Breastfeeding in women with Polycystic Ovary Syndrome: Data from the Australian Longitudinal Women’s Health Study — ASN Events

Breastfeeding in women with Polycystic Ovary Syndrome: Data from the Australian Longitudinal Women’s Health Study (#120)

Natalie Nanayakkara 1 2 , Anju Joham 1 2 , Vanky Eszter 3 , Sophia Zoungas 1 2 , Deborah Loxon 4 , Helena Teede 1 2
  1. Monash Applied Research Stream, School of Public Health and Preventative Medicine, Monash University, Clayton, VIC, Australia
  2. Diabetes and Vascular Medicine Unit, Monash Health , Clayton, VIC , Australia
  3. Obstetrics and Gynaecology, Trondheim University Hospital, Trondheim, Norway
  4. Research Centre for Gender, Health and Ageing, University of Newcastle, Callaghan, NSW, Australia

Context: Polycystic Ovary Syndrome (PCOS) affects 12-21% of women with significant metabolic, psychological and reproductive complications including sub-fertility. With the rising rates of obesity, a greater proportion of pregnant women are overweight or obese. The interplay between breastfeeding, PCOS and obesity are unclear.

Objective: To examine breastfeeding initiation and duration and relationship to body mass index (BMI) in women with and without PCOS.

Design: Cross-sectional analysis of a longitudinal cohort study

Setting: General community setting

Participants: Participants were women randomly selected from the community. Mailed survey data were collected at five time points. Data from respondents to survey five (2009) who reported at least one children (n=4271) were analysed.

Main outcome measures: Self-reported PCOS, BMI and breastfeeding

Methods: We conducted a cross-sectional analysis of data from the large, Australian Longitudinal Study on Women’s Health. Participants are women aged 31 to 36 years, randomly selected from the national health insurance (Medicare) database. Standardised data collection occurred at 5 survey time points. Logistic and linear regression analysis was used where appropriate to examine factors associated with breastfeeding.

Results: PCOS prevalence was 7.0% (95% CI: 6.2%-7.9%). Mean BMI was higher in women who did not breastfeed compared to women who breastfed (28.1±6.9 kg/m2 and 25.7±5.7 kg/m2 respectively, p<0.001). 87.2% of women reporting PCOS indicated breastfeeding compared with 90.7% of women not reporting PCOS (p=0.03). Average duration of breastfeeding was similar in women reporting PCOS compared to women not reporting PCOS (7.4±2.0 months and 6.1±0.4 months respectively, p=0.50). Both PCOS and BMI were both associated with breastfeeding on univariable analysis (p=0.02 and p<0.001 respectively). BMI was independently associated with not breastfeeding (OR 1.11, 95% CI 1.07-1.16, p<0.001) after adjusting for age, education, smoking, parity, Caesarean sections, postnatal depression, low birth-weight and prematurity. Linear regression revealed that every 5 unit increase in BMI was associated with an approximately 20 day reduction in breastfeeding duration (p<0.001). PCOS was not independently associated with not breastfeeding (OR 1.72, 95% CI 0.71-4.13, p=0.23).

Conclusions: In this large community-based cohort of reproductive-aged women, we demonstrate that higher BMI is independently associated with reduced breastfeeding, highlighting the need for greater lactation support for these women.