Respiratory Department, Priority Research Centre Grow Up Well, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.
Respiratory Department, Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia.
Pediatr Pulmonol. 2020 Jul;55(7):1690-1696. doi: 10.1002/ppul.24756. Epub 2020 Apr 6.
Maternal asthma increases the risk of infant wheeze. Breastfeeding may offer protection but there is limited evidence in this high-risk group. We examined associations between breastfeeding and respiratory outcomes, in infants born to women with asthma. This study was a secondary analysis of two prospective cohorts of pregnant women with asthma, and their infants, conducted between 2007 and 2018. At 6 ± 1 (T1) and 12 ± 1 (T2) months post-partum, mothers reported breastfeeding patterns and infant wheeze (primary outcome), bronchiolitis, and related medication use and healthcare utilization, via a validated questionnaire; a subgroup completed face-to-face interviews. χ tests and logistic regression models, adjusting for confounders, were utilized. Data were complete for 605 participants at T1 and 486 (80%) at T2. Of 605 participants: 89% initiated breastfeeding and 38% breastfed for more than 6 months. Breastfeeding for more than 6 months vs "never" was associated with a reduced adjusted relative risk of infant wheeze at T1 (0.54, 95% confidence interval, 0.30-0.96). Bronchiolitis risk was reduced at T1 and T2 with more tha 6 months of breastfeeding vs "never." Breastfeeding duration of 1 to 3 months, 4 to 6 months, and more than 6 months were associated with a reduced risk of infant healthcare utilization (all P < .05, vs "never"), but not medication use (P > .05). Breastfeeding for more than 6 months was associated with a reduced risk of wheeze, bronchiolitis, and wheeze-related healthcare utilization in infants at risk due to maternal asthma. Notably, breastfeeding for shorter durations was associated with a reduced risk of healthcare utilization compared with none. Larger cohorts are needed to further examine the impact of breastfeeding exposure on respiratory health in infants exposed to maternal asthma.
母亲哮喘会增加婴儿喘息的风险。母乳喂养可能提供保护，但在这个高风险群体中，证据有限。我们研究了哮喘孕妇所生婴儿的母乳喂养与呼吸结局之间的关系。这项研究是对 2007 年至 2018 年期间进行的两项前瞻性哮喘孕妇及其婴儿队列研究的二次分析。产后 6 ± 1 个月（T1）和 12 ± 1 个月（T2）时，母亲通过经过验证的问卷报告母乳喂养模式和婴儿喘息（主要结局）、细支气管炎以及相关药物使用和医疗保健利用情况；一个亚组完成了面对面访谈。利用 χ 检验和调整混杂因素的逻辑回归模型进行分析。T1 时数据完整的有 605 名参与者，T2 时数据完整的有 486 名（80%）。在 605 名参与者中：89%的人开始母乳喂养，38%的人母乳喂养时间超过 6 个月。与“从未”相比，母乳喂养时间超过 6 个月与 T1 时婴儿喘息的调整后相对风险降低相关（0.54，95%置信区间，0.30-0.96）。T1 和 T2 时，与“从未”相比，母乳喂养时间超过 6 个月与细支气管炎风险降低相关。母乳喂养 1-3 个月、4-6 个月和超过 6 个月与婴儿医疗保健利用率降低相关（均 P < 0.05，与“从未”相比），但与药物使用无关（P > 0.05）。对于因母亲哮喘而处于风险中的婴儿，母乳喂养时间超过 6 个月与喘息、细支气管炎和与喘息相关的医疗保健利用率降低风险降低相关。值得注意的是，与不进行母乳喂养相比，较短时间的母乳喂养与医疗保健利用率降低风险相关。需要更大的队列来进一步研究暴露于母亲哮喘的婴儿中母乳喂养暴露对呼吸健康的影响。
