Division of Neonatology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee.
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee.
Ann Allergy Asthma Immunol. 2022 Aug;129(2):205-211. doi: 10.1016/j.anai.2022.04.034. Epub 2022 May 10.
Postnatal exposures, including breastfeeding, may influence asthma development.
To investigate the association between breastfeeding duration and child asthma.
We studied 2021 mother-child dyads in the ECHO PATHWAYS consortium of prospective pregnancy cohorts (GAPPS, CANDLE, TIDES). Women reported the duration of any and exclusive breastfeeding and child asthma outcomes during follow-up at child age 4 to 6 years. Outcomes included current wheeze (previous 12 months), ever asthma, current asthma (having ≥2 of current wheeze, ever asthma, medication use in past 12-24 months), and strict current asthma (ever asthma with either or both current wheeze and medication use in past 12-24 months). We used multivariable logistic regression to assess associations (odds ratios and 95% confidence intervals) between breastfeeding and asthma outcomes adjusting for potential confounders. We assessed effect modification by mode of delivery, infant sex, and maternal asthma.
Among women, 33%, 13%, 9%, and 45% reported 0 to less than 2, 2 to 4, 5 to 6, and more than 6 months of any breastfeeding, respectively. The duration of any breastfeeding had a protective linear trend with ever asthma but no other outcomes. There was a duration-dependent protective association of exclusive breastfeeding and child asthma outcomes (eg, current asthma adjusted odds ratio [95% confidence interval], 0.64 [0.41-1.02], 0.61 [0.38-0.98], and 0.52 (0.31-0.87) for 2to 4 months, 5 to 6 months, and more than 6 months, respectively, compared with <2 months). For exclusive breastfeeding, protective associations were stronger in dyads with children born by vaginal vs cesarean delivery although interactions did not reach statistical significance (P 0.12-0.40).
Longer duration of exclusive breastfeeding had a protective association with child asthma.
产后暴露，包括母乳喂养，可能会影响哮喘的发展。
研究母乳喂养持续时间与儿童哮喘之间的关系。
我们研究了 ECHO PATHWAYS 前瞻性妊娠队列联盟中的 2021 对母婴对子（GAPPS、CANDLE、TIDES）。在随访期间，女性报告了任何和纯母乳喂养的持续时间以及儿童在 4 至 6 岁时的哮喘结局。结果包括当前喘息（过去 12 个月）、曾有哮喘、当前哮喘（有≥2 项当前喘息、曾有哮喘、过去 12-24 个月内用药）和严格当前哮喘（曾有哮喘，并且当前喘息和过去 12-24 个月内用药均有）。我们使用多变量逻辑回归来评估母乳喂养与哮喘结果之间的关联（优势比和 95%置信区间），调整了潜在的混杂因素。我们评估了分娩方式、婴儿性别和母亲哮喘的效应修饰作用。
在女性中，分别有 33%、13%、9%和 45%报告了 0 至不到 2 个月、2 至 4 个月、5 至 6 个月和超过 6 个月的任何母乳喂养。任何母乳喂养的持续时间与曾有哮喘呈保护性线性趋势，但与其他结果无关。纯母乳喂养与儿童哮喘结果存在依赖于持续时间的保护关联（例如，当前哮喘的调整后优势比[95%置信区间]，2 至 4 个月、5 至 6 个月和超过 6 个月分别为 0.64[0.41-1.02]、0.61[0.38-0.98]和 0.52[0.31-0.87]，与<2 个月相比）。对于纯母乳喂养，阴道分娩的母婴对子中保护关联更强，尽管交互作用没有达到统计学意义（P 0.12-0.40）。
更长时间的纯母乳喂养与儿童哮喘有保护关联。
