Department of Community Medicine and School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Int J Epidemiol. 2010 Feb;39(1):297-305. doi: 10.1093/ije/dyp274. Epub 2009 Aug 20.
Observational studies from mainly Western settings suggest breastfeeding may protect against childhood adiposity; however, breastfeeding and adiposity share social patterning potentially generating confounding, making evidence from other settings valuable.
We used multivariable linear regression to examine the prospective adjusted associations of breastfeeding with body mass index (BMI), height and weight z-scores at 7 years of age relative to the 2007 World Health Organization (WHO) growth reference, in a large (n = 8327), population-representative Hong Kong Chinese birth cohort, recruited between April and May 1997 with high follow-up (n = 7026).
Low socio-economic position (SEP) was associated with never breastfeeding and with exclusive breastfeeding for > or =3 months. We did not find any association between breastfeeding and BMI [z-score mean difference 0.07, 95% confidence interval (CI) -0.05 to 0.19], height (0.02, 95% CI -0.07 to 0.11) or weight (0.07, 95% CI -0.05 to 0.18), adjusted for sex, birth weight, gestational age, SEP, second-hand smoke (SHS) exposure, parity, mother's age at birth, mother's place of birth and serious infant morbidity.
In a non-European setting, breastfeeding was not associated with child adiposity, suggesting that observed protective effects may be due to socially patterned confounding by SEP, maternal adiposity and maternal smoking.
主要来自西方环境的观察性研究表明，母乳喂养可能有助于预防儿童肥胖；然而，母乳喂养和肥胖存在社会模式，可能会产生混杂因素，因此其他环境的证据具有价值。
我们使用多变量线性回归，在一个大型的、具有代表性的（n=8327）香港华人出生队列中，调查了与 2007 年世界卫生组织（WHO）生长标准相比，7 岁时母乳喂养与体质指数（BMI）、身高和体重 z 分数的前瞻性调整关联，该队列于 1997 年 4 月至 5 月期间招募，随访率较高（n=7026）。
低社会经济地位（SEP）与从未母乳喂养和纯母乳喂养 >或=3 个月有关。我们没有发现母乳喂养与 BMI[z 分数平均差异 0.07，95%置信区间（CI）-0.05 至 0.19]、身高（0.02，95%CI-0.07 至 0.11）或体重（0.07，95%CI-0.05 至 0.18）之间存在关联，这些关联在调整了性别、出生体重、胎龄、SEP、二手烟（SHS）暴露、产次、母亲的出生年龄、母亲的出生地和严重婴儿发病率后仍然存在。
在非欧洲环境中，母乳喂养与儿童肥胖无关，这表明观察到的保护作用可能归因于社会模式的混杂因素，包括社会经济地位、母亲肥胖和母亲吸烟。
