Severe Maternal Morbidity and Breastfeeding Among Nulliparous Individuals in the United States.

Abstract

We examined whether severe maternal morbidity (SMM) at delivery was associated with the initiation and duration of breastfeeding among nulliparous individuals in the United States in a secondary analysis from the prospective nuMoM2b-HHS (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be Heart Health Study). Among 6,762 nulliparous individuals, the frequency of any breastfeeding by duration was as follows: 759 (11.2%) breastfed for less than 6 weeks; 1,847 (27.3%) breastfed for 6 weeks to 6 months; and 3,359 (49.7%) breastfed for more than 6 months, and the frequency of exclusive breastfeeding among those with any breastfeeding was 4,653 (85.4%). The frequency of any SMM was 160 (2.4%) and nontransfusion SMM was 124 (1.8%). Breastfeeding initiation did not vary by SMM status. Among those who breastfed, SMM was associated with a lower likelihood of breastfeeding for more than 6 months (adjusted odds ratio [aOR] 0.50; 95% CI, 0.36-0.68) and a lower likelihood of exclusive breastfeeding (aOR 0.60; 95% CI, 0.37-0.98). In a prospective cohort of nulliparous pregnant individuals from across the United States, SMM at delivery was not associated with breastfeeding initiation, but was associated with a significantly lower likelihood of breastfeeding duration and exclusive breastfeeding.