Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - Effects of an intervention to promote breastfeeding on maternal adiposity and blood pressure at 11.5 y postpartum
T2 - results from the Promotion of Breastfeeding Intervention Trial, a cluster-randomized controlled trial
AU - Oken, Emily
AU - Patel, Rita
AU - Guthrie, Lauren B.
AU - Vilchuck, Konstantin
AU - Bogdanovich, Natalia
AU - Sergeichick, Natalia
AU - Palmer, Tom M.
AU - Kramer, Michael S.
AU - Martin, Richard M.
PY - 2013/10
Y1 - 2013/10
N2 - BACKGROUND: Differences between mothers who do and do not succeed in breastfeeding are likely to confound associations of lactation with later maternal adiposity.OBJECTIVE: We compared adiposity and blood pressure (BP) in women randomly assigned to an intervention to promote prolonged and exclusive breastfeeding or usual care.DESIGN: We performed a cluster-randomized trial at 31 hospitals in Belarus in 1996-1997.RESULTS: Of 17,046 women enrolled at delivery, we assessed 11,867 women (69.6%) at 11.5 y postpartum. The prevalence of exclusive breastfeeding ≥3 mo was 44.5% in 6321 women in the intervention group and 7.1% in 5546 women in the control group. At 11.5 y postpartum, mean (±SD) body mass index (BMI; in kg/m(2)) was 26.5 ± 5.5, the percentage of body fat was 33.6% ± 8.3%, and systolic BP was 124.6 ± 14.6 mm Hg. On intention-to-treat analysis (without imputation) with adjustment for clustering by hospital, mean outcomes were lower in intervention compared with control mothers for BMI (mean difference: -0.27; 95% CI: -0.91, 0.37), body fat (-0.49%; 95% CI: -1.25%, 0.27%), and systolic BP (-0.81 mm Hg; 95% CI: -3.33, 1.71 mm Hg), but effect sizes were small, CIs were wide, and results were attenuated further toward the null after adjustment for baseline characteristics. Results were similar in sensitivity analyses [ie, by using conventional observational analyses disregarding treatment assignment, instrumental variable analyses to estimate the causal effect of breastfeeding, and multiple imputation to account for missing outcome measures (n = 17,046)].CONCLUSION: In women who initiated breastfeeding, an intervention to promote longer breastfeeding duration did not result in an important lowering of adiposity or BP. This trial was registered at clinicaltrials.gov as NCT01561612 and at Current Controlled Trials as ISRCTN37687716.
AB - BACKGROUND: Differences between mothers who do and do not succeed in breastfeeding are likely to confound associations of lactation with later maternal adiposity.OBJECTIVE: We compared adiposity and blood pressure (BP) in women randomly assigned to an intervention to promote prolonged and exclusive breastfeeding or usual care.DESIGN: We performed a cluster-randomized trial at 31 hospitals in Belarus in 1996-1997.RESULTS: Of 17,046 women enrolled at delivery, we assessed 11,867 women (69.6%) at 11.5 y postpartum. The prevalence of exclusive breastfeeding ≥3 mo was 44.5% in 6321 women in the intervention group and 7.1% in 5546 women in the control group. At 11.5 y postpartum, mean (±SD) body mass index (BMI; in kg/m(2)) was 26.5 ± 5.5, the percentage of body fat was 33.6% ± 8.3%, and systolic BP was 124.6 ± 14.6 mm Hg. On intention-to-treat analysis (without imputation) with adjustment for clustering by hospital, mean outcomes were lower in intervention compared with control mothers for BMI (mean difference: -0.27; 95% CI: -0.91, 0.37), body fat (-0.49%; 95% CI: -1.25%, 0.27%), and systolic BP (-0.81 mm Hg; 95% CI: -3.33, 1.71 mm Hg), but effect sizes were small, CIs were wide, and results were attenuated further toward the null after adjustment for baseline characteristics. Results were similar in sensitivity analyses [ie, by using conventional observational analyses disregarding treatment assignment, instrumental variable analyses to estimate the causal effect of breastfeeding, and multiple imputation to account for missing outcome measures (n = 17,046)].CONCLUSION: In women who initiated breastfeeding, an intervention to promote longer breastfeeding duration did not result in an important lowering of adiposity or BP. This trial was registered at clinicaltrials.gov as NCT01561612 and at Current Controlled Trials as ISRCTN37687716.
KW - Adiposity
KW - Adult
KW - Blood Pressure
KW - Body Mass Index
KW - Breast Feeding
KW - Female
KW - Follow-Up Studies
KW - Health Promotion
KW - Humans
KW - Lactation
KW - Maternal Welfare
KW - Pregnancy
KW - Quality Assurance, Health Care
KW - Republic of Belarus
KW - Time Factors
U2 - 10.3945/ajcn.113.065300
DO - 10.3945/ajcn.113.065300
M3 - Journal article
C2 - 23945719
VL - 98
SP - 1048
EP - 1056
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
SN - 0002-9165
IS - 4
ER -