OBJECTIVE Breastfeeding duration is inversely associated with risks of cardiovascular disease (CVD) and type 2 diabetes in parous women. However, the association among women at high risk, including women with type 2 diabetes or gestational diabetes (GDM) is unclear. RESEARCH DESIGN AND METHODS We included 15,146 parous women with type 2 diabetes from the Nurses’ Health Study I and II (NHS, NHS II) and 4,537 women with a history of GDM from NHS II. Participants reported history of breastfeeding via follow-up questionnaires. Incident CVD by 2017 comprised stroke or coronary heart disease (CHD: myocardial infarction, coronary revascularization). Adjusted hazard ratios (aHRs) and 95% CIs were estimated using Cox models. RESULTS We documented 1,159 incident CVD cases among women with type 2 diabetes in both cohorts during 188,874 person-years of follow-up and 132 incident CVD cases among women with a GDM history during 100,218 person-years of follow-up. Longer lifetime duration of breastfeeding was significantly associated with lower CVD risk among women with type 2 diabetes, pooled aHR of 0.68 (95% CI 0.54–0.85) for >18 months versus 0 months, and 0.94 (0.91–0.98) per 6-month increment in breastfeeding. Similar associations were observed with CHD (pooled aHR 0.93 [0.88–0.97]), however, not with stroke (0.96 [0.91–1.02]) per 6-month increment in breastfeeding. Among women with GDM history, >18 months versus 0 months of breastfeeding was associated with an aHR of 0.49 (0.28–0.86) for total CVD. CONCLUSIONS Longer duration of breastfeeding was associated with lower risk of CVD in women with type 2 diabetes or GDM.

中文翻译：

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患有 2 型糖尿病或有妊娠期糖尿病史的女性的终生母乳喂养持续时间和心血管风险：来自两个大型前瞻性队列的研究结果

目的 母乳喂养持续时间与经产妇女患心血管疾病 (CVD) 和 2 型糖尿病的风险呈负相关。然而，高危女性（包括患有 2 型糖尿病或妊娠糖尿病 (GDM) 的女性）之间的关联尚不清楚。研究设计和方法 我们纳入了来自护士健康研究 I 和 II（NHS、NHS II）的 15,146 名患有 2 型糖尿病的经产妇女以及来自 NHS II 的 4,537 名有 GDM 病史的妇女。参与者通过后续调查问卷报告母乳喂养史。截至 2017 年，CVD 事件包括中风或冠心病（CHD：心肌梗塞、冠状动脉血运重建）。使用 Cox 模型估计调整后的危险比 (aHR) 和 95% CI。结果 我们在 188,874 人年的随访期间，记录了两个队列中 2 型糖尿病女性中 1,159 例 CVD 病例，在 100,218 人年的随访期间，有 GDM 病史的女性中记录了 132 例 CVD 病例。2 型糖尿病女性中，较长的终生母乳喂养时间与较低的 CVD 风险显着相关，>18 个月与 0 个月相比，汇总 aHR 为 0.68 (95% CI 0.54–0.85)，每 6 个月为 0.94 (0.91–0.98)。母乳喂养的月增量。在 CHD 中也观察到了类似的关联（汇总 aHR 为 0.93 [0.88–0.97]），但母乳喂养每增加 6 个月与中风（0.96 [0.91–1.02]）没有相关性。在有 GDM 病史的女性中，母乳喂养 >18 个月与 0 个月相比，总 CVD 的 aHR 为 0.49 (0.28-0.86)。结论 较长的母乳喂养时间与患有 2 型糖尿病或 GDM 的女性较低的 CVD 风险相关。