以大豆配方奶喂养的婴儿的神经发育结局：一项回顾性、全国性基于人群的观察性队列研究。

Neurodevelopmental Outcomes in Infants Fed with Soy Formula: A Retrospective, National Population-Based Observational Cohort Study.

机构信息

Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.

Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea.

出版信息

J Nutr. 2021 Oct 1;151(10):3045-3052. doi: 10.1093/jn/nxab229.

DOI:10.1093/jn/nxab229

PMID:34486658

Abstract

BACKGROUND

Soy-based infant formulas are increasingly popular, but data regarding their effects on neurodevelopmental outcomes during early childhood is scanty.

OBJECTIVE

This study investigated the effect of consuming soy-based infant formula at 9-12 mo after birth on the subsequent development of epilepsy, neurodevelopmental disorders, and developmental status.

METHODS

This nationwide retrospective administrative study used health screening examinations and linked insurance claims data of children born in Korea during 2008 and 2009. Infants who received soy formula were compared with those who received cow's milk formula using propensity score matching that considered birth history, economic status, clinical conditions, and drug prescription records. Exposure was defined as soy formula feeding determined from questionnaires completed by the parents when children were 9-12 mo old. Outcomes were epilepsy, attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and developmental status. Children were followed until 31 December, 2017.

RESULTS

A total of 153,841 eligible participants were enrolled; 11,535 (7.5%) children received soy formula, while 142,864 (92.5%) received cow's milk formula. The incidence rate of epilepsy during the follow-up period was 29.8 per 100,000 person-years (95% CI: 19.48, 41.65) in the soy formula group and 22.6 per 100,000 person-years (95% CI: 31.97, 59.07) in the cow's milk formula group, with no significant difference (aHR: 1.318; 95% CI: 0.825, 2.106). The 2 groups also had no difference based on prespecified analysis using different definitions of epilepsy. Likewise, no significant associations of soy formula with ADHD (aHR: 1.26; 95% CI: 1.00, 1.60) or ASD (aHR: 0.99; 95% CI: 0.54, 1.83), or delays of developmental stages were observed.

CONCLUSIONS

Feeding with soy formula rather than cow's milk formula had no apparent association with increased risks of epilepsy, ADHD, ASD, and developmental status, according to this cohort composed of a general pediatric population.

摘要

背景

以大豆为基础的婴儿配方奶粉越来越受欢迎，但关于其在幼儿期对神经发育结果影响的数据却很少。

目的

本研究旨在调查婴儿在出生后 9-12 个月食用大豆配方奶粉对随后癫痫、神经发育障碍和发育状况的影响。

方法

本全国性回顾性行政研究使用了韩国 2008 年和 2009 年出生儿童的健康筛查检查和保险理赔数据，并通过考虑出生史、经济状况、临床情况和药物处方记录的倾向评分匹配，将接受大豆配方奶粉的婴儿与接受牛奶配方奶粉的婴儿进行比较。暴露定义为从父母在婴儿 9-12 个月大时填写的问卷中确定的大豆配方喂养。结果为癫痫、注意缺陷多动障碍（ADHD）、自闭症谱系障碍（ASD）和发育状况。儿童随访至 2017 年 12 月 31 日。

结果

共纳入 153841 名合格参与者；11535 名（7.5%）儿童接受大豆配方奶粉，142864 名（92.5%）接受牛奶配方奶粉。在随访期间，大豆配方组癫痫的发生率为每 100000 人年 29.8 例（95%CI：19.48，41.65），牛奶配方组为每 100000 人年 22.6 例（95%CI：31.97，59.07），差异无统计学意义（aHR：1.318；95%CI：0.825，2.106）。根据使用不同癫痫定义的预设分析，两组之间也没有差异。同样，大豆配方与 ADHD（aHR：1.26；95%CI：1.00，1.60）或 ASD（aHR：0.99；95%CI：0.54，1.83）或发育阶段延迟也没有显著关联。