Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia.
Discipline of Surgery, Adelaide Medical School, University of Adelaide, The Queen Elizabeth Hospital, Adelaide, Australia; Robinson Research Institute, Adelaide Medical School, University of Adelaide, Australia.
Early Hum Dev. 2021 May;156:105342. doi: 10.1016/j.earlhumdev.2021.105342. Epub 2021 Mar 3.
Many women report low milk supply as the reason for premature breastfeeding cessation. Altered mammary gland development may impact a woman's lactation ability.
This review identifies modern exogenous exposures which alter mammary gland development during embryonic life, puberty and pregnancy.
A systematic review was undertaken whereby Medline, CINAHL and Embase articles published from January 1, 2005 to November 20, 2020 were searched using the keywords puberty or embry* or fetal or foetal or foetus or fetus or pregnan* or gestation* AND "mammary gland development" or "breast development" or "mammary development" or "mammary gland function" or "mammary function" or "insufficient glandular tissue" or "mammary hypoplasia" or "breast hypoplasia" or "mammary gland hypoplasia" or "tubular breast*" or "tuberous breast*" or "glandular tissue" or "breast composition" or "mammary composition" or "mammary gland composition". After initial screening of 1207 records, 60 full texts were assessed for eligibility; 6 were excluded due to lack of information about exposure or outcome, leaving 54 studies.
The review included results from 52 animal (rats and mice, monkeys, rabbits, sheep, goats pigs and cows) and 2 human studies. Various endocrine disrupting chemicals and an obesogenic diet were found to be associated with altered mammary gland morphology during key development stages.
To improve lactation outcomes, future studies need to focus on lactation as the endpoint and be conducted in a standardised manner to allow for a more significant contribution to the literature that allows for better comparison across studies.
许多女性报告母乳供应不足是导致母乳喂养过早停止的原因。乳腺发育的改变可能会影响女性的泌乳能力。
本综述旨在确定在胚胎期、青春期和孕期改变乳腺发育的现代外源性暴露因素。
进行了系统综述，使用关键词“青春期”或“胚胎”或“胎儿”或“胎儿”或“胎儿”或“妊娠”或“孕期”，并结合“乳腺发育”或“乳房发育”或“乳腺发育”或“乳腺功能”或“乳腺功能”或“腺体组织不足”或“乳腺发育不全”或“乳房发育不全”或“乳腺发育不全”或“管状乳房”或“结节状乳房”或“腺体组织”或“乳房成分”或“乳腺成分”或“乳腺组织成分”，对 2005 年 1 月 1 日至 2020 年 11 月 20 日期间 Medline、CINAHL 和 Embase 文章进行了检索。经过对 1207 条记录的初步筛选，评估了 60 篇全文的合格性；由于缺乏关于暴露或结局的信息，有 6 篇被排除在外，留下 54 项研究。
该综述包括 52 项动物（大鼠和小鼠、猴子、兔子、绵羊、山羊、猪和牛）和 2 项人类研究的结果。研究发现，各种内分泌干扰化学物质和致肥胖饮食与关键发育阶段乳腺形态的改变有关。
为了改善泌乳结局，未来的研究需要以泌乳为终点，并以标准化的方式进行，以便为文献做出更显著的贡献，从而使研究之间能够更好地进行比较。
