ArticleThe American journal of clinical nutrition2023
Mediators of the association between maternal body mass index and breastfeeding duration in 3 international cohorts.
Article in The American journal of clinical nutrition, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07457515 (Analysis of the Transmission of Overweight/Obesity in the Mother-breastmilk-child Triad in Relation to Maternal Cardiometabolic Status and Diet), which is not on this map. Cited by 8 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Analysis of the Transmission of Overweight/Obesity in the Mother-breastmilk-child Triad in Relation to Maternal Cardiometabolic Status and Diet
Who cites it
8 citing papers in PubMed, 15 citations in OpenAlex.
- Optimizing the Postpartum Period to Support Lifelong Health for Women with Obesity.Current obesity reports · 2026Review
- High breastfeeding continuation at two months after birth in women receiving home-based postnatal midwifery care and factors associated with breastfeeding cessation: A prospective cohort study.European journal of midwifery · 2026Article
- Article
- Impact of Maternal Body Composition, Hydration, and Metabolic Health on Breastfeeding Success: A Comprehensive Review.Medical science monitor : international medical journal of experimental and clinical research · 2024Review
- Negative association between higher maternal pre-pregnancy body mass index and breastfeeding outcomes is not mediated by DNA methylation.Scientific reports · 2024Article
- Human Milk Composition Is Associated with Maternal Body Mass Index in a Cross-Sectional, Untargeted Metabolomics Analysis of Human Milk from Guatemalan Mothers.Current developments in nutrition · 2024Article
- Anthropometric Changes During Pregnancy and Their Association with Adequacy of Gestational Weight Gain.Current developments in nutrition · 2024Article
- Association of breastfeeding duration with overweight and obesity among women in Ghana.Frontiers in global women's health · 2024Article
Corrections and comments
- Commented on by
Authors and funding
16 authors at 13 institutions in 4 countries.
Funding
Abstract
backgroundMaternal obesity has been associated with shorter breastfeeding duration, but little is known about mediating factors explaining this association. It is important to assess these relationships across diverse populations because breastfeeding is culturally patterned.
objectivesWe investigated the association of prepregnancy maternal body mass index (BMI) with breastfeeding outcomes and potential mediators of this relationship in 3 culturally diverse international cohorts.
methodsWe analyzed 5120 singleton pregnancies from mother-child cohorts in Spain (INfancia y Medio Ambiente), Greece (Rhea), and the United States (Project Viva). Outcome variables were duration of any and exclusive breastfeeding. A priori hypothesized mediators in the association of maternal prepregnancy BMI with breastfeeding were birthweight (BW), maternal prenatal C-reactive protein (CRP), cesarean delivery, maternal dietary inflammatory index (DII) during pregnancy, gestational age at delivery, and gestational diabetes mellitus (GDM). We estimated the association between BMI and breastfeeding duration using linear regression adjusting for confounders. Mediation analysis estimated direct and indirect effects of maternal overweight/obesity on breastfeeding for each mediator.
resultsWomen with overweight and obesity had shorter duration of any and exclusive breastfeeding compared with normal-weight women (any: overweight β = -0.79 mo, 95% CI: -1.17, -0.40; obese β = -1.75 mo 95% CI: -2.25, -1.25; exclusive: overweight β = -0.30 mo, 95% CI: -0.42, -0.16; obese β = -0.73 mo, 95% CI: -0.90, -0.55). Significant mediators (% change in effect estimate) of this association were higher CRP (exclusive: 5.12%), cesarean delivery (any: 6.54%; exclusive: 7.69%), and higher DII (any: 6.48%; exclusive: 7.69%). GDM, gestational age, and BW did not mediate the association of maternal weight status with breastfeeding.
conclusionsHigher prepregnancy BMI is associated with shorter duration of any and exclusive breastfeeding. Maternal dietary inflammation, systemic inflammation, and mode of delivery may be key modifiable mediators of this association. Identification of mediators provides potential targets for interventions to improve breastfeeding outcomes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.