Kalies H, Heinrich Joachim, Borte N, Schaaf B, von Berg A, von Kries R, Wichmann H-E, Bolte G
GSF National Research Center for Environment and Health, Institute of Epidemiology, Ingolstaedter Landstr. 1, D-85764 Neuherberg, Germany.
Eur J Med Res. 2005 Jan 28;10(1):36-42.
The objective of this study was to examine whether duration of exclusive breastfeeding is associated with elevated weight gain in infants during the first two years of life. In this prospective cohort study 2624 healthy term neonates were followed from birth to age 2 years in 4 German study centres. Data on breastfeeding and potential confounders were gathered by questionnaires. Data on anthropometric measures at birth and age 2 years were obtained from routine standardised medical check up documentation. Odds ratios for the association between breastfeeding and weight gain until age 2 years (> or = 90th sex-specific percentile of the cohort) were calculated by logistic regression, adjusting for age at introduction and composition of solid food, maternal BMI, maternal smoking during pregnancy, socioeconomic status, study centre, birth order and, in unstratified analysis, sex. Children exclusively breastfed for less than 6 months had a greater risk of elevated weight gain at the age of 2 years than children breastfed for 6 months and more (OR (95% CI): 1.65 (1.17, 2.30)). Duration of exclusive breastfeeding was inversely associated with the risk of elevated weight gain in a strongly duration-dependent way. Those infants who were exclusively breastfed 1 month at the most had twice as often elevated weight gain (OR (95% CI): 1.99 (1.34, 2.97)) compared to infants breastfed at least 6 months. Our data show that exclusive breastfeeding protects against elevated weight gain during infancy which may be the first step on the pathway of obesity development.
本研究的目的是检验纯母乳喂养的持续时间是否与婴儿出生后头两年体重增加过多有关。在这项前瞻性队列研究中,德国4个研究中心对2624名足月健康新生儿从出生一直追踪到2岁。通过问卷调查收集母乳喂养及潜在混杂因素的数据。出生时和2岁时人体测量指标的数据来自常规标准化医学检查记录。通过逻辑回归计算母乳喂养与2岁前体重增加过多(≥队列中按性别划分的第90百分位数)之间关联的比值比,并对开始添加固体食物的年龄、固体食物的成分、母亲体重指数、孕期母亲吸烟情况、社会经济地位、研究中心、出生顺序以及在未分层分析中的性别进行校正。纯母乳喂养少于6个月的儿童在2岁时体重增加过多的风险高于纯母乳喂养6个月及以上的儿童(比值比(95%置信区间):1.65(1.17,2.30))。纯母乳喂养的持续时间与体重增加过多的风险呈负相关,且具有很强的持续时间依赖性。与至少纯母乳喂养6个月的婴儿相比,纯母乳喂养最多1个月的婴儿体重增加过多的情况多出一倍(比值比(95%置信区间):1.99(1.34,2.97))。我们的数据表明,纯母乳喂养可预防婴儿期体重增加过多,这可能是肥胖发展过程的第一步。