{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T05:25:13Z","timestamp":1792733113845,"version":"4.5.0"},"reference-count":51,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T00:00:00Z","timestamp":1715040000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Breastfeeding represents an important opportunity to optimize health outcomes for both mother and infant, particularly in the context of maternal metabolic conditions such as diabetes and polycystic ovary syndrome. However, evidence suggests that women affected by these conditions breastfeed at reduced rates and durations. Our aim was to use the large, prospective, community\u2010based Australian Longitudinal Study on Women's Health (ALSWH) to conduct an in\u2010depth exploratory analysis of breastfeeding outcomes in Australian women affected by key maternal metabolic conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>Data from 12\u2009920 pregnancies to 5605 women from the 1973\u20131978 birth cohort of the ALSWH were examined. Univariable and multivariable regression using generalized estimating equation models were applied to assess breastfeeding initiation and duration (outcome measures) in relation to key self\u2010reported maternal metabolic diagnoses (pre\u2010gestational type 1 and type 2 diabetes, gestational diabetes, and polycystic ovary syndrome; main explanatory variables). Key sociodemographic and clinical covariates were also considered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Results showed no significant association between specific maternal metabolic diagnoses (pre\u2010gestational or gestational diabetes, or polycystic ovary syndrome) and breastfeeding outcomes. However, maternal body mass index emerged as a key predictor of suboptimal breastfeeding outcomes. Pregnancies affected by maternal obesity were associated with a 2.1\u2010fold increase in the odds of not initiating breastfeeding, after adjusting for other key variables (95% CI 1.67 to 2.60, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Maternal overweight and obesity were, respectively, associated with an adjusted 1.4\u2010fold (95% CI 1.20 to 1.55, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) and 1.8\u2010fold increase (95% CI 1.60 to 2.10, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) in the odds of a breastfeeding duration less than 6\u2009months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Maternal obesity, rather than any specific maternal metabolic condition, appears to be a key predictor of breastfeeding outcomes in Australian women.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14868","type":"journal-article","created":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T04:49:09Z","timestamp":1715143749000},"page":"1570-1583","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Maternal metabolic conditions as predictors of breastfeeding outcomes: Insights from an Australian cohort study"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1492-483X","authenticated-orcid":false,"given":"Kate","family":"Rassie","sequence":"first","affiliation":[{"name":"Monash center for Health Research and Implementation (MCHRI), Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Victoria Australia"},{"name":"Department of Diabetes Monash Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raja Ram","family":"Dhungana","sequence":"additional","affiliation":[{"name":"Monash center for Health Research and Implementation (MCHRI), Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya","family":"Mousa","sequence":"additional","affiliation":[{"name":"Monash center for Health Research and Implementation (MCHRI), Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Teede","sequence":"additional","affiliation":[{"name":"Monash center for Health Research and Implementation (MCHRI), Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Victoria Australia"},{"name":"Department of Diabetes Monash Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anju\u00a0E.","family":"Joham","sequence":"additional","affiliation":[{"name":"Monash center for Health Research and Implementation (MCHRI), Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Victoria Australia"},{"name":"Department of Diabetes Monash Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,7]]},"reference":[{"key":"e_1_2_14_2_1","volume-title":"Diabetes: Australian Facts","author":"Australian Institute of Health and Welfare","year":"2023"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12850"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgad463"},{"key":"e_1_2_14_5_1","volume-title":"Infant Feeding Guidelines: Information for Health Workers","author":"National Health and Medical Research Council","year":"2012"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.13133"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqy311"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-019-1121-x"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000155"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-2237"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.7978"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01024-7"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12238"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/1010539519833497"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340802007676"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1732365"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12846"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2017.11.005"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2021.0032"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/1753-6405.12629"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-020-05271-9"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0054409"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1037\/met0000024"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.13265"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-2345"},{"key":"e_1_2_14_26_1","volume-title":"Global Strategy for Infant and Young Child Feeding","author":"World Health Organisation","year":"2003"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980014000792"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2004.01379.x"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/0009922813496455"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6909.2009.01052.x"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980013003054"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2007.02148.x"},{"key":"e_1_2_14_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.1074"},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-1916"},{"key":"e_1_2_14_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.13232"},{"key":"e_1_2_14_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2006.04.005"},{"key":"e_1_2_14_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1740-8709.2008.00134.x"},{"key":"e_1_2_14_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-7-9"},{"key":"e_1_2_14_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1740-8709.2012.00439.x"},{"key":"e_1_2_14_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12288"},{"key":"e_1_2_14_41_1","volume-title":"The Australian National Breastfeeding Strategy: 2019 and Beyond","author":"COAG Health Council","year":"2019"},{"key":"e_1_2_14_42_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.2010.29192"},{"key":"e_1_2_14_43_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2011.0007"},{"key":"e_1_2_14_44_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.113.5.e465"},{"key":"e_1_2_14_45_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2006.tb00115.x"},{"key":"e_1_2_14_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12865"},{"key":"e_1_2_14_47_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-2747"},{"key":"e_1_2_14_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-015-1858-z"},{"key":"e_1_2_14_49_1","volume-title":"2010 Australian National Infant Feeding Survey: Indicator Results","author":"Health AIo, Welfare","year":"2011"},{"key":"e_1_2_14_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2018.08.008"},{"key":"e_1_2_14_51_1","volume-title":"Comparison of the Australian Longitudinal Study on Women's Health Cohorts with Women of the Same Age in the 2001 Census: Technical Report","author":"Powers J","year":"2004"},{"key":"e_1_2_14_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2010.01.002"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14868","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,6]],"date-time":"2025-04-06T10:43:47Z","timestamp":1743936227000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.14868"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,7]]},"references-count":51,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1111\/aogs.14868"],"URL":"https:\/\/doi.org\/10.1111\/aogs.14868","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,7]]},"assertion":[{"value":"2024-01-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}