Rothenbacher Dietrich, Bode Guenter, Brenner Hermann
Department of Epidemiology, German Centre for Research on Ageing, Heidelberg, Germany.
Int J Epidemiol. 2002 Jun;31(3):632-7. doi: 10.1093/ije/31.3.632.
Helicobacter pylori infection is predominantly acquired in early childhood. Therefore, childhood nutrition may be related to acquisition of infection. However, there are few current data from developed countries to elucidate this association. We investigated the relation between history of breastfeeding and H. pylori infection in a large population-based sample.
Study subjects were all pre-school children in the city of Ulm, located in southern Germany and two nearby communities who were screened for school fitness between January and July 1997. The infection status of the children and of the accompanying mother was determined by the 13C-urea breath test. The parents provided additional information through a standardized questionnaire.
In all, 946 children (mean age 5.9 years) and their mothers were included in the final analysis (response in study population 80.2%). Overall, H. pylori prevalence was 9.8% in children and 34.7% in their mothers; there was a strong association between children's and mother's infection. Of the children, 82.5% had ever been breastfed. Prevalence of H. pylori infection was higher in children breastfed compared to never breastfed children (10.1% versus 8.4%) and showed a positive relationship with duration of breastfeeding. After controlling for covariates, including mother's H. pylori status, by means of multivariable analysis, the odds ratio (OR) for children's H. pylori infection was 1.56 (95% CI: 0.79-3.11) for any versus never breastfeeding and 2.57 (95% CI: 1.19-5.55) given the child was breastfed > or =6 months.
These data suggest that breastfeeding in infancy does not protect against H. pylori infection among pre-school children in industrialized countries.
幽门螺杆菌感染主要在儿童早期获得。因此，儿童期营养可能与感染的获得有关。然而，目前发达国家几乎没有数据来阐明这种关联。我们在一个基于人群的大样本中研究了母乳喂养史与幽门螺杆菌感染之间的关系。
研究对象为德国南部乌尔姆市及附近两个社区的所有学龄前儿童，这些儿童于1997年1月至7月期间接受入学健康筛查。通过13C-尿素呼气试验确定儿童及其陪同母亲的感染状况。父母通过标准化问卷提供额外信息。
共有946名儿童（平均年龄5.9岁）及其母亲纳入最终分析（研究人群应答率80.2%）。总体而言，儿童幽门螺杆菌感染率为9.8%，母亲为34.7%；儿童与母亲的感染之间存在强关联。在这些儿童中，82.5%曾接受母乳喂养。与从未母乳喂养的儿童相比，母乳喂养儿童的幽门螺杆菌感染率更高（10.1%对8.4%），且与母乳喂养持续时间呈正相关。在通过多变量分析控制包括母亲幽门螺杆菌状态在内的协变量后，对于任何母乳喂养与从未母乳喂养的儿童，幽门螺杆菌感染的比值比（OR）为1.56（95%CI：0.79-3.11），而对于母乳喂养≥6个月的儿童，OR为2.57（95%CI：1.19-5.55）。
这些数据表明，在工业化国家，婴儿期母乳喂养并不能预防学龄前儿童感染幽门螺杆菌。
