Miyake Y, Tanaka K, Sasaki S, Kiyohara C, Ohya Y, Fukushima W, Yokoyama T, Hirota Y
Department of Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Pediatr Allergy Immunol. 2008 Sep;19(6):490-6. doi: 10.1111/j.1399-3038.2007.00701.x. Epub 2008 Feb 11.
Epidemiological evidence for an effect of breastfeeding on asthma continues to be inconclusive. The present prospective study examined the relationship between breastfeeding and the risk of wheeze and asthma in Japanese infants. A birth cohort of 763 infants was followed. The first survey during pregnancy and the second survey between 2 and 9 months postpartum collected information on potential confounding factors. Data on breastfeeding, wheeze, and asthma were obtained from questionnaires in the third survey from 16 to 24 months postpartum. Adjustment was made for maternal age, maternal and paternal history of asthma, atopic eczema, and allergic rhinitis, indoor domestic pets (cats, dogs, birds, or hamsters), family income, maternal and paternal education, maternal smoking during pregnancy, baby's sex, baby's older siblings, household smoking in the same room as the infant, and time of delivery before the third survey. By the third survey, the cumulative incidence of wheeze and asthma was 22.1% and 4.3%, respectively. Neither exclusive breastfeeding for 4 months or more nor partial breastfeeding for 6 months or more were materially related to the risk of wheeze. No measurable association was observed between exclusive breastfeeding for 4 months or more and the risk of asthma. Partial breastfeeding for 6 months or more was inversely related to the risk of asthma although the adjusted odds ratio (OR) was not statistically significant. When infants were stratified according to whether there was a negative or positive allergic history in at least 1 parent, a nearly 40% and 60% decrease, respectively, in the ORs were found for exclusive and partial breastfeeding only in infants without a parental allergic history, although the ORs were not statistically significant. The present prospective study showed no statistically significant relationship between breastfeeding duration and the risk of wheeze or asthma in Japanese infants.
母乳喂养对哮喘影响的流行病学证据仍然没有定论。本前瞻性研究调查了日本婴儿母乳喂养与喘息和哮喘风险之间的关系。对763名婴儿的出生队列进行了跟踪。孕期的首次调查以及产后2至9个月的第二次调查收集了潜在混杂因素的信息。母乳喂养、喘息和哮喘的数据来自产后16至24个月第三次调查的问卷。对产妇年龄、父母哮喘病史、特应性皮炎、过敏性鼻炎、室内家养宠物（猫、狗、鸟或仓鼠）、家庭收入、父母教育程度、孕期产妇吸烟、婴儿性别、婴儿的哥哥姐姐、与婴儿同室的家庭吸烟情况以及第三次调查前的分娩时间进行了调整。到第三次调查时，喘息和哮喘的累积发病率分别为22.1%和4.3%。母乳喂养4个月及以上或部分母乳喂养6个月及以上均与喘息风险无实质性关联。未观察到母乳喂养4个月及以上与哮喘风险之间存在可测量的关联。母乳喂养6个月及以上与哮喘风险呈负相关，尽管调整后的优势比（OR）无统计学意义。当根据至少1名父母有无过敏史对婴儿进行分层时，仅在无父母过敏史的婴儿中，纯母乳喂养和部分母乳喂养的OR值分别降低了近40%和60%，尽管这些OR值无统计学意义。本前瞻性研究表明，母乳喂养持续时间与日本婴儿喘息或哮喘风险之间无统计学意义上的关联。
