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母乳喂养、其他早期生活暴露因素与儿童白血病和淋巴瘤

Breastfeeding, Other Early Life Exposures and Childhood Leukemia and Lymphoma.

作者信息

Amitay Efrat Lev, Dubnov Raz Gal, Keinan-Boker Lital

机构信息

a School of Public Health , University of Haifa , Haifa , Israel.

b Exercise, Lifestyle and Nutrition Clinic , The Edmond and Lily Safra Children's Hospital, Sheba Medical Center , Ramat Gan , Israel.

出版信息

Nutr Cancer. 2016 Aug-Sep;68(6):968-77. doi: 10.1080/01635581.2016.1190020. Epub 2016 Jun 28.

Abstract

Childhood cancer incidence increases and although rare, it is a leading cause of mortality. Leukemia and lymphoma comprise 40% of all cancers in children but little is known of their etiology. In this study, we examined the associations of breastfeeding and other early life exposures with childhood leukemia and lymphoma. A population-based case-control study carried out in 2011-2013 comprised mothers of 190 incidents (2005-2013) of leukemia/lymphoma cases aged 1-19 yr at diagnosis and 384 population-based controls. Interviews based on a computerized structured questionnaire were conducted with the mothers. Multivariate logistic regression models adjusted for potential confounders assessed the association between breastfeeding patterns and childhood leukemia/lymphoma. Ever breastfeeding category was associated with a 64% decreased risk for childhood leukemia/lymphoma lsqb;odds ratio (OR) = 0.36, 95% confidence interval (CI): 0.22, 0.60lrqb; and similar trends, with a dose-response effect, were observed for any breastfeeding (exclusive and/or partial) category for 6, 12, and 18+ mo. Other infant exposures associated with cancer risk were child iron supplementation (OR = 0.39, 95% CI: 0.26, 0.59), pet ownership (OR = 0.50, 95% CI: 0.33, 0.78), paternal smoking (OR = 1.93, 95% CI: 1.18, 3.15), and having older siblings (OR = 1.18, 95% CI: 1.05, 1.33). Breastfeeding-a controllable and modifiable exposure-is inversely associated with risk for childhood leukemia and lymphoma with a dose-response effect.

摘要

儿童癌症发病率呈上升趋势,尽管罕见,但却是主要的死亡原因之一。白血病和淋巴瘤占儿童所有癌症的40%,但其病因鲜为人知。在本研究中,我们调查了母乳喂养及其他早期生活暴露因素与儿童白血病和淋巴瘤之间的关联。2011年至2013年开展的一项基于人群的病例对照研究纳入了190例白血病/淋巴瘤病例(诊断时年龄为1至19岁,发病时间为2005年至2013年)的母亲以及384名基于人群的对照。对母亲们进行了基于计算机结构化问卷的访谈。针对潜在混杂因素进行调整的多因素逻辑回归模型评估了母乳喂养模式与儿童白血病/淋巴瘤之间的关联。曾经母乳喂养组与儿童白血病/淋巴瘤风险降低64%相关[比值比(OR)=0.36,95%置信区间(CI):0.22,0.60];对于6个月、12个月和18个月及以上的任何母乳喂养(纯母乳喂养和/或部分母乳喂养)组,也观察到了类似趋势,且存在剂量反应效应。其他与癌症风险相关的婴儿暴露因素包括儿童铁补充剂(OR = 0.39,95% CI:0.26,0.59)、养宠物(OR = 0.50,95% CI:0.33,0.78)、父亲吸烟(OR = 1.93,95% CI:1.18,3.15)以及有哥哥姐姐(OR = 1.18,95% CI:1.05,1.33)。母乳喂养——一种可控且可改变的暴露因素——与儿童白血病和淋巴瘤风险呈负相关,且存在剂量反应效应。

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