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Poster Session 4

Category: Medical/Surgical/Diseases/Complications

Poster Session 4

(1133) Severe maternal morbidity and breastfeeding among US nulliparous individuals

Thursday, February 12, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Tracy Caroline Bank, MD (she/her/hers)

Maternal Fetal Medicine Fellow
The Ohio State University Wexner Medical Center
COLUMBUS, Ohio, United States

Coauthor(s)

JW

Jiqiang Wu, MSc

The Ohio State University Wexner Medical Center
Columbus, Ohio, United States
JC

Janet Catov, MS, PhD

Professor, Department of Obstetrics, Gynecology & Reproductive Sciences
University of Pittsburgh
Pittsburgh, Pennsylvania, United States
Lynn M. Yee, MD, MPH (she/her/hers)

Associate Professor
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
DH

David M. Haas, MD

Attending Physician
Indiana University School of Medicine
Indianapolis, Indiana, United States
RM

Rebecca B. McNeil, PhD

Senior Research Statistician
RTI International
Triangle Park, North Carolina, United States
JP

Jessica Pippen, MD

MetroHealth Medical Center
Cleveland, Ohio, United States
Hyagriv Simhan, MD, MS

Professor
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania, United States
UR

Uma M. Reddy, MD, MPH

Professor
Columbia University Irving Medical Center
New York, New York, United States
RS

Robert M. Silver, MD

Department of Obstetrics and Gynecology, University of Utah Health
Salt Lake City, Utah, United States
LL

Lisa Levine, MD, MSCE

Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, United States
GS

George R. Saade, MD

Department of Obstetrics and Gynecology, Eastern Virginia Medical School at Old Dominion University
Norfolk, Virginia, United States
Judith H. Chung, MD

Professor of Clinical Obstetrics and Gynecology
University of California Irvine Medical Center
Irvine, California, United States
Courtney C. Lynch, MPH, PhD

Associate Professor
Ohio State University Wexner Medical Center
COLUMBUS, Ohio, United States
WG

William A. Grobman, MBA, MD

Professor
Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States
Kartik K. Venkatesh, MD, PhD (he/him/his)

Associate Professor
The Ohio State University Wexner Medical Center
The Ohio State University Wexner Medical Center, Ohio, United States

Objective:
While certain delivery complications, such as postpartum hemorrhage, have been associated with less breastfeeding, little is known about breastfeeding following deliveries complicated by severe maternal morbidity (SMM). Therefore, we examined whether SMM at delivery hospitalization was associated with the likelihood and duration of breastfeeding among US nulliparous individuals.

Study Design:
This was a secondary analysis from the prospective cohort Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be Heart Health Study. The primary exposure was any SMM, based on the Centers for Disease Control and Prevention definition, and secondarily, non-transfusion SMM. The primary outcomes were self-reported breastfeeding initiation (yes/no) and, among those who initiated breastfeeding, its duration ( < 6 weeks as reference, 6 weeks to 6 months, and >6 months) assessed 6 months after delivery. Secondarily, exclusive breastfeeding and its duration were assessed. Multivariable logistic regression and ordinal logistic regression were used and adjusted for age, insurance, and pre-pregnancy body mass index.

Results:
Among 6,762 nulliparous individuals, those who experienced SMM had similar odds of breastfeeding initiation as those without SMM (83.8% vs. 88.3%; aOR: 0.73; 95%CI: 0.46, 1.15), but among those who breastfed, SMM was associated with a shorter duration of breastfeeding (aOR: 0.50; 95%CI: 0.36, 0.68). SMM was associated with significantly lower odds of exclusive breastfeeding (76.4% vs. 85.6%; aOR: 0.60; 95% CI: 0.37, 0.98), albeit not the duration of exclusive breastfeeding (aOR: 1.06; 95%CI: 0.70, 1.64). Once transfusion was removed as a component of SMM, point estimates revealed even stronger associations with reduction in the duration of breastfeeding (TABLE).

Conclusion:
SMM at delivery hospitalization was associated with significantly lower odds of initiating and sustaining breastfeeding. Future research is needed to understand how to better support individuals in optimizing lactation following deliveries complicated by SMM.