Rajagopalan Vidya, Hsu Eustace, Luo Shan
medRxiv. 2023 Jan 7:2023.01.06.23284287. doi: 10.1101/2023.01.06.23284287.
It is yet unknown if breastfeeding (bf) benefits, to brain and body development of children, persist into peri-adolescence and vary by socioeconomic environments (SEEs).
We aim to investigate SEE-independent and SEE-modulated relationships between bf duration and child brain structure and adiposity markers during peri-adolescence.
This was a cross-sectional study of children aged 9-10 enrolled in the multi-center Adolescent Brain and Cognitive Development (ABCD) Study®.
Bf duration was self-reported. Neighborhood-level SEE was assessed using area deprivation index (ADI).
T1-weighted magnetic resonance imaging was used to assess global brain measures: volumes of white, cortical, and subcortical gray matter (GM), cortical thickness, and surface area (SA). Adiposity markers included age- and sex-specific body mass index (BMI scores), waist circumference, and waist-to-height ratio (WHtR). Mixed effects models examined associations of bf duration with brain structure and adiposity markers controlling for sociodemographic, pre- and post-natal covariates. Stratified analysis was performed by tertiles of ADI.
The sample consisted of 7,511 children (51.7% males; 18.8% no bf, 35.3% 1-6 months, 24.9% 7-12 months, 21.0% >12 months). Child's total SA (β (95% CI) = 0.053 (0.033, 0.074); FDR corrected <0.001), cortical (β (95% CI) = 0.021 (0.010, 0.032); FDR corrected <0.001) and subcortical GM volume (β (95% CI) = 0.016 (0.003, 0.030); FDR corrected <0.001) increased monotonically with bf duration, after controlling for covariates. Child's BMI -scores (β (95% CI) = -0.040 (-0.063, -0.016); FDR corrected =0.001), waist circumference (β (95% CI) = -0.037 (-0.060, -0.014), FDR corrected =0.002) and WHtR (β (95% CI) = -0.040 (-0.064, -0.018), FDR corrected =0.001) decreased monotonically with increased bf duration, after controlling for covariates. Bf duration was inversely associated with adiposity in children from high- and medium-ADI neighborhoods. Bf duration was positively associated with SA across ADI tertiles.
Our results imply that long-term benefits of bf on body and brain development in offspring increase as bf duration increases, particularly in children from low SEEs. Policies and social support aimed to incremental increases in bf duration among women from low SEEs would confer long-term benefits for offspring.
Do benefits of breastfeeding(bf), on children's brain and body development, persist long-term and are these benefits uniform across socioeconomic environments (SEEs)? Longer bf duration is associated with lower adiposity, greater cortical and subcortical gray matter volume, and cortical surface area in 9-10-year-old children. Children from lower SEEs showed stronger negative relationships between bf duration and adiposity. Children across all SEEs demonstrated positive relationships between bf duration and surface area. Our results imply that long-term benefits to child brain and body development increase with bf duration; and children from lower SEEs benefited more from longer bf duration.
母乳喂养对儿童大脑和身体发育的益处是否会持续到青春期前期，以及是否因社会经济环境（SEEs）而异，目前尚不清楚。
我们旨在研究青春期前期母乳喂养持续时间与儿童脑结构和肥胖标志物之间与社会经济环境无关以及受社会经济环境调节的关系。
设计、地点和参与者：这是一项对多中心青少年大脑与认知发展（ABCD）研究®中9至10岁儿童的横断面研究。
母乳喂养持续时间通过自我报告获得。使用地区贫困指数（ADI）评估邻里层面的社会经济环境。
采用T1加权磁共振成像评估全脑指标：白质、皮质灰质和皮质下灰质（GM）体积、皮质厚度和表面积（SA）。肥胖标志物包括年龄和性别特异性体重指数（BMI分数）、腰围和腰高比（WHtR）。混合效应模型在控制了社会人口统计学、产前和产后协变量的情况下，检验了母乳喂养持续时间与脑结构和肥胖标志物之间的关联。按ADI三分位数进行分层分析。
样本包括7511名儿童（51.7%为男性；18.8%未进行母乳喂养，35.3%母乳喂养1至6个月，24.9%母乳喂养7至12个月，21.0%母乳喂养超过12个月）。在控制协变量后，儿童的总表面积（β（95%CI）=0.053（0.033，0.074）；FDR校正<0.001）、皮质（β（95%CI）=0.021（0.010，0.032）；FDR校正<0.001）和皮质下GM体积（β（95%CI）=0.016（0.003，0.030）；FDR校正<0.001）随母乳喂养持续时间单调增加。儿童的BMI分数（β（95%CI）=-0.040（-0.063，-0.016）；FDR校正=0.0
