婴儿期母乳喂养与中老年期死亡率：一项前瞻性队列研究和荟萃分析。

Breastfeeding in infancy and mortality in middle and late adulthood: A prospective cohort study and meta-analysis.

作者信息

Wang Xiaoyan, Yan Mengsha, Zhang Yanyu, Wang Wenjie, Zhang Weiwei, Luo Junkai, Gan Da, Yang Haomin, Zhu Shankuan, He Wei

机构信息

Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.

Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.

出版信息

J Intern Med. 2023 May;293(5):624-635. doi: 10.1111/joim.13619. Epub 2023 Mar 5.

DOI:10.1111/joim.13619

PMID:36815686

Abstract

BACKGROUND

Breastfeeding in infancy is associated with a lower risk of mortality among children, but the impact on mortality in middle and late adulthood remains unknown.

OBJECTIVES

To assess the association between breastfeeding in infancy and mortality in middle and late adulthood.

METHODS

We included 383,627 participants aged 40-73 from the UK Biobank (2006-2010) and followed up until 2021. Hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality according to breastfeeding in infancy were estimated with Cox proportional hazards regression models. We further did a meta-analysis, including results from our present study and three other cohort studies (PROSPERO; number CRD42022348925).

RESULTS

During a total of 4732,751 person-years of follow-up, 25,581 deaths were identified. Breastfeeding in infancy was associated with lower risks of mortality in middle and late adulthood, with adjusted HRs (95% CIs) of 0.95 (0.93-0.98) for all-cause mortality; 0.91 (0.87-0.96) for cardiovascular mortality and 0.94 (0.874-0.999) for respiratory mortality. Specifically, the association with mortality seemed to attenuate with age - stronger in middle-aged adults than in older adults. A similar association between breastfeeding in infancy and all-cause mortality was found in the meta-analysis.

CONCLUSION

Breastfeeding in infancy is associated with a lower risk of mortality - even decades later - in middle and late adulthood.

摘要

背景

婴儿期母乳喂养与儿童死亡率较低相关，但对中老年期死亡率的影响尚不清楚。

目的

评估婴儿期母乳喂养与中老年期死亡率之间的关联。

方法

我们纳入了英国生物银行（2006 - 2010年）中383,627名年龄在40 - 73岁之间的参与者，并随访至2021年。使用Cox比例风险回归模型估计根据婴儿期母乳喂养情况得出的全因死亡率和特定原因死亡率的风险比（HR）及95%置信区间（CI）。我们进一步进行了一项荟萃分析，纳入了本研究及其他三项队列研究的结果（PROSPERO；注册号CRD42022348925）。

结果

在总共4732751人年的随访期间，共确定了25581例死亡。婴儿期母乳喂养与中老年期较低的死亡风险相关，全因死亡率的调整后HR（95%CI）为0.95（0.93 - 0.98）；心血管死亡率为0.91（0.87 - 0.96），呼吸死亡率为0.94（0.874 - 0.999）。具体而言，与死亡率的关联似乎随年龄增长而减弱——在中年成年人中比在老年人中更强。在荟萃分析中也发现了婴儿期母乳喂养与全因死亡率之间类似的关联。