Sadeharju Karita, Knip Mikael, Virtanen Suvi M, Savilahti Erkki, Tauriainen Sisko, Koskela Pentti, Akerblom Hans K, Hyöty Heikki
Department of Virology, University of Tampere and Tampere University Hospital, Tampere, Finland.
Pediatrics. 2007 May;119(5):941-6. doi: 10.1542/peds.2006-0780.
Enterovirus infections are frequent in infants and may cause severe complications. We set out to assess whether breastfeeding can protect against these infections and whether such an effect is related to maternal antibodies in breast milk or in the peripheral circulation of the infant.
One hundred fifty infants who were prospectively followed up from birth were monitored for enterovirus infections. The duration of breastfeeding was recorded, and maternal breast milk and blood samples were regularly taken at 3-month intervals for the detection of enterovirus antibodies and RNA. Maternal serum was available from early pregnancy, delivery, and 3 months postpartum.
Enterovirus infections were frequent and were diagnosed in 43% of infants before the age of 1 year and in 15% of the mothers during pregnancy. Infants exclusively breastfed for >2 weeks had fewer enterovirus infections by the age of 1 year compared with those exclusively breastfed for < or =2 weeks (0.38 vs 0.59 infections per child). High maternal antibody levels in serum and in breast milk were associated with a reduced frequency of infections. This effect was seen only in those infants breastfed >2 weeks, indicating that breast milk antibodies mediate this effect. Enterovirus RNA was not found in any of the breast milk samples.
These results suggest that breastfeeding has a protective effect against enterovirus infections in infancy. This effect seems to be mediated primarily by maternal antibodies in breast milk.
肠道病毒感染在婴儿中很常见，且可能导致严重并发症。我们旨在评估母乳喂养是否能预防这些感染，以及这种作用是否与母乳或婴儿外周血循环中的母体抗体有关。
对150名从出生开始进行前瞻性随访的婴儿进行肠道病毒感染监测。记录母乳喂养的持续时间，并每隔3个月定期采集母体母乳和血液样本，以检测肠道病毒抗体和RNA。可获得孕早期、分娩时及产后3个月的母体血清。
肠道病毒感染很常见，1岁前43%的婴儿及孕期15%的母亲被诊断感染。与纯母乳喂养≤2周的婴儿相比，纯母乳喂养>2周的婴儿在1岁时肠道病毒感染较少（每名儿童感染率分别为0.38和0.59）。母体血清和母乳中的高抗体水平与感染频率降低有关。这种作用仅在母乳喂养>2周的婴儿中可见，表明母乳抗体介导了这种作用。所有母乳样本中均未检测到肠道病毒RNA。
这些结果表明，母乳喂养对婴儿肠道病毒感染有保护作用。这种作用似乎主要由母乳中的母体抗体介导。
