Association of breastfeeding duration with carotid intima-media thickness in later life: a systematic review and meta-analysis

Abstract

Objective

To assess the relationship of breastfeeding duration with maternal ultrasound carotid intima-media thickness (CIMT) in later life.

Methods

PubMed, Scopus, Web of Science, Embase, and Cochrane Central database searching up to December 15, 2020, for eligible studies that reported on the breastfeeding duration and ultrasound measurement of CIMT in later life. The exposed group corresponded to breastfeeding duration ≥ 6 months whereas the control group was women with breastfeeding of shorter duration or nil breastfeeding. The methodological quality of reviewed articles was appraised using the Newcastle-Ottawa Scale (NOS). Results are reported as the mean difference (MD) or the standardized MD (SMD) and their 95% confidence intervals (CIs). The study was registered in the PROSPERO database.

Results

Of 532 unique studies, three studies met inclusion criteria including 1721 women with a mean age ranging between 36.6 ± 6.9 and 55.7 ± 5.3 years, comparing breastfeeding duration ≥ 6 months versus 1–5 months (NOS: 7–8). Common CIMT was lower in women who breastfed for a longer duration (SMD = −0.10, 95% CI −0.20 to −0.00). Circulating HDL-cholesterol was higher in women with longer breastfeeding duration (MD = 3.25, 95% CI 0.88–5.61). There were no significant differences for total cholesterol, LDL-cholesterol, triglycerides, glucose, and blood pressure between breastfeeding 6 or more months and the control group.

Conclusions

The available studies showed lower CIMT and higher HDL-cholesterol levels in women who breastfed for 6 or more months as compared to controls.

母乳喂养时间与晚年颈动脉内膜中层厚度的关系:一项系统回顾和荟萃分析 摘要

目的:探讨母乳喂养时间与孕妇晚年超声颈动脉内膜中层厚度（CIMT）的关系。方法: 截至2020年12月15日在PubMed、Scopus、科学网、Embase和Cochrane Central数据库中搜索符合条件的研究, 这些研究报告了母乳喂养时间和晚年CIMT的超声测量。暴露组对应母乳喂养时间≥6个月, 而对照组是母乳喂养时间较短或没有母乳喂养的妇女。采用纽卡斯尔-渥太华量表（NOS）对综述文章的方法学质量进行评估。结果以平均差（MD）或标准化平均差（SMD）及其95%置信区间报告。该研究已在PROSPERO数据库中注册。结果:在532项独立研究中, 三项研究符合纳入标准, 包括1721名平均年龄在36.6±6.9岁和55.7±5.3岁之间的女性, 比较母乳喂养持续时间≥6个月对比1-5个月(NOS:7-8)。母乳喂养时间较长的女性普遍CIMT指数较低。（SMD = -0.10, 95%置信区间 -0.20到 -0.00）.母乳喂养时间越长的女性, 循环高密度脂蛋白胆固醇越高(MD = 3.25, 95%置信区间0.88–5.61)。母乳喂养6个月或更长时间与对照组相比, 总胆固醇、低密度脂蛋白胆固醇、甘油三酯、葡萄糖和血压没有显著差异。结论:现有的研究显示, 与对照组相比, 母乳喂养6个月或更长时间的女性CIMT值更低, 高密度脂蛋白胆固醇水平更高。

Keywords:

• Breastfeeding
• lactation
• carotid intima-media thickness
• sub-clinical atherosclerosis
• HDL-cholesterol
• atherosclerosis

Acknowledgments

The authors would like to thank Dr. E. Armeni and Dr. M. Countouris for providing complementary information of their publications [references 21 and 22, respectively].

Disclosure statement

The authors report no conflicts of interest and alone are responsible for the content and the writing of the article.

Additional information

Funding

Peter Chedraui is supported by the Sistema de Investigación y Desarrollo (SINDE) and the Vice-Rectorado de Investigación & Postgrado (VRIP) of the Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador, through grant No. SIU # 554-56: ‘Evaluación de resultantes vinculadas a la salud de la mujer en etapa reproductiva y no reproductiva: Proyecto Omega III’.