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婴儿母乳喂养与过敏性疾病——一项前瞻性出生队列研究

Breast feeding and allergic diseases in infants-a prospective birth cohort study.

作者信息

Kull I, Wickman M, Lilja G, Nordvall S L, Pershagen G

机构信息

Department of Environmental Health, Stockholm County Council, Stockholm, Sweden.

出版信息

Arch Dis Child. 2002 Dec;87(6):478-81. doi: 10.1136/adc.87.6.478.

Abstract

AIMS

To investigate the effect of breast feeding on allergic disease in infants up to 2 years of age.

METHODS

A birth cohort of 4089 infants was followed prospectively in Stockholm, Sweden. Information about various exposures was obtained by parental questionnaires when the infants were 2 months old, and about allergic symptoms and feeding at 1 and 2 years of age. Duration of exclusive and partial breast feeding was assessed separately. Symptom related definitions of various allergic diseases were used. Odds ratios (OR) and 95% confidence intervals (CI) were estimated in a multiple logistic regression model. Adjustments were made for potential confounders.

RESULTS

Children exclusively breast fed during four months or more exhibited less asthma (7.7% v 12%, OR(adj) = 0.7, 95% CI 0.5 to 0.8), less atopic dermatitis (24% v 27%, OR(adj) = 0.8, 95% CI 0.7 to 1.0), and less suspected allergic rhinitis (6.5% v 9%, OR(adj) = 0.7, 95% CI 0.5 to 1.0) by 2 years of age. There was a significant risk reduction for asthma related to partial breast feeding during six months or more (OR(adj) = 0.7, 95% CI 0.5 to 0.9). Three or more of five possible allergic disorders-asthma, suspected allergic rhinitis, atopic dermatitis, food allergy related symptoms, and suspected allergic respiratory symptoms after exposure to pets or pollen-were found in 6.5% of the children. Exclusive breast feeding prevented children from having multiple allergic disease (OR(adj) = 0.7, 95% CI 0.5 to 0.9) during the first two years of life.

CONCLUSION

Exclusive breast feeding seems to have a preventive effect on the early development of allergic disease-that is, asthma, atopic dermatitis, and suspected allergic rhinitis, up to 2 years of age. This protective effect was also evident for multiple allergic disease.

摘要

目的

研究母乳喂养对2岁以下婴儿过敏性疾病的影响。

方法

在瑞典斯德哥尔摩对4089名婴儿组成的出生队列进行前瞻性随访。当婴儿2个月大时,通过父母问卷调查获取各种暴露信息,在1岁和2岁时获取过敏症状和喂养情况信息。分别评估纯母乳喂养和部分母乳喂养的持续时间。采用各种过敏性疾病的症状相关定义。在多元逻辑回归模型中估计比值比(OR)和95%置信区间(CI)。对潜在混杂因素进行了调整。

结果

纯母乳喂养4个月或更长时间的儿童在2岁时患哮喘的比例较低(7.7%对12%,校正OR = 0.7,95% CI 0.5至0.8),患特应性皮炎的比例较低(24%对27%,校正OR = 0.8,95% CI 0.7至1.0),患疑似过敏性鼻炎的比例较低(6.5%对9%,校正OR = 0.7,95% CI 0.5至1.0)。6个月或更长时间的部分母乳喂养与哮喘风险显著降低相关(校正OR = 0.7,95% CI 0.5至0.9)。在6.5%的儿童中发现了五种可能的过敏性疾病(哮喘、疑似过敏性鼻炎、特应性皮炎、食物过敏相关症状以及接触宠物或花粉后疑似过敏性呼吸道症状)中的三种或更多种。纯母乳喂养可防止儿童在生命的前两年患多种过敏性疾病(校正OR = 0.7,95% CI 0.5至0.9)。

结论

纯母乳喂养似乎对过敏性疾病(即哮喘、特应性皮炎和疑似过敏性鼻炎)在2岁之前的早期发展具有预防作用。这种保护作用在多种过敏性疾病中也很明显。

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