(548) Association of perinatal inflammation and breastfeeding intensity

The Stress, Pregnancy, and Health (SPAH) observational study included 605 participants enrolled mid-gestation with singleton pregnancies. Participants completed surveys and antecubital blood draws between 20-27 and after 32 weeks gestation. Clinical outcomes were abstracted from the medical record. A sub-group of SPAH participants additionally completed surveys at 1 week, 6 weeks, 3 months, and 6 months postpartum as well as an additional blood draw at 6 weeks. Breastfeeding intensity was self-reported at all 4 surveys, and cytokines IL-1RA, IL-6, IL-10, and TNF-α, and C-reactive protein were measured in serum. Inflammation markers were log-transformed for normality and z-scored, and z-scores were summed into composites. Stepwise regression identified key covariates, which were retained in multiple regression models.

Results: 155 individuals were included in the analysis. As indicated by the stepwise regression, we retained marital status, SES, and any diabetes in prenatal models and gestational weeks at delivery, any diabetes, and hypertensive disorders of pregnancy, last BMI measured during pregnancy, and resource composite score in postpartum models. Adjusted models indicated that lower circulating inflammatory markers during pregnancy were associated with higher breastfeeding intensity across week 6, month 3, and month 6 time points. The postpartum inflammatory composite was associated with breastfeeding intensity at point of blood draw (6 weeks).

Conclusion: Lower prenatal inflammatory markers were associated with higher rates of breastfeeding in the postpartum period, but postpartum inflammatory markers were not. Inflammation in pregnancy may influence lactogenesis and breastfeeding initiation, differentiating breastfeeding outcomes in the postpartum period.