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Prepregnancy weight excess and cessation of exclusive breastfeeding: a systematic review and meta-analysis

European Journal of Clinical Nutrition volume 72, pages 480–488 (2018)Cite this article

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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.

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Acknowledgements

Thaynã R Flores was funded by a scholarship from the Coordinator for the Improvement of Higher Education Personnel (CAPES), Brazil.

Author contributions

TRF participated in all stages of the manuscript (definition and search in databases, selecting, reading articles, extracting data, and analyzing), interpreted the results, and wrote down the text. AW participated in the selection, reading of articles, and review of the manuscript. GIM participated in reading the articles, collaborated with data analyses, and did a critical review of the manuscript. BPN collaborated with data extraction, data analysis, and critical review of the manuscript. ADB guided and critically reviewed the manuscript.

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Authors and Affiliations

  1. Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil

    Thaynã Ramos Flores, Gregore Iven Mielke, Andrea Wendt & Andréa Dâmaso Bertoldi

  2. School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, Australia

    Gregore Iven Mielke

  3. Department of Nursing, Federal University of Pelotas, Pelotas, Brazil

    Bruno P Nunes

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  1. Thaynã Ramos Flores
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Correspondence to Thaynã Ramos Flores.

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Flores, T.R., Mielke, G.I., Wendt, A. et al. Prepregnancy weight excess and cessation of exclusive breastfeeding: a systematic review and meta-analysis. Eur J Clin Nutr 72, 480–488 (2018). https://doi.org/10.1038/s41430-017-0073-y

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