Inserm, Center for Research in Epidemiology and Population Health, U1018, Epidemiology of Diabetes, Obesity and Renal Diseases, Lifelong Approach Team, F-94807 Villejuif, France.
J Pediatr. 2013 Jul;163(1):36-42.e1. doi: 10.1016/j.jpeds.2012.11.090. Epub 2013 Jan 11.
To investigate the dose-response relationship between breastfeeding duration and cognitive development in French preschool children.
In the French EDEN Mother-Child Cohort Study, we evaluated language ability with the Communicative Development Inventory (CDI) in 1387 2-year-old children and overall development with the Ages and Stages Questionnaire (ASQ) in 1199 3-year-old children. Assessments were compared between breastfed and non-breastfed children and also according to breastfeeding duration in multivariable linear models, controlling for a wide range of potential confounders. We tested departure from linearity.
After adjustments, ever-breastfed children scored 3.7 ± 1.8 (P = .038) points higher than never-breastfed children on the CDI and 6.2 ± 1.9 (P = .001) points higher on the ASQ. Among breastfed children, exclusive and any-breastfeeding durations were positively associated with both CDI and ASQ scores. The fine motor domain of ASQ was associated with any-breastfeeding duration, and the problem solving domain with exclusive-breastfeeding duration. We did not observe significant departures from linearity. No interactions were found between the child's sex, parental education or socioeconomic status, and breastfeeding duration.
Longer breastfeeding duration was associated with better cognitive and motor development in 2- and 3-year-old children and a dose-response relationship was suggested.
研究母乳喂养持续时间与法国学龄前儿童认知发展之间的剂量反应关系。
在法国 EDEN 母婴队列研究中，我们使用沟通发展量表（CDI）评估了 1387 名 2 岁儿童的语言能力，使用年龄与阶段问卷（ASQ）评估了 1199 名 3 岁儿童的整体发育情况。在多变量线性模型中，我们比较了母乳喂养和非母乳喂养儿童之间的评估结果，同时也根据母乳喂养持续时间进行了比较，控制了广泛的潜在混杂因素。我们测试了线性偏离情况。
调整后，曾母乳喂养的儿童在 CDI 上的得分比从未母乳喂养的儿童高 3.7 ± 1.8 分（P =.038），在 ASQ 上的得分高 6.2 ± 1.9 分（P =.001）。在母乳喂养的儿童中，纯母乳喂养和任何形式的母乳喂养持续时间与 CDI 和 ASQ 评分均呈正相关。ASQ 的精细运动领域与任何形式的母乳喂养持续时间相关，而解决问题的领域与纯母乳喂养持续时间相关。我们没有观察到明显的线性偏离。未发现儿童性别、父母教育程度或社会经济地位与母乳喂养持续时间之间存在交互作用。
母乳喂养持续时间与 2 岁和 3 岁儿童的认知和运动发育较好相关，并且存在剂量反应关系。
