Institute of Environmental Medicine, Karolinska Institutet, SE-171 76 Stockholm, Sweden.
J Allergy Clin Immunol. 2010 May;125(5):1013-9. doi: 10.1016/j.jaci.2010.01.051. Epub 2010 Apr 14.
The evidence from previous studies on beneficial effects of breast-feeding in relation to development of asthma is conflicting.
To investigate the relation between breast-feeding and asthma and/or sensitization during the first 8 years of life.
In a birth cohort, children were followed up to 8 years by questionnaires at ages 2 months and 1, 2, 4, and 8 years to collect information on exposures and health effects. Determination of serum IgE antibodies to common inhalant and food allergens was performed at 4 and 8 years. Longitudinal analyses were applied by using general estimated equations. The study population consisted of 3825 children (93% of the original cohort), of whom 2370 gave blood and 2564 performed lung function measurements at 8 years.
Children exclusively breast-fed 4 months or more had a reduced risk of asthma during the first 8 years of life (adjusted odds ratio [OR], 0.63; 95% CI, 0.50-0.78) compared with children breast-fed less than 4 months. At 8 years, reduced risks of sensitization (adjusted OR, 0.79; 95% CI, 0.64-0.99) and asthma in combination with sensitization (adjusted OR, 0.59; 95% CI, 0.37-0.93) were seen among children exclusively breast-fed 4 months or more. This group also had a significantly better lung function measured with peak expiratory flow.
Breast-feeding for 4 months or more seems to reduce the risk of asthma up to 8 years. At this age, a reduced risk was observed particularly for asthma combined with sensitization. Furthermore, breast-feeding seems to have a beneficial effect on lung function.
之前关于母乳喂养对哮喘发展有益影响的研究证据存在矛盾。
研究母乳喂养与儿童在 8 岁前哮喘和/或致敏的关系。
在一项出生队列研究中,通过问卷调查在 2 个月、1、2、4 和 8 岁时对儿童进行随访,以收集暴露和健康影响相关信息。在 4 岁和 8 岁时检测血清 IgE 抗体,以确定常见吸入性和食物过敏原。采用广义估计方程进行纵向分析。研究人群包括 3825 名儿童(原始队列的 93%),其中 2370 名儿童在 8 岁时采集了血液样本,2564 名儿童进行了肺功能检测。
与母乳喂养时间少于 4 个月的儿童相比,4 个月或以上时间完全母乳喂养的儿童在 8 岁前患哮喘的风险较低(调整后的比值比 [OR],0.63;95%CI,0.50-0.78)。8 岁时,对于完全母乳喂养 4 个月或以上的儿童,其致敏(调整后的 OR,0.79;95%CI,0.64-0.99)和哮喘合并致敏(调整后的 OR,0.59;95%CI,0.37-0.93)的风险也显著降低。这组儿童的最大呼气峰流速的肺功能也明显更好。
母乳喂养 4 个月或以上似乎可以降低儿童 8 岁前哮喘的风险。在这个年龄,观察到母乳喂养对哮喘合并致敏的风险降低尤其明显。此外,母乳喂养似乎对肺功能有有益的影响。