Breastfeeding duration and subsequent risk of mortality among US women: A prospective cohort study
Summary: Background: Breastfeeding has been associated with a reduced maternal long-term risk of chronic diseases, but its association with mortality is poorly known. Methods: We included 166,708 female United States (US) nurses from the Nurses’ Health Study (1986-2016) and the Nurses’ Health Study...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537022004230 |
| _version_ | 1811182524782608384 |
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| author | Yi-Xin Wang Mariel Arvizu Janet W. Rich-Edwards JoAnn E. Manson Liang Wang Stacey A. Missmer Jorge E. Chavarro |
| author_facet | Yi-Xin Wang Mariel Arvizu Janet W. Rich-Edwards JoAnn E. Manson Liang Wang Stacey A. Missmer Jorge E. Chavarro |
| author_sort | Yi-Xin Wang |
| collection | DOAJ |
| description | Summary: Background: Breastfeeding has been associated with a reduced maternal long-term risk of chronic diseases, but its association with mortality is poorly known. Methods: We included 166,708 female United States (US) nurses from the Nurses’ Health Study (1986-2016) and the Nurses’ Health Study II (1989-2019) who experienced at least one pregnancy lasting at least six months across their reproductive lifespan. Hazard ratios and 95% confidence intervals (CI) for mortality according to lifetime breastfeeding duration were estimated with time-dependent Cox proportional hazards regression models. Findings: During 4,705,160 person-years of follow-up, 36,634 deaths were documented in both cohorts, including 9880 from cancer and 7709 from cardiovascular disease (CVD). Lifetime total breastfeeding duration was associated with a lower subsequent risk of all-cause mortality in a non-linear manner (p-value for non-linearity=0.0007). The pooled multivariable-adjusted hazard ratios of all-cause mortality were 0.95 (95% CI: 0.92 to 0.98), 0.94 (95% CI: 0.91 to 0.98), 0.93 (95% CI: 0.90 to 0.97), and 0.93 (95% CI: 0.89 to 0.97), respectively, for women reporting lifetime total breastfeeding duration of 4–6, 7–11, 12–23, and ≥24 months, compared to women who breastfed for ≤3 months over their reproductive lifespan. Cause-specific analysis showed a similar pattern of non-linear inverse associations between lifetime total breastfeeding duration and CVD and cancer mortality (both p-values for non-linearity <0.01). There was no evidence of interactions between breastfeeding duration and pre-pregnancy lifestyle factors on mortality risk. Interpretation: Parous women with longer lifetime breastfeeding duration had a modestly lower risk of mortality. Funding: The National Institutes of Health grants. |
| first_indexed | 2024-04-11T09:32:02Z |
| format | Article |
| id | doaj.art-32d1a5379e664091aa01b48b729e76ca |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-04-11T09:32:02Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-32d1a5379e664091aa01b48b729e76ca2022-12-22T04:31:49ZengElsevierEClinicalMedicine2589-53702022-12-0154101693Breastfeeding duration and subsequent risk of mortality among US women: A prospective cohort studyYi-Xin Wang0Mariel Arvizu1Janet W. Rich-Edwards2JoAnn E. Manson3Liang Wang4Stacey A. Missmer5Jorge E. Chavarro6Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Corresponding author at: Harvard T.H. Chan School of Public Health, Building II 3rd floor, 655 Huntington Avenue, Boston, MA 02115, USA.Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USADepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, USADepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USADepartment of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USADepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, USADepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USASummary: Background: Breastfeeding has been associated with a reduced maternal long-term risk of chronic diseases, but its association with mortality is poorly known. Methods: We included 166,708 female United States (US) nurses from the Nurses’ Health Study (1986-2016) and the Nurses’ Health Study II (1989-2019) who experienced at least one pregnancy lasting at least six months across their reproductive lifespan. Hazard ratios and 95% confidence intervals (CI) for mortality according to lifetime breastfeeding duration were estimated with time-dependent Cox proportional hazards regression models. Findings: During 4,705,160 person-years of follow-up, 36,634 deaths were documented in both cohorts, including 9880 from cancer and 7709 from cardiovascular disease (CVD). Lifetime total breastfeeding duration was associated with a lower subsequent risk of all-cause mortality in a non-linear manner (p-value for non-linearity=0.0007). The pooled multivariable-adjusted hazard ratios of all-cause mortality were 0.95 (95% CI: 0.92 to 0.98), 0.94 (95% CI: 0.91 to 0.98), 0.93 (95% CI: 0.90 to 0.97), and 0.93 (95% CI: 0.89 to 0.97), respectively, for women reporting lifetime total breastfeeding duration of 4–6, 7–11, 12–23, and ≥24 months, compared to women who breastfed for ≤3 months over their reproductive lifespan. Cause-specific analysis showed a similar pattern of non-linear inverse associations between lifetime total breastfeeding duration and CVD and cancer mortality (both p-values for non-linearity <0.01). There was no evidence of interactions between breastfeeding duration and pre-pregnancy lifestyle factors on mortality risk. Interpretation: Parous women with longer lifetime breastfeeding duration had a modestly lower risk of mortality. Funding: The National Institutes of Health grants.http://www.sciencedirect.com/science/article/pii/S2589537022004230Breastfeeding durationMortalityCohort studyWomen's health |
| spellingShingle | Yi-Xin Wang Mariel Arvizu Janet W. Rich-Edwards JoAnn E. Manson Liang Wang Stacey A. Missmer Jorge E. Chavarro Breastfeeding duration and subsequent risk of mortality among US women: A prospective cohort study EClinicalMedicine Breastfeeding duration Mortality Cohort study Women's health |
| title | Breastfeeding duration and subsequent risk of mortality among US women: A prospective cohort study |
| title_full | Breastfeeding duration and subsequent risk of mortality among US women: A prospective cohort study |
| title_fullStr | Breastfeeding duration and subsequent risk of mortality among US women: A prospective cohort study |
| title_full_unstemmed | Breastfeeding duration and subsequent risk of mortality among US women: A prospective cohort study |
| title_short | Breastfeeding duration and subsequent risk of mortality among US women: A prospective cohort study |
| title_sort | breastfeeding duration and subsequent risk of mortality among us women a prospective cohort study |
| topic | Breastfeeding duration Mortality Cohort study Women's health |
| url | http://www.sciencedirect.com/science/article/pii/S2589537022004230 |
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