(699) Association between breastfeeding and neurodevelopmental outcomes after late preterm birth

Friday, January 31, 2025

10:30 AM – 12:30 PM

Submitting Author and Presenting Author(s)

Anna Palatnik, MD

Associate Professor
Medical College of Wisconsin
Milwaukee, Wisconsin, United States

Objective: Despite the known benefits, it remains unclear whether breastfeeding improves neurodevelopmental outcomes. We tested the hypothesis that breastfeeding is associated with improved neurodevelopmental outcomes among children delivered late preterm.

Study Design: Secondary analysis of a prospective, follow-up study of ≥ 6 years old children enrolled in the NICHD Antenatal Late Preterm Steroid (ALPS) Trial, a multicenter study that assessed betamethasone administration in pregnancies at risk for late preterm birth (34-36wks). Term births and those with missing breastfeeding data or the Differential Ability Scales-II (DAS-II) were excluded. The exposure was breastfeeding at 3 months of life collected via interviews. The primary outcome was cognitive function at age ≥ 6, measured by DAS-II core components of the General Conceptual Ability (GCA) that includes verbal, non-verbal reasoning, and spatial abilities. General linear models were used to evaluate the association of breastfeeding with DAS-II GCA after controlling for pre-specified baseline characteristics (maternal age and education, gestational age at birth, child age, sex, tobacco use in pregnancy, ALPS study group, study center).

Results:

Of 541 participants included in the analysis, 273 (50.5%) were breastfeeding at 3 months of life. Participants who breastfed were older, more likely to be white, have a college degree, be married, have private insurance, and less likely to use tobacco in pregnancy (Table 1). There was no difference in birthweight or gestational age at birth by breastfeeding status. The primary outcome, DAS-II GGA, was higher among children who were breastfed at 3 months, 98.9±13.3 vs. 93.0±12.9, mean difference of 5.90 (95% CI 3.59, 8.21, adjusted mean difference 2.27, 95% CI 0.03, 4.50) (Table 2). In secondary analyses, differences in the overall GCA appear to be driven by increased scores for spatial ability.

Conclusion: Among children born late preterm at 34-36 weeks, breastfeeding at 3 months of life was associated with improved neurodevelopmental outcomes at age 6 or older.