Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
PLoS One. 2022 Oct 14;17(10):e0267689. doi: 10.1371/journal.pone.0267689. eCollection 2022.
Norovirus and sapovirus are important causes of childhood acute gastroenteritis (AGE). Breastfeeding prevents AGE generally; however, it is unknown if breastfeeding prevents AGE caused specifically by norovirus and sapovirus.
We investigated the association between breastfeeding and norovirus or sapovirus AGE episodes in a birth cohort. Weekly data on breastfeeding and AGE episodes were captured during the first year of life. Stools were collected from children with AGE and tested by RT-qPCR for norovirus and sapovirus. Time-dependent Cox models estimated associations between weekly breastfeeding and time to first norovirus or sapovirus AGE.
From June 2017 to July 2018, 444 newborns were enrolled in the study. In the first year of life, 69 and 34 children experienced a norovirus and a sapovirus episode, respectively. Exclusive breastfeeding lasted a median of 2 weeks, and any breastfeeding lasted a median of 43 weeks. Breastfeeding in the last week did not prevent norovirus (HR: 1.09, 95% CI: 0.62, 1.92) or sapovirus (HR: 1.00, 95% CI: 0.82, 1.21) AGE in a given week, adjusting for household sanitation, consumption of high-risk foods, and mother's and child's histo-blood group phenotypes. Maternal secretor-positive phenotype was protective against norovirus AGE, whereas child's secretor-positive phenotype was a risk factor for norovirus AGE.
Exclusive breastfeeding in this population was short-lived, and no conclusions could be drawn about its potential to prevent norovirus or sapovirus AGE. Non-exclusive breastfeeding did not prevent norovirus or sapovirus AGE in the first year of life. However, maternal secretor-positive phenotype was associated with a reduced hazard of norovirus AGE.
诺如病毒和星状病毒是导致儿童急性肠胃炎（AGE）的重要原因。母乳喂养通常可以预防 AGE；然而，尚不清楚母乳喂养是否可以预防由诺如病毒和星状病毒引起的 AGE。
我们在一个出生队列中研究了母乳喂养与诺如病毒或星状病毒 AGE 发作之间的关联。在生命的第一年，每周收集关于母乳喂养和 AGE 发作的数据。从患有 AGE 的儿童中采集粪便样本，并通过 RT-qPCR 检测诺如病毒和星状病毒。时间依赖性 Cox 模型估计了每周母乳喂养与首次诺如病毒或星状病毒 AGE 发作之间的关联。
从 2017 年 6 月至 2018 年 7 月，共有 444 名新生儿入组该研究。在生命的第一年，分别有 69 名和 34 名儿童经历了诺如病毒和星状病毒感染。纯母乳喂养持续时间中位数为 2 周，任何形式的母乳喂养持续时间中位数为 43 周。在给定的一周内，最后一周的母乳喂养并不能预防诺如病毒（HR：1.09，95%CI：0.62，1.92）或星状病毒（HR：1.00，95%CI：0.82，1.21）AGE，调整了家庭卫生、高危食品的摄入以及母亲和儿童的组织血型表型。母亲分泌型阳性表型对诺如病毒 AGE 具有保护作用，而儿童分泌型阳性表型是诺如病毒 AGE 的危险因素。
在该人群中，纯母乳喂养持续时间很短，无法得出其对预防诺如病毒或星状病毒 AGE 的潜在作用的结论。非纯母乳喂养在生命的第一年并没有预防诺如病毒或星状病毒 AGE。然而，母亲分泌型阳性表型与诺如病毒 AGE 的发病风险降低有关。
