Abstract
OBJECTIVE: Breastfeeding prevalence and challenges among women of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) is under-researched especially in the Middle East-North Africa region. This study aimed to assess breastfeeding initiation, duration and predictors of early discontinuation (<6 months post partum) among Egyptian mothers with SLE or RA. METHODS: This multicentre retrospective cohort study included 320 pregnancies: 62 SLE (105 pregnancies), 71 RA (110 pregnancies) and 59 healthy mothers (105 pregnancies). Data on pregnancy history, breastfeeding intent, initiation, duration and weaning reasons were collected. RESULTS: Exclusive breastfeeding was lowest in SLE (29.9%) vs RA (50.6%) and controls (60%, p<0.001). Continuation beyond 6 months was significantly lower in SLE (36.2%) and RA (33.6%) vs controls (81%, p<0.001). Postpartum depression independently predicted discontinuation in SLE (adjusted OR (aOR)=0.06, 95% CI 0.01 to 0.6) and RA (aOR=0.34, 95% CI 0.13 to 0.9). Multivariable generalised estimating equation confirmed SLE reduced breastfeeding odds versus controls (aOR=0.41, p=0.040). CONCLUSION: Breastfeeding is significantly less prevalent among Egyptian mothers with SLE and RA when compared with control group. Targeted educational programme and support may help improve breastfeeding rates in SLE/RA mothers.