Interpregnancy Interval, Intention to Breastfeed and Breastfeeding Initiation Among Women with Class 3 Obesity

Background: Interpregnancy intervals (IPI) relate to adverse perinatal outcomes, however, associations of IPIs, severe obesity and breastfeeding (BF) are underreported.Objective: To estimate differences in comorbidities and in intention to BF as declared prior to delivery with infant feeding at discharge among women with Class 3 obesity stratified by short (< 18 months), intermediate (18-59 months) or long ( 60 months) IPIs.Methods: Retrospective study of 339 women with Class 3 obesity who delivered live births at 34 weeks gestation.IPI was calculated from the first live birth to the conception of the next.Results: Overall, 95 (28%) women with short and 160 (47%) with intermediate IPI were similar.Conversely, 84 (25%) in the long group differed from the intermediate in intention to BF (55 vs 68%), prior BF (46 vs 61%), age (31 vs 29y), advanced maternal age (30 vs 13%), public healthcare assistance (70 vs 55%), A2 gestational diabetes (17 vs 6%), chronic hypertension on meds (21 vs 6%), median pregestational weight (129 vs 115kg) and weight at delivery (140 vs 126kg), primary cesarean (23 vs 10%), NICU admission (19 vs 13%) and hypoglycemia (29 vs 16%).At discharge, exclusive BF (21 vs 36%) and BF initiation (48 vs 66%) rates were lower, while formula feeding (52 vs 34%) was higher.Conclusions: Women with Class 3 obesity and long IPI are associated with severe comorbidities and lower intention to BF and BF initiation rates.Modifiable factors need to be addressed if the benefits of BF are to be achieved.