Evidence map›Paper›PMID 39472928›Full record

ArticleInternational breastfeeding journal2024

Breastfeeding in patients with peripartum cardiomyopathy: clinical outcomes and physician counseling.

Angelina Noll, Kris R Kawamoto, Maya T Dassanayake, Laura Leuenberger, Stephanie M Spehar, Jenny Wu, Elizabeth Langen, Melinda B Davis

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Article in International breastfeeding journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Angelina Noll *Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
Kris R Kawamoto *Cardiovascular Diseases, Queen's University Medical Group, Honolulu, HI, USA.
Maya T DassanayakeDepartment of Medicine, Division of Cardiology, University of South Carolina-Greenville, Greenville, SC, USA.
Laura LeuenbergerDepartment of Medicine, Division of Pulmonary, Critical Care and Sleep, Ohio State University, Columbus, OH, USA.
Stephanie M SpeharDepartment of Medicine, Division of Cardiovascular Medicine, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.
Jenny WuDepartment of Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
Elizabeth LangenDepartment of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI, 48105, USA.
Melinda B DavisDepartment of Medicine, Division of Cardiovascular Medicine, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA. davismb@umich.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeripartum cardiomyopathy (PPCM) is a form of heart failure occurring towards the end of pregnancy or in the months following delivery. Concerns regarding the role of prolactin (the polypeptide hormone responsible for lactation) driving the pathogenesis of PPCM have led experts to discourage patients from breastfeeding; however, limited clinical data exist. We sought to (1) determine whether lactation was associated with less cardiac recovery and (2) assess the counseling about breastfeeding given to patients at the time of their initial diagnosis.

methodsPatients diagnosed with PPCM from 1999 to 2019 were identified through detailed chart review and demographic characteristics, comorbidities, outcomes, and lactation status were collected. Cardiac recovery was defined as left ventricular ejection fraction (LVEF) 55% or higher. A survey about breastfeeding and patient experience was administered by mail. Patients were only included in this analysis if definitive information about lactation status was documented.

resultsOf 220 patients with confirmed PPCM, lactation status was known definitively in 54 patients; of these, 18 (33%) had breastfed for at least 6 weeks and 36 (67%) did not breastfeed. There were no significant differences in the breastfeeding and non-breastfeeding groups related to baseline LVEF, age, race, gestational diabetes, smoking, hypertensive disorders of pregnancy, and medication treatments. Despite similar baseline LVEF at the time of diagnosis, there was no statistically significant difference in cardiac recovery based on lactation status. In a subset of patients with severe cardiac dysfunction at the time of diagnosis, there remained no significant differences in recovery based on lactation status. Of the 34 survey respondents, 62% were told not to breastfeed due to their diagnosis or concerns regarding safety of medications, and none were encouraged to breastfeed.

conclusionIn this retrospective cohort, lactation was not associated with lower rates of myocardial recovery. Importantly, a majority of patients had received counseling that they should not breastfeed. Future studies of the role of lactation in PPCM are needed in order to better understand the impact of breastfeeding and improve patient counseling.

Indexed as

Breast FeedingCardiomyopathiesCounselingPeripartum PeriodPregnancy Complications, CardiovascularAdultFemaleHumansLactationPregnancyRetrospective StudiesBreastfeedingLactationMyocardial recoveryPeripartum cardiomyopathyPostpartum cardiomyopathyPregnancy-associated heart failure

Identifiers

PMID39472928
PMCPMC11523573

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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.