{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:36:03Z","timestamp":1777876563946,"version":"3.51.4"},"reference-count":40,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neonatal-Perinatal Medicine"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Class 3 obesity is composed of\n                    <jats:italic>morbid<\/jats:italic>\n                    (BMI 40\u201349\u00a0kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    ) and\n                    <jats:italic>extreme<\/jats:italic>\n                    (BMI \u2265 50\u00a0kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    ) subgroups. Adverse perinatal outcomes have been associated with obesity; however, data on breastfeeding (BF) initiation for women in either group remains limited.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Objective:<\/jats:bold>\n                    To compare BF initiation rates (exclusive or partial BF) and related comorbidities of 890 women with\n                    <jats:italic>morbid<\/jats:italic>\n                    and 890 with\n                    <jats:italic>extreme<\/jats:italic>\n                    obesity matched by race, parity, and year of delivery.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    Retrospective cohort study of women who delivered singletons at \u2265 34\u00a0weeks gestation (2013\u20132021). Those who had bariatric surgery or infants with major malformations were excluded.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Both groups were similar in: primiparity (38%), age (29y), white race (58%), African American (36%), current (10 vs 12%) and former (25 vs 27%) smokers, gestational hypertension (15 vs 16%), polycystic ovary syndrome (5 vs 7%), gastroesophageal reflux disease (10 vs 10%), and anemia (17 vs 17%). Women in the\n                    <jats:italic>extreme<\/jats:italic>\n                    group had a higher prevalence of gestational (17 vs 12%) and pregestational diabetes (12 vs 6%), chronic hypertension (41 vs 17%), severe preeclampsia (18 vs 12%), obstructive sleep apnea (12 vs 3%), asthma (22 vs 16%), and cesarean deliveries (62 vs 44%). Intention to BF (64 vs 71%), exclusive BF (23 vs 34%), and BF initiation (57 vs 64%) rates were lower in the\n                    <jats:italic>extreme<\/jats:italic>\n                    obesity group at discharge.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Higher frequency of comorbidities in the\n                    <jats:italic>extreme<\/jats:italic>\n                    obesity group highlights the need for antenatal, intrapartum, and postpartum targeted interventions if the benefits of BF to mothers and infants are to be realized.\n                  <\/jats:p>","DOI":"10.1177\/19345798241296331","type":"journal-article","created":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T06:48:02Z","timestamp":1733208482000},"page":"70-78","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Breastfeeding initiation according to the severity of Class 3 obesity"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7300-3577","authenticated-orcid":false,"given":"Leandro","family":"Cordero","sequence":"first","affiliation":[{"name":"Department of Pediatrics, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4840-7742","authenticated-orcid":false,"given":"Michael R","family":"Stenger","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark B","family":"Landon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley J","family":"Needleman","sequence":"additional","affiliation":[{"name":"Department of Surgery, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1260-6638","authenticated-orcid":false,"given":"Sabrena","family":"Noria","sequence":"additional","affiliation":[{"name":"Department of Surgery, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig A","family":"Nankervis","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,11]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2017.1362552"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004395"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1801040"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000155"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0187923"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8101625"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2018.0196"},{"key":"e_1_3_4_9_2","unstructured":"Centers for Disease Control and Prevention. 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