Breastfeeding and postpartum outcomes among women with congenital heart disease

Abstract Background Although breastfeeding can cause an increase in the maternal cardiac load, little is known about how it affects the postpartum clinical course among women with congenital heart disease (CHD). The aim of this study was to evaluate whether breastfeeding affects the incidence of postpartum cardiovascular events and the levels of brain natriuretic peptide (BNP) among mothers with CHD. Methods A review of 153 pregnancies in 153 women with CHD was conducted. Postpartum outcomes, including late postpartum cardiovascular events and BNP levels, were analysed by breastfeeding status. Results Ninety-three were primarily breastfeeding (the breastfed-group) and 60 were primarily formula feeding (the formula-group). The formula-group had a significantly higher rate of women with severe conditions, defined as class II-III and III of the modified World Health Organization (WHO) classification of maternal cardiovascular risk, than the breastfed-group (p = 0.03). Late postpartum cardiovascular events occurred in 11 women and not feeding status, but medication use, was the only correlated factor for the events in multivariate analysis. The values of BNP in the third trimester (29.2 pg/mL vs 32.8 pg/mL; p = 0.15) and at one-month postpartum (23.7 pg/mL vs 24.9 pg/mL; p = 0.26) were not statistically different between the breastfed-group and the formula-group. Even when limited to women with the modified WHO class III disease, BNP values were not significantly different between the two groups. Conclusions Among postpartum women with CHD, the cardiovascular event rates and BNP values may not be affected by feeding status, but mostly by disease severity.