.7%). The quality of the evidence using GRADE ranged from very low to moderate, which was mainly driven by high between-studies heterogeneity. Strengths of associations did not differ by mean age at study entry, median follow-up duration, mean parity, level of adjustment, study quality, or geographical region. A progressive risk reduction of all CVD outcomes with lifetime durations of breastfeeding from 0 up to 12 months was found, with some uncertainty about shapes of associations for longer durations.
Conclusions: Breastfeeding was associated with reduced maternal risk of CVD outcomes.
Original languageEnglish
Article numbere022746
JournalJournal of the American Heart Association
Volume11
Issue number2
Early online date11 Jan 2022
DOIs
Publication statusPublished - 18 Jan 2022

Bibliographical note

Funding Information:
This work was funded by the Austrian Science Fund (P 32488 and T 1253).

Publisher Copyright:
© 2022 The Authors. Published on behalf of the American Heart Association, Inc.

Keywords

  • breastfeeding
  • cardiovascular diseases
  • maternal risk
  • meta-analysis
  • systematic review

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