Huus Karina, Ludvigsson Jonas F, Enskär Karin, Ludvigsson Johnny
Division of Pediatrics, Diabetes Research Centre, Linköping University, Sweden.
BMC Pediatr. 2008 Oct 9;8:42. doi: 10.1186/1471-2431-8-42.
Overweight and obesity are increasing among children all over the world. Socio-economic factors may influence the development of overweight and obesity in childhood, and it has been proposed that breastfeeding may protect against obesity. The aim of our study was to examine the relationship between exclusive breastfeeding and obesity when potential confounders, such as socioeconomic factors, are considered.
The data analyzed was from ABIS (All Babies in Southeast Sweden), a prospective cohort study. All parents with children born between October 1, 1997 and October 1, 1999 in Southeast Sweden (n = 21,700) were asked to participate. Parents were asked to answer periodic questionnaires from the time of the child's birth (n = 16,058) until he/she was five years of age (n = 7,356). Cutoffs for overweight and obesity were defined according to Cole et al, age and gender adjusted. Short-term exclusive breastfeeding was defined as < 4 months of exclusive breastfeeding. Multiple logistic regressions were used to identify variables that predict the child's BMI (Body Mass Index) at five years of age.
At five years of age, 12.9% of the children in the study were overweight and 4.3% were obese. At the age of three months, 78.4% of the children were being breastfed exclusively. The median exclusive breastfeeding duration was four months. High maternal BMI > 30 (AOR = 1.07; CI = 1.05-1.09; P < 0.001), maternal smoking (AOR = 1.43; CI = 1.05-1.95; P = 0.023) and being a single parent (AOR = 2.10; CI = 1.43-3.09; P < 0.001) were associated with short-term exclusive breastfeeding (less than 4 months). Short-term exclusive breastfeeding was less common if one of the parents had a university degree (Mother: AOR = 0.74; CI = 0.61-0.90; P = 0.003 Father: AOR = 0.73; CI = 0.58-0.92; P = 0.008) or if the father was more than 37 years old (AOR = 0.74; CI = 0.55-0.99; P = 0.045). Short-term exclusive breastfeeding was associated with obesity in five-year-old children (simple logistic regression: OR = 1.44; CI = 1.00-2.07; P = 0.050), but when including other independent factors in the analysis, short-term exclusive breastfeeding did not attain statistical significance.
We cannot exclude the possibility that exclusive breastfeeding influences weight development, but it does not seem to protect against obesity at five years of age.
全球儿童超重和肥胖现象日益增多。社会经济因素可能影响儿童期超重和肥胖的发展，并且有人提出母乳喂养可能预防肥胖。我们研究的目的是在考虑社会经济因素等潜在混杂因素的情况下，研究纯母乳喂养与肥胖之间的关系。
分析的数据来自ABIS（瑞典东南部所有婴儿），这是一项前瞻性队列研究。邀请了1997年10月1日至1999年10月1日在瑞典东南部出生子女的所有父母参与（n = 21,700）。要求父母回答从孩子出生时（n = 16,058）到其五岁时（n = 7,356）的定期问卷。超重和肥胖的临界值根据科尔等人的标准定义，并根据年龄和性别进行了调整。短期纯母乳喂养定义为纯母乳喂养时间<4个月。使用多元逻辑回归来确定预测儿童五岁时BMI（身体质量指数）的变量。
在五岁时，研究中的儿童有12.9%超重，4.3%肥胖。在三个月大时，78.4%的儿童正在进行纯母乳喂养。纯母乳喂养的中位持续时间为四个月。母亲BMI>30（优势比[AOR]=1.07；可信区间[CI]=1.05 - 1.09；P<0.001）、母亲吸烟（AOR = 1.43；CI = 1.05 - 1.95；P = 0.023）以及单亲家庭（AOR = 2.10；CI = 1.43 - 3.09；P<0.001）与短期纯母乳喂养（少于4个月）相关。如果父母一方拥有大学学位（母亲：AOR = 0.74；CI = 0.61 - 0.90；P = 0.003；父亲：AOR = 0.73；CI = 0.58 - 0.92；P = 0.008）或者父亲年龄超过37岁（AOR = 0.74；CI = 0.55 - 0.99；P = 0.045），短期纯母乳喂养则不太常见。短期纯母乳喂养与五岁儿童肥胖相关（简单逻辑回归：比值比[OR]=1.44；CI = 1.00 - 2.07；P = 0.050），但在分析中纳入其他独立因素后，短期纯母乳喂养未达到统计学显著性。
我们不能排除纯母乳喂养影响体重发展的可能性，但它似乎并不能预防五岁时的肥胖。
