Poster Session 2
Ukachi N. Emeruwa, MD, MPH (she/her/hers)
Assistant Professor/Women's Reproductive Health Research Scholar
University of California, San Diego
San Diego, California, United States
Kysha Mercader, BS
University of California, San Diego School of Medicine
La Jolla, California, United States
Chaukim Peters, BA
St. George's University School of Medicine
St. George's, Virgin Islands, U.S., U.S. Virgin Islands
Shai Bejerano, MS
Data Analyst
Columbia University Medical Center
New York, New York, United States
Toluwalasé A. Ajayi, MD
University of California San Diego/Rady Children's Hospital
San Diego, California, United States
Gregory A. Aarons, PhD
University of California San Diego
La Jolla, California, United States
Bonnie Kaiser, MPH, PhD
University of California San Diego
La Jolla, California, United States
Sarah Averbach, MPH
Associate Professor of Obstetrics, Gynecology and Reproductive Sciences
University of California San Diego
La Jolla, California, United States
Michelle Leff, MD
University of California San Diego
La Jolla, California, United States
Russell S. Miller, MD (he/him/his)
Sloane Hospital for Women Associate Professor of Prenatal Pediatrics (in Obstetrics and Gynecology)
Columbia University Medical Center
New York, New York, United States
Cynthia Gyamfi-Bannerman, MD, MS (she/her/hers)
Professor and Chair
University of California, San Diego
San Diego, California, United States
Growing evidence supports loop-diuretic use to reduce postpartum (PP) hypertensive morbidity, but little is known about how these medications affect breastfeeding and associated neonatal outcomes. We aimed to explore breastfeeding rates and newborn weight loss among lactating patients taking low-dose furosemide after delivery.
Study Design:
This was a secondary analysis of the Lasix for the Prevention of de novo Postpartum Hypertension Trial (PMID: 38641089), which randomized 82 normotensive patients at high risk for de novo PP hypertension to 5 days of daily furosemide 20mg PO or placebo within 8 hours after delivery. Parent trial participants completed electronic surveys at 2 and 6 weeks PP, which included infant feeding practice questions. Data on feeding practices and neonatal weight were also abstracted from electronic medical records. The primary outcome of this analysis was exclusive breastfeeding (EBF) continuation rates among those who reported EBF intent on delivery admission. Secondary outcomes included EBF rates among those practicing EBF at discharge, any breastfeeding rates, formula supplementation reasons, and newborn delivery to discharge weight change.
Results:
Of 79 parent trial participants enrolled through 6 weeks PP, 70 (89%) at least partially completed the 2 week survey; 55 (70%) at least partially completed the 6 week survey. There was no difference in EBF continuation rates for participants randomly assigned to furosemide who intended to exclusively breastfeed (54% at 2 weeks; 64% at 6 weeks) compared to placebo (38% at 2 weeks, p=0.43; 31% at 6 weeks, p=0.11). (Figure 1) Of reported supplementation reasons, there was no difference in milk supply or neonatal concerns between groups. Newborn weight declined a median of 5% [IQR -7,-3%] in the furosemide group and 6% [IQR -8,-4%] in the placebo group (p=0.17) by discharge, consistent with physiologic norms. (Table 1) There is no evidence in our trial that low-dose furosemide impacts breastfeeding continuation rates or physiologic newborn weight loss. These data are reassuring for loop-diuretic use in lactating people.
Conclusion:
