Kato Tsuguhiko, Yorifuji Takashi, Yamakawa Michiyo, Inoue Sachiko, Saito Keiko, Doi Hiroyuki, Kawachi Ichiro
Department of Public Health and Health Policy, Institute of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, Okayama, Japan.
BMJ Open. 2015 Mar 20;5(3):e006982. doi: 10.1136/bmjopen-2014-006982.
We investigated the association between breastfeeding duration during the first half year of life and the risk of early childhood caries from the age of 30 to 66 months in Japan.
Observational study of a longitudinal survey.
A secondary data analysis of the Japanese Longitudinal Survey of Babies in the 21st Century.
43,383 infants at the age of 6 months.
Early childhood caries--defined as a child's visit to a dentist for treatment of dental caries during the past 12 months--was ascertained from the caregiver from the age of 30 months in the survey. We estimated the risk of dental caries each year according to duration of breast feeding using logistic regression analyses. We controlled for a set of biological factors (birth weight, sex, parity and maternal age at delivery) and socioeconomic factors (maternal educational attainment and smoking status, marital status at delivery, family income and region of birth and residence).
We found that infants who had been breast fed for at least 6 or 7 months, both exclusively and partially, were at elevated risk of dental caries at the age of 30 months compared with those who had been exclusively formula fed. Adjusted ORs were 1.78 (95% CI, (1.45 to 2.17)) for the exclusively breastfed group and 1.39 (1.14 to 1.70) for the partially breastfed group. However, the associations became attenuated through the follow-up period and were no longer statistically significant beyond the age of 42 months for the partially breastfed group and beyond the age of 54 months for the exclusively breastfed group.
We found an association between breast feeding for at least 6 or 7 months and elevated risk of dental caries at age 30 months. However, the association became attenuated as children grew older.
我们在日本调查了生命前半年的母乳喂养时长与30至66个月大儿童患早期龋齿风险之间的关联。
纵向调查的观察性研究。
对21世纪日本婴儿纵向调查进行二次数据分析。
43383名6个月大的婴儿。
早期龋齿定义为儿童在过去12个月内因龋齿问题前往牙医处就诊，该指标通过调查中30个月大儿童的照料者来确定。我们使用逻辑回归分析根据母乳喂养时长估算每年患龋齿的风险。我们控制了一系列生物学因素（出生体重、性别、胎次和分娩时的母亲年龄）以及社会经济因素（母亲的教育程度和吸烟状况、分娩时的婚姻状况、家庭收入以及出生和居住地区）。
我们发现，与完全采用配方奶喂养的婴儿相比，完全或部分母乳喂养至少6或7个月的婴儿在30个月大时患龋齿的风险更高。完全母乳喂养组的校正比值比为1.78（95%置信区间，1.45至2.17），部分母乳喂养组为1.39（1.14至1.70）。然而，在随访期间这种关联减弱，对于部分母乳喂养组，42个月龄后不再具有统计学意义；对于完全母乳喂养组，54个月龄后不再具有统计学意义。
我们发现母乳喂养至少6或7个月与30个月龄时患龋齿风险升高之间存在关联。然而，随着儿童年龄增长，这种关联减弱。
