Interpregnancy Interval, Intention to Breastfeed and Breastfeeding Initiation Among Women With Pregestational Diabetes Mellitus

Abstract

Background: Interpregnancy intervals (IPI) have been related to adverse perinatal outcomes, however, correlation between IPI and BF initiation among women with pregestational diabetes (PGDM) have not been described. Objective: To determine associations of short (< 18 months), intermediate (18-59 months) and long (≥ 60 months) IPI with intention to breastfeed (BF) and with exclusive BF, partial BF or formula feeding (FF) at discharge. Methods: Retrospective cohort study of 205 women with PGDM who delivered (2013-2018) at ≥ 34 weeks GA. IPI was calculated as months elapsed between a live birth ( previous ) and the start of the pregnancy of the next live birth (subsequent) . Results: IPI distribution was 34% short, 42% intermediate and 24% long. Short as compared to long IPI included more type 1 women (41 vs. 18%), younger women (31 vs. 34y), fewer BMI kg/m 2 ≥ 35 (46 vs. 64%) and more NICU admis - sions (26 vs. 2%). Prior BF experience was similar among the groups (short 63%, intermediate 59% and long IPI 54%). Intention to BF was similar for short and intermediate IPI (67 & 65%) and lower for long IPI (44%). At discharge comparing short vs. long IPI, exclusive BF was higher (37 vs. 18%), partial BF was similar (36 vs. 28%) and FF was lower (27 vs. 54%). Conclusions: Among women with PGDM, short IPI is as - sociated with exclusive BF at discharge while long IPI was associated with lower intention to BF, lower rate of exclusive BF and higher rate of FF at discharge. IPI outside recommended guidelines affect perinatal outcomes and increase the risk for BF initiation failure.