Di Filippo Paola, Lizzi Mauro, Raso Massimiliano, Di Pillo Sabrina, Chiarelli Francesco, Attanasi Marina
Department of Pediatrics, University of Chieti, Chieti, Italy.
Front Pediatr. 2022 Apr 28;10:829414. doi: 10.3389/fped.2022.829414. eCollection 2022.
Breastfeeding is associated with a lower risk of wheezing in early childhood, but its effect later in childhood remains unclear. We investigated the association of breastfeeding and respiratory outcomes in children aged 11 years.
We performed an observational longitudinal study including 110 prepubertal children. Information about breastfeeding duration, wheezing and asthma was collected by questionnaires. At 11 years of age, we measured spirometry parameters, lung volumes, diffusing lung capacity, and fractional exhaled nitric oxide. We used logistic and linear regression models to examine the associations of breastfeeding duration with the odds of asthma and lung function measures. All multivariable analyses were adjusted for sex, smoking during pregnancy, gestational age at birth, twins, and mode of delivery (confounder model).
Breastfeeding duration was associated with FEV z-score [β = 0.04, CI 95% (0.02-0.09)], FEF75 z-score [β = 0.06, CI 95% (0.03-0.09)] and FEV/FVC z-score [β = 0.03, CI 95% (0.00-0.07)], but not with diffusing lung capacity and fractional exhaled nitric oxide. No association of breastfeeding duration with preschool wheezing, ever asthma and current asthma was documented.
We showed that children breastfed for longer time presented higher FEV, FEV/FVC, and FEF75 z-score values at 11 years of age compared to children breastfed for shorter time, suggesting a protective effect of breastfeeding on airways, and not on lung parenchyma (lung volumes and alveolar capillary membrane) or allergic airway inflammation. The positive effect of breastfeeding duration on lung function lays the foundation to promote breastfeeding more and more as effective preventive measure.
母乳喂养与幼儿期喘息风险较低相关,但其对儿童后期的影响尚不清楚。我们调查了11岁儿童母乳喂养与呼吸结局之间的关联。
我们进行了一项观察性纵向研究,纳入110名青春期前儿童。通过问卷调查收集母乳喂养持续时间、喘息和哮喘的信息。在11岁时,我们测量了肺活量测定参数、肺容积、肺弥散功能和呼出一氧化氮分数。我们使用逻辑回归和线性回归模型来检验母乳喂养持续时间与哮喘几率和肺功能指标之间的关联。所有多变量分析均针对性别、孕期吸烟、出生孕周、双胞胎和分娩方式进行了调整(混杂因素模型)。
母乳喂养持续时间与第一秒用力呼气容积(FEV)z评分[β = 0.04,95%置信区间(CI)(0.02 - 0.09)]、最大呼气流量75%(FEF75)z评分[β = 0.06,95% CI(0.03 - 0.09)]和FEV/用力肺活量(FVC)z评分[β = 0.03,95% CI(0.00 - 0.07)]相关,但与肺弥散功能和呼出一氧化氮分数无关。未记录到母乳喂养持续时间与学龄前喘息、曾患哮喘和当前哮喘之间的关联。
我们发现,与母乳喂养时间较短的儿童相比,母乳喂养时间较长的儿童在11岁时FEV、FEV/FVC和FEF75的z评分更高,这表明母乳喂养对气道有保护作用,而对肺实质(肺容积和肺泡毛细血管膜)或过敏性气道炎症没有保护作用。母乳喂养持续时间对肺功能的积极影响为越来越多地推广母乳喂养作为有效的预防措施奠定了基础。