高血圧と授乳結果の関連性を示す研究(Study finds link between hypertension and breastfeeding outcomes)

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2025-07-18 イェール大学

イェール大学の研究により、妊娠高血圧症(HDP)を経験した女性は、母乳育児を始めない確率が11%高く、開始しても中止するリスクが17%高いことが判明しました。HDP群では授乳継続期間が中央値で17週短く、特に非ヒスパニック系ブラックやアメリカ先住民で中止リスクが高い傾向が見られました。母子の健康や将来の心血管リスクを考慮し、妊娠期からの授乳支援が重要とされています。

<関連情報>

米国女性における妊娠中の高血圧障害と授乳 Hypertensive Disorders of Pregnancy and Breastfeeding Among US Women

Deanna Nardella, MD, MHS; Maureen E. Canavan, PhD, MPH2; Sarah N. Taylor, MD, MSCR1; et al
JAMA Network Open  Published:July 18, 2025
DOI:10.1001/jamanetworkopen.2025.21902

高血圧と授乳結果の関連性を示す研究(Study finds link between hypertension and breastfeeding outcomes)

Key Points

Question Are hypertensive disorders of pregnancy (HDP) associated with breastfeeding initiation and duration?

Findings In this cross-sectional study representing over 10 million US women, HDP was associated with higher odds of never breastfeeding. Among those who initiated breastfeeding, HDP was associated with a higher hazard of breastfeeding cessation and fewer weeks of breastfeeding.

Meaning These findings suggest that postpartum women with HDP may benefit from tailored interventions to promote the cardioprotective benefits of breastfeeding.

Abstract

Importance Hypertension contributes to US maternal-infant morbidity and mortality, with potential attenuation from breastfeeding. Little is known regarding breastfeeding outcomes among mother-infant dyads exposed to hypertensive disorders of pregnancy (HDP).

Objective To quantify the extent to which HDP is associated with never breastfeeding and the time to breastfeeding cessation among postpartum women in the US.

Design, Setting, and Participants This cross-sectional study used nationally representative data from the Centers for Disease Control and Prevention Pregnancy Risk Assessment Monitoring System (PRAMS). Participants included women from 43 US states, Washington, DC, and Puerto Rico who had a live birth between January 2016 and November 2022. Complete data for HDP exposure, outcomes of breastfeeding noninitiation or cessation, and all covariates were included in the analysis, performed from October to December 2024.

Exposure Self-reported high blood pressure or hypertension, preeclampsia, or eclampsia before or during pregnancy.

Main Outcomes and Measures Odds of never breastfeeding, hazard of breastfeeding cessation, and median time to breastfeeding cessation, adjusted for sociodemographic and maternal-infant health covariates.

Results Of 205 247 women (weighted number, 10 915 302), mean (SD) age was 30.0 (5.8) years; 99.0% were first-time mothers; 54.0% had private and 40.0% had Medicaid insurance; and 91.0% delivered a term infant. HDP and breastfeeding initiation were reported by approximately 17.0% and 88.0% of women, respectively. Adjusting for covariates, HDP was associated with higher odds of never breastfeeding (adjusted odds ratio, 1.11; 95% CI, 1.05-1.18), and among those who breastfed, a higher adjusted hazard of breastfeeding cessation (adjusted hazard ratio, 1.17; 95% CI, 1.14-1.21). The median time to breastfeeding cessation among those with HDP was 17 weeks shorter than among those without HDP (unadjusted median duration, 17 [IQR, 5.0 to >46.7] vs 34 [IQR, 9.0 to >46.7] weeks).

Conclusions and Relevance In this cross-sectional study representing more than 10 million US postpartum women, HDP was associated with higher odds of never breastfeeding and a higher hazard of breastfeeding cessation. Studies to understand the potential mechanisms of this association are required to develop targeted breastfeeding support strategies for individuals with HDP.

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