Thompson John M D, Tanabe Kawai, Moon Rachel Y, Mitchell Edwin A, McGarvey Cliona, Tappin David, Blair Peter S, Hauck Fern R
Department of Paediatrics: Child and Youth Health and Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand;
Departments of Family Medicine and.
Pediatrics. 2017 Nov;140(5). doi: 10.1542/peds.2017-1324.
Sudden infant death syndrome (SIDS) is a leading cause of postneonatal infant mortality. Our previous meta-analyses showed that any breastfeeding is protective against SIDS with exclusive breastfeeding conferring a stronger effect.The duration of breastfeeding required to confer a protective effect is unknown.
To assess the associations between breastfeeding duration and SIDS.
Individual-level data from 8 case-control studies.
Case-control SIDS studies with breastfeeding data.
Breastfeeding variables, demographic factors, and other potential confounders were identified. Individual-study and pooled analyses were performed.
A total of 2267 SIDS cases and 6837 control infants were included. In multivariable pooled analysis, breastfeeding for <2 months was not protective (adjusted odds ratio [aOR]: 0.91, 95% confidence interval [CI]: 0.68-1.22). Any breastfeeding ≥2 months was protective, with greater protection seen with increased duration (2-4 months: aOR: 0.60, 95% CI: 0.44-0.82; 4-6 months: aOR: 0.40, 95% CI: 0.26-0.63; and >6 months: aOR: 0.36, 95% CI: 0.22-0.61). Although exclusive breastfeeding for <2 months was not protective (aOR: 0.82, 95% CI: 0.59-1.14), longer periods were protective (2-4 months: aOR: 0.61, 95% CI: 0.42-0.87; 4-6 months: aOR: 0.46, 95% CI: 0.29-0.74).
The variables collected in each study varied slightly, limiting our ability to include all studies in the analysis and control for all confounders.
Breastfeeding duration of at least 2 months was associated with half the risk of SIDS. Breastfeeding does not need to be exclusive to confer this protection.
婴儿猝死综合征（SIDS）是新生儿期后婴儿死亡的主要原因。我们之前的荟萃分析表明，任何形式的母乳喂养都对SIDS有预防作用，纯母乳喂养的预防效果更强。产生预防作用所需的母乳喂养时长尚不清楚。
评估母乳喂养时长与SIDS之间的关联。
8项病例对照研究的个体水平数据。
有母乳喂养数据的病例对照SIDS研究。
确定母乳喂养变量、人口统计学因素和其他潜在混杂因素。进行个体研究分析和汇总分析。
共纳入2267例SIDS病例和6837例对照婴儿。在多变量汇总分析中，母乳喂养不足2个月无预防作用（调整优势比[aOR]：0.91，95%置信区间[CI]：0.68 - 1.22）。母乳喂养≥2个月有预防作用，且随着时长增加预防作用增强（2 - 4个月：aOR：0.60，95% CI：0.44 - 0.82；4 - 6个月：aOR：0.40，95% CI：0.26 - 0.63；>6个月：aOR：0.36，95% CI：0.22 - 0.61）。虽然纯母乳喂养不足2个月无预防作用（aOR：0.82，95% CI：0.59 - 1.14），但更长时间有预防作用（2 - 4个月：aOR：0.61，95% CI：0.42 - 0.87；4 - 6个月：aOR：0.46，95% CI：0.29 - 0.74）。
每项研究收集的变量略有不同，限制了我们将所有研究纳入分析并控制所有混杂因素的能力。
母乳喂养至少2个月可使SIDS风险降低一半。母乳喂养无需是纯母乳喂养即可产生这种保护作用。
