Kale Aarti, Deardorff Julianna, Lahiff Maureen, Laurent Cecile, Greenspan Louise C, Hiatt Robert A, Windham Gayle, Galvez Maida P, Biro Frank M, Pinney Susan M, Teitelbaum Susan L, Wolff Mary S, Barlow Janice, Mirabedi Anousheh, Lasater Molly, Kushi Lawrence H
School of Public Health, University of California, Berkeley, Berkeley, CA, USA,
Matern Child Health J. 2015 Mar;19(3):519-27. doi: 10.1007/s10995-014-1533-9.
To examine the association of breastfeeding or its duration with timing of girls' pubertal onset, and the role of BMI as a mediator in these associations. A population of 1,237 socio-economically and ethnically diverse girls, ages 6-8 years, was recruited across three geographic locations (New York City, Cincinnati, and the San Francisco Bay Area) in a prospective study of predictors of pubertal maturation. Breastfeeding practices were assessed using self-administered questionnaire/interview with the primary caregiver. Girls were seen on at least annual basis to assess breast and pubic hair development. The association of breastfeeding with pubertal timing was estimated using parametric survival analysis while adjusting for body mass index, ethnicity, birth-weight, mother's education, mother's menarcheal age, and family income. Compared to formula fed girls, those who were mixed-fed or predominantly breastfed showed later onset of breast development [hazard ratios 0.90 (95 % CI 0.75, 1.09) and 0.74 (95 % CI 0.59, 0.94), respectively]. Duration of breastfeeding was also directly associated with age at onset of breast development (p trend = 0.008). Associations between breastfeeding and pubic hair onset were not significant. In stratified analysis, the association of breastfeeding and later breast onset was seen in Cincinnati girls only. The association between breast feeding and pubertal onset varied by study site. More research is needed about the environments within which breastfeeding takes place in order to better understand whether infant feeding practices are a potentially modifiable risk factor that may influence age at onset of breast development and subsequent risk for disease in adulthood.
探讨母乳喂养或其持续时间与女孩青春期启动时间的关联，以及体重指数（BMI）在这些关联中作为中介因素的作用。在一项关于青春期成熟预测因素的前瞻性研究中，从三个地理位置（纽约市、辛辛那提和旧金山湾区）招募了1237名社会经济和种族背景各异的6至8岁女孩。通过自我填写问卷/与主要照顾者访谈来评估母乳喂养情况。至少每年对女孩进行检查，以评估乳房和阴毛发育情况。在调整体重指数、种族、出生体重、母亲教育程度、母亲初潮年龄和家庭收入后，使用参数生存分析来估计母乳喂养与青春期时间的关联。与人工喂养的女孩相比，混合喂养或主要母乳喂养的女孩乳房发育开始时间较晚[风险比分别为0.90（95%可信区间0.75，1.09）和0.74（95%可信区间0.59，0.94）]。母乳喂养持续时间也与乳房发育开始年龄直接相关（p趋势 = 0.008）。母乳喂养与阴毛发育开始之间的关联不显著。在分层分析中，母乳喂养与较晚乳房发育开始的关联仅在辛辛那提的女孩中观察到。母乳喂养与青春期启动之间的关联因研究地点而异。需要对母乳喂养发生的环境进行更多研究，以便更好地理解婴儿喂养方式是否是一个潜在的可改变风险因素，可能会影响乳房发育开始的年龄以及成年后患疾病的后续风险。
