{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T07:48:42Z","timestamp":1778140122713,"version":"3.51.4"},"reference-count":23,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"unspecified","delay-in-days":84,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2025,9,10]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Breastfeeding prevalence and challenges among women of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) is under-researched especially in the Middle East-North Africa region. This study aimed to assess breastfeeding initiation, duration and predictors of early discontinuation (&lt;6 months post partum) among Egyptian mothers with SLE or RA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicentre retrospective cohort study included 320 pregnancies: 62 SLE (105 pregnancies), 71 RA (110 pregnancies) and 59 healthy mothers (105 pregnancies). Data on pregnancy history, breastfeeding intent, initiation, duration and weaning reasons were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Exclusive breastfeeding was lowest in SLE (29.9%) vs RA (50.6%) and controls (60%, p&lt;0.001). Continuation beyond 6 months was significantly lower in SLE (36.2%) and RA (33.6%) vs controls (81%, p&lt;0.001). Postpartum depression independently predicted discontinuation in SLE (adjusted OR (aOR)=0.06, 95%\u2009CI 0.01 to 0.6) and RA (aOR=0.34, 95%\u2009CI 0.13 to 0.9). Multivariable generalised estimating equation confirmed SLE reduced breastfeeding odds versus controls (aOR=0.41, p=0.040).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Breastfeeding is significantly less prevalent among Egyptian mothers with SLE and RA when compared with control group. Targeted educational programme and support may help improve breastfeeding rates in SLE\/RA mothers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/lupus-2025-001733","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T04:50:32Z","timestamp":1758603032000},"page":"e001733","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Breastfeeding determinants in Egyptian mothers with systemic lupus erythematosus or rheumatoid arthritis: a retrospective cohort study"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3392-6603","authenticated-orcid":false,"given":"Omima Ahmed","family":"El-Farra","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Rehabilitation and Physical Medicine, Faculty of Medicine, Minia University, Minia, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4995-6015","authenticated-orcid":false,"given":"Amal Mohamed","family":"Elmesiry","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Rehabilitation, Faculty of Medicine, Al-Azhar University, Nasr City, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hager Adel Yehia","family":"Abdelfattah","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Fayoum University, Faiyum, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1275-4234","authenticated-orcid":false,"given":"Nermeen Mohammed","family":"Elmenayar","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Rehabilitation and Physical Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8914-0791","authenticated-orcid":false,"given":"Ahmed Adel","family":"Abdel Azim","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Assiut University, Asyut, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3689-3184","authenticated-orcid":false,"given":"Ahmed Ibrahim","family":"Ewais","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Cairo University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6777-1973","authenticated-orcid":false,"given":"Gamal Saeed","family":"Gamal","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Zagazig University, Zagazig, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abrar Ghassan Mousa","family":"Balousha","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Al-Quds University, Jerusalem, State of Palestine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alaa Ali","family":"Awad","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Rehabilitation and Physical Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,9,22]]},"reference":[{"key":"2026010700554219000_12.2.e001733.1","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2022-057988","article-title":"Policy Statement: Breastfeeding and the Use of Human Milk","volume":"150","author":"Meek","year":"2022","journal-title":"Pediatrics"},{"key":"2026010700554219000_12.2.e001733.2","doi-asserted-by":"crossref","DOI":"10.1136\/lupus-2021-000491","article-title":"Breastfeeding in women with rheumatic diseases","volume":"8","author":"Ikram","year":"2021","journal-title":"Lupus Sci Med"},{"key":"2026010700554219000_12.2.e001733.3","doi-asserted-by":"publisher","DOI":"10.1002\/art.20621"},{"key":"2026010700554219000_12.2.e001733.4","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-015-3131-7"},{"key":"2026010700554219000_12.2.e001733.5","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.180805"},{"key":"2026010700554219000_12.2.e001733.6","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200005)43:5<1010::AID-ANR8>3.0.CO;2-O"},{"key":"2026010700554219000_12.2.e001733.7","unstructured":"Ince-a H . The impact of rheumatoid arthritis during pregnancy on mother and child the impact of rheumatoid arthritis during pregnancy on mother and child de impact van reumato\u00efde artritis tijdens de zwangerschap proefschrift ter verkrijging van de graad van doctor."