Abstract
Background and aims
Breastfeeding has been associated with reduced risk of maternal type 2 diabetes in
some cohort studies, but the evidence from published studies have differed with regard
to the strength of the association. To clarify this association we conducted a systematic
review and dose–response meta-analysis of breastfeeding and maternal risk of type
2 diabetes.
Methods and results
We conducted a systematic review and dose–response meta-analysis of prospective studies
of breastfeeding and maternal risk of type 2 diabetes. We searched the PubMed, Embase
and Ovid databases up to September 19th 2013. Summary relative risks were estimated
using a random effects model. Six cohort studies including 10,842 cases among 273,961
participants were included in the meta-analysis. The summary RR for the highest duration
of breastfeeding vs. the lowest was 0.68 (95% CI: 0.57–0.82, I2 = 75%, pheterogeneity = 0.001, n = 6). The summary RR for a three month increase in the duration of breastfeeding
per child was 0.89 (95% CI: 0.77–1.04, I2 = 93%, pheterogeneity < 0.0001, n = 3) and the summary RR for a one year increase in the total duration of breastfeeding
was 0.91 (95% CI: 0.86–0.96, I2 = 81%, pheterogeneity = 0.001, n = 4). There was little difference in the summary estimates whether or not BMI had
been adjusted for. The inverse associations appeared to be nonlinear, pnonlinearity < 0.0001 for both analyses, and in both analyses the reduction in risk was steeper
when increasing breastfeeding from low levels.
Conclusion
This meta-analysis suggests that there is a statistically significant inverse association
between breastfeeding and maternal risk of type 2 diabetes.
Keywords
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Article info
Publication history
Published online: January 21, 2014
Accepted:
October 18,
2013
Received in revised form:
October 17,
2013
Received:
June 21,
2013
Identification
Copyright
© 2013 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
