1.
Prepregnancy weight excess and cessation of exclusive breastfeeding: a systematic review and meta-analysis.
Flores, TR, Mielke, GI, Wendt, A, Nunes, BP, Bertoldi, AD
European journal of clinical nutrition. 2018;(4):480-488
Abstract
Recent studies have identified a relationship between maternal body mass index during prepregnancy (BMI) and exclusive breastfeeding (EBF), which is less common among mothers with higher BMI. The purpose of this literature review is to provide a pooled effect for the association between maternal excess weight during prepregnancy and cessation of exclusive breastfeeding. A systematic review was performed using articles present in six databases (PubMed, Scopus, Web off Science, Science direct, CINAHL and LILACS) published till February 2017. Studies investigating the association between excess maternal weight during prepregnancy and cessation of exclusive breastfeeding were included in the review. A meta-analysis using random effects to obtain a pooled effect of the studied association was conducted only with studies reporting odds ratio (OR) or available data for the calculation. Univariate meta-regression was performed to evaluate possible sources of heterogeneity. Egger's tests were also performed to verify possible publication bias. From the 6889 studies identified, 102 were read in full and 17 were included in the meta-analysis, providing 28 estimates for the association. Overall, a positive association was observed between maternal excess weight during prepregnancy and cessation of exclusive breastfeeding (ES: 1.60 (95% CI: 1.47, 1.74), I2: 93.2%). According to the used independent variables, no sources of heterogeneity were identified between studies Bias in publication was found. Maternal excess weight during prepregnancy was associated with cessation of exclusive breastfeeding. A standardized measure for exclusive breastfeeding is still needed for estimating its duration, in addition to further studies in developing countries to understand what could explain the heterogeneity of the findings.
2.
Association Between Duration of Breastfeeding and Maternal Hypertension: A Systematic Review and Meta-Analysis.
Qu, G, Wang, L, Tang, X, Wu, W, Sun, Y
Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine. 2018;(5):318-326
Abstract
OBJECTIVES Recently, an increasing number of studies have implied that breastfeeding has a protective effect on maternal hypertension, but it remains controversial. The aim of this study is to evaluate the effect of breastfeeding on maternal hypertension through meta-analysis. MATERIALS AND METHODS Eligible studies were searched and identified in various databases. Meta-analysis was conducted to assess the association between the duration of breastfeeding and maternal hypertension. RESULTS Seven eligible studies that contained 444,759 participants were included in our study. Meta-analysis of these seven studies showed a significant protective effect of breastfeeding on maternal hypertension. Specifically, pooled odds ratios (ORs) of hypertension for >0-6, >6-12, and >12 months of breastfeeding were 0.92 (95% confidence interval [CI]: 0.88-0.96, I2 = 67.5%), 0.89 (95% CI: 0.86-0.92, I2 = 0), and 0.88 (95% CI: 0.84-0.93, I2 = 43.9%), respectively, compared with nonbreastfeeding mothers, and the pooled OR of hypertension was 0.93 (95% CI: 0.91-0.95, I2 = 40.8%) for women who breastfed compared with women who had not. Furthermore, the pooled hazard ratio of hypertension was 1.34 (95% CI: 1.17-1.52, I2 = 58.7%) for women who did not breastfeed compared with women who breastfed for more than 12 months for their first child. CONCLUSION Different durations of breastfeeding have different protective effects against the development of maternal hypertension, and breastfeeding for >12 months has a better effect than <12 months.
3.
Maternal obesity in Africa: a systematic review and meta-analysis.
Onubi, OJ, Marais, D, Aucott, L, Okonofua, F, Poobalan, AS
Journal of public health (Oxford, England). 2016;(3):e218-e231
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Abstract
BACKGROUND Maternal obesity is emerging as a public health problem, recently highlighted together with maternal under-nutrition as a 'double burden', especially in African countries undergoing social and economic transition. This systematic review was conducted to investigate the current evidence on maternal obesity in Africa. METHODS MEDLINE, EMBASE, Scopus, CINAHL and PsycINFO were searched (up to August 2014) and identified 29 studies. Prevalence, associations with socio-demographic factors, labour, child and maternal consequences of maternal obesity were assessed. Pooled risk ratios comparing obese and non-obese groups were calculated. RESULTS Prevalence of maternal obesity across Africa ranged from 6.5 to 50.7%, with older and multiparous mothers more likely to be obese. Obese mothers had increased risks of adverse labour, child and maternal outcomes. However, non-obese mothers were more likely to have low-birthweight babies. The differences in measurement and timing of assessment of maternal obesity were found across studies. No studies were identified either on the knowledge or attitudes of pregnant women towards maternal obesity; or on interventions for obese pregnant women. CONCLUSIONS These results show that Africa's levels of maternal obesity are already having significant adverse effects. Culturally adaptable/sensitive interventions should be developed while monitoring to avoid undesired side effects.