Poster Presentation - SOMANZ ASM Society of Obstetric Medicine of Australia and New Zealand ASM 2023

Lactation intensity and reduction in the prevalence of metabolic syndrome after a maternal complication of pregnancy (The LEMON Study): an observational study protocol (#66)

Maleesa Pathirana 1 2 3 , Prabha Andraweera 1 2 3 , Melanie Wittwer 2 3 , Emily Aldridge 1 2 3 , Gustaaf Dekker 1 2 4 , Margaret Arstall 2 3
  1. Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
  2. Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
  3. Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia
  4. Division of Women’s Health, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia

Introduction: Major pregnancy complications such as preeclampsia and gestational diabetes mellitus are associated with development of type II diabetes mellitus and coronary heart disease, which are becoming ever more prevalent in young women. Despite clinical recommendations to optimise CVD risk factors after a complication of pregnancy, tailored lifestyle programs have poor adherence and are not suited to the lifestyle of a postpartum mother. Breastfeeding (lactation) is associated with reduction in hypertension and diabetes later in life, however there has not been a direct focus on elucidating how breastfeeding affects certain components of cardiometabolic health in women with a previous pregnancy complication within the early postpartum period. This project aims to determine if lactation intensity is associated with a reduction in the rate of metabolic syndrome in women with a maternal complication of pregnancy at 6 months postpartum

Methods:  The LEMON study is a prospective, observational cohort study to be conducted at the Lyell McEwin Hospital (LMH), which services a region with some of the highest rates of coronary artery disease, diabetes, smoking and obesity in metropolitan Australia. Women between 18 and 45 years of age eligible if they are being referred to the Cardiovascular Obstetric Follow-up for education and evaluation (COFFEE) clinic for a major complication of pregnancy, including preeclampsia, gestational hypertension, and gestational diabetes mellitus (GDM), and preterm delivery, delivery of a small for gestational age infant and placental abruption. Women will complete online questionnaires on breastfeeding frequency for 6 months prior to their first clinic appointment. Lactation intensity will be ascertained using a calculated intensity ratio, which assess the number of breastfeeds per day in relation to all other forms of feeding over the course of 6 months. This will be assessed in relation to metabolic syndrome, which is the cluster of the most dangerous coronary heart disease risk factors (obesity and two or more of the following: hypertension, impaired glycaemia and/or elevated triglycerides or reduced HDL-C) and is a precursor of T2DM and CAD.

Conclusion: This study will enable us to quantify how lactation at different intensities over 6 months can affect the development of metabolic syndrome in young women with a previous complication of pregnancy thereby leading to targeted therapeutic strategies in cardiometabolic disease risk optimisation and improving guidelines for postpartum follow-up after a complicated pregnancy.