},{"key":"2026010700554219000_12.2.e001733.8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13006-023-00576-y","article-title":"Breastfeeding in women with systemic lupus erythematosus: results from a Norwegian quality register","volume":"18","author":"Bjerkaas Hanssen","year":"2023","journal-title":"Int Breastfeed J"},{"key":"2026010700554219000_12.2.e001733.9","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1093\/rheumatology\/ket456","article-title":"Breastfeeding practice, oral contraceptive use and risk of rheumatoid arthritis among Chinese women: the Guangzhou Biobank Cohort Study","volume":"53","author":"Adab","year":"2014","journal-title":"Rheumatology (Sunnyvale)"},{"key":"2026010700554219000_12.2.e001733.10","first-page":"913","article-title":"Breastfeeding in women affected by systemic lupus erythematosus: Rate, duration and associated factors","volume":"30","author":"Orefice","year":"2021","journal-title":"Lupus (Los Angel)"},{"key":"2026010700554219000_12.2.e001733.11","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1089\/bfm.2022.0142","article-title":"Breastfeeding Initiation, Duration, and Associated Factors in Mothers with Systemic Lupus Erythematosus","volume":"17","author":"Li","year":"2022","journal-title":"Breastfeed Med"},{"key":"2026010700554219000_12.2.e001733.12","doi-asserted-by":"publisher","DOI":"10.1002\/art.40930"},{"key":"2026010700554219000_12.2.e001733.13","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.138461"},{"key":"2026010700554219000_12.2.e001733.14","doi-asserted-by":"crossref","first-page":"2075","DOI":"10.1136\/annrheumdis-2024-eular.2854","article-title":"AB1439\u2005UPDATE OF THE EULAR POINTS TO CONSIDER FOR USE OF ANTIRHEUMATIC DRUGS IN REPRODUCTION, PREGNANCY AND LACTATION","volume":"83","author":"F\u00f6rger","year":"2024","journal-title":"Ann Rheum Dis"},{"key":"2026010700554219000_12.2.e001733.15","first-page":"973","article-title":"Breastfeeding in mothers with systemic lupus erythematosus","volume":"25","author":"Noviani","year":"2016","journal-title":"Lupus (Los Angel)"},{"key":"2026010700554219000_12.2.e001733.16","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1007\/s00296-017-3750-1","article-title":"Breastfeeding initiation, duration, and reasons for weaning in patients with systemic lupus erythematosus","volume":"37","author":"Acevedo","year":"2017","journal-title":"Rheumatol Int"},{"key":"2026010700554219000_12.2.e001733.17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/rmdopen-2022-002194","article-title":"Active counselling and well-controlled disease result in a higher percentage of women with rheumatoid arthritis that breast feed: results from the PreCARA study","volume":"8","author":"Kemper","year":"2022","journal-title":"RMD Open"},{"key":"2026010700554219000_12.2.e001733.18","doi-asserted-by":"crossref","first-page":"199","DOI":"10.37897\/RJR.2016.4.5","article-title":"BREASTFEEDING IN RHEUMATOID ARTHRITIS IN ROMANIA","volume":"25","author":"Bobirca","year":"2016","journal-title":"Ro J Rheumatol"},{"key":"2026010700554219000_12.2.e001733.19","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.181067"},{"key":"2026010700554219000_12.2.e001733.20","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2021-eular.1814"},{"key":"2026010700554219000_12.2.e001733.21","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-208840"},{"key":"2026010700554219000_12.2.e001733.22","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.midw.2019.08.002","article-title":"\u201cNobody knows, or seems to know how rheumatology and breastfeeding works\u201d: Women\u2019s experiences of breastfeeding whilst managing a long-term limiting condition - A qualitative visual methods study","volume":"78","author":"Williams","year":"2019","journal-title":"Midwifery"},{"key":"2026010700554219000_12.2.e001733.23","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1007\/s10067-018-04415-y","article-title":"Prolactin, autoimmunity, and motherhood: when should women avoid breastfeeding?","volume":"38","author":"Vieira Borba","year":"2019","journal-title":"Clin Rheumatol"}],"container-title":["Lupus Science &amp; Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/lupus-2025-001733","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T08:56:17Z","timestamp":1767776177000},"score":1,"resource":{"primary":{"URL":"https:\/\/lupus.bmj.com\/lookup\/doi\/10.1136\/lupus-2025-001733"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":23,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,9,22]]},"published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1136\/lupus-2025-001733"],"URL":"https:\/\/doi.org\/10.1136\/lupus-2025-001733","relation":{},"ISSN":["2053-8790"],"issn-type":[{"value":"2053-8790","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]}}}