母乳喂养与 5 岁儿童智商得分的关系。

Association of Breastfeeding and Child IQ Score at Age 5 Years.

机构信息

Departments of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, University of Texas, Southwestern, Dallas, Texas, University of Utah Health Sciences Center, Salt Lake City, Utah, Wayne State University, Detroit, Michigan, Columbia University, New York, New York, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, University of Texas Medical Branch at Galveston, Galveston, Texas, University of Alabama at Birmingham, Birmingham, Alabama, Brown University, Providence, Rhode Island, University of Texas, Houston, Houston, Texas, Case Western Reserve University, Cleveland, Ohio, Oregon Health & Science University, Portland, OR, and University of Pittsburgh, Pittsburgh, Pennsylvania; and the George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.

出版信息

Obstet Gynecol. 2021 Apr 1;137(4):561-570. doi: 10.1097/AOG.0000000000004314.

DOI:10.1097/AOG.0000000000004314

PMID:33706345

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8104129/

Abstract

OBJECTIVE

To evaluate whether breastfeeding and its duration are associated with a reduced risk of low IQ scores or other neurodevelopmental problems.

METHODS

We conducted a secondary analysis of two parallel multicenter, double-blinded randomized controlled trials in which participants with a singleton pregnancy and either subclinical hypothyroidism or hypothyroxinemia were treated with thyroxine or placebo. Our primary outcome was a low IQ score (less than 85 on the WPPSI-III [Wechsler Preschool and Primary Scale of Intelligence III] at age 5 years). Secondary outcomes included performance measures on other validated neurodevelopmental tests. Univariable and multivariable analyses were performed to evaluate the association between breastfeeding and neurodevelopmental outcomes. Stepwise backward proceeding linear and logistic regression models were used to develop the final adjusted models.

RESULTS

Of the 772 participants studied, 614 (80%) reported breastfeeding. Of these, 31% reported breastfeeding for less than 4 months, 19% for 4-6 months, 11% for 7-9 months, 15% for 10-12 months and 23% for more than 12 months. IQ scores were available for 756 children; mean age-5 scores were higher with any breastfeeding (96.7±15.1) than without (91.2±15.0, mean difference 5.5, 95% CI 2.8-8.2), and low IQ scores were less frequent with any breastfeeding (21.5%) than with no breastfeeding (36.2%, odds ratio 0.48, 95% CI 0.33-0.71). In adjusted analyses, breastfeeding remained associated with reduced odds of low IQ score (adjusted odds ratio [aOR] 0.62, 95% CI 0.41-0.93), and each additional month of breastfeeding was associated with lower odds of a low IQ scores (aOR 0.97, 95% CI 0.939-0.996). No significant associations between breastfeeding and other neurodevelopmental outcomes were identified in adjusted analyses.

CONCLUSION

Breastfeeding and its duration are associated with lower odds of low IQ score at age 5 years.

摘要

目的

评估母乳喂养及其持续时间是否与较低的智商得分或其他神经发育问题的风险降低有关。

方法

我们对两项平行的多中心、双盲随机对照试验进行了二次分析，这些试验纳入了患有亚临床甲状腺功能减退或甲状腺素血症的单胎妊娠参与者，并对其进行甲状腺素或安慰剂治疗。我们的主要结局是智商得分较低（5 岁时 WPPSI-III[韦氏学前和小学智力量表第三版]得分低于 85）。次要结局包括其他经过验证的神经发育测试的表现测量。我们进行了单变量和多变量分析，以评估母乳喂养与神经发育结局之间的关联。采用逐步后退线性和逻辑回归模型来建立最终的调整模型。

结果

在研究的 772 名参与者中，有 614 名（80%）报告了母乳喂养。其中，31%报告母乳喂养时间少于 4 个月，19%报告母乳喂养 4-6 个月，11%报告母乳喂养 7-9 个月，15%报告母乳喂养 10-12 个月，23%报告母乳喂养时间超过 12 个月。756 名儿童的智商评分可用；任何母乳喂养（96.7±15.1）的平均 5 岁得分均高于无母乳喂养（91.2±15.0，平均差异 5.5，95%CI 2.8-8.2），任何母乳喂养的低智商评分发生率均低于无母乳喂养（21.5%），而无母乳喂养（36.2%）（比值比 0.48，95%CI 0.33-0.71）。在调整分析中，母乳喂养与较低的低智商评分的可能性相关（调整比值比[aOR]0.62，95%CI 0.41-0.93），并且母乳喂养时间每增加一个月，低智商评分的可能性也随之降低（aOR 0.97，95%CI 0.939-0.996）。在调整分析中，母乳喂养与其他神经发育结局之间没有显著关联。