Filipiak Birgit, Zutavern Anne, Koletzko Sibylle, von Berg Andrea, Brockow Inken, Grübl Armin, Berdel Dietrich, Reinhardt Dietrich, Bauer Carl Peter, Wichmann H-Erich, Heinrich Joachim
GSF-National Research Center for Environment and Health, Institute of Epidemiology, Neuherberg, Germany.
J Pediatr. 2007 Oct;151(4):352-8. doi: 10.1016/j.jpeds.2007.05.018. Epub 2007 Aug 23.
To assess the association between the introduction of solid foods in the first 12 months and the occurrence of eczema during the first 4 years of life in a prospective study of newborns.
Data were taken from annually administered questionnaires from a large birth cohort (recruited 1995-1998) comprised of an intervention and a nonintervention group. Outcomes were doctor-diagnosed and symptomatic eczema. Multiple generalized estimation equation models were performed for the 2 study groups.
From the 5991 recruited infants, 4753 (79%) were followed up. The 2 study groups were different in their family risk of allergies and feeding practices. No association was found between the time of introduction of solids or the diversity of solids and eczema. In the nonintervention group, a decreased risk was observed for avoidance of soybean/nuts, but an increased risk was seen in doctor-diagnosed eczema for the avoidance of egg in the first year.
The evidence from this study supports neither a delayed introduction of solids beyond the fourth month nor a delayed introduction of the most potentially allergenic solids beyond the sixth month of life for the prevention of eczema. However, effects under more extreme conditions cannot be ruled out.
在一项针对新生儿的前瞻性研究中,评估出生后12个月内引入固体食物与4岁前湿疹发生之间的关联。
数据取自一个大型出生队列(1995 - 1998年招募)每年发放的问卷,该队列由一个干预组和一个非干预组组成。结局指标为医生诊断的有症状的湿疹。对两个研究组进行了多个广义估计方程模型分析。
在招募的5991名婴儿中,4753名(79%)接受了随访。两个研究组在家庭过敏风险和喂养方式上存在差异。未发现引入固体食物的时间或固体食物的种类与湿疹之间存在关联。在非干预组中,观察到避免食用大豆/坚果会降低风险,但在出生后第一年避免食用鸡蛋会增加医生诊断的湿疹风险。
本研究的证据既不支持为预防湿疹而在出生后第四个月后延迟引入固体食物,也不支持在出生后第六个月后延迟引入最具潜在致敏性的固体食物。然而,不能排除在更极端条件下的影响。