An Observational Study Protocol for Assessing Lactation Intensity and Reduction in the Prevalence of Metabolic Syndrome After a Maternal Complication of Pregnancy (LEMON Study)

BACKGROUND: Major pregnancy complications, such as hypertensive disorders of pregnancy, gestational diabetes mellitus, delivery of a small for gestational age infant, preterm delivery, and placental abruption, are associated with the development of Type II diabetes mellitus and cardiovascular disease. Improving breastfeeding longevity may reduce long-term risk for cardiovascular disease for those with major pregnancy complications. Metabolic syndrome (i.e., the presence of at least three specific cardiovascular disease risk factors) is an appropriate marker to assess future cardiovascular risk in the early postpartum. RESEARCH AIM: To determine whether lactation intensity in the first 6 months postpartum is associated with metabolic syndrome at 6 months postpartum among people who previously had a major pregnancy complication.Planned Analysis:This is a prospective observational cohort study is being conducted at a tertiary hospital in Adelaide, South Australia (ANZCTN12624001351505). We will be recruiting a total of 250 participants referred to a postpartum cardiovascular clinic after experiencing a major complication in pregnancy. To assess lactation intensity, participants complete online questionnaires on infant feeding patterns for 6 months postpartum. We will examine the relationship between lactation intensity and the development of metabolic syndrome at 6 months postpartum via binary logistic regression. DISCUSSION: Results of this study aid our understanding of the complex relationship between major pregnancy complications, early postpartum metabolic syndrome, and lactation. This data will inform whether interventions to support lactation should be leveraged to prevent primary cardiovascular disease in these high-risk pregnancy cohorts.