Leth-Møller Magnus, Kampmann Ulla, Hede Susanne, Ovesen Per G, Hulman Adam, Knorr Sine
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.
Am J Clin Nutr. 2025 Apr;121(4):835-842. doi: 10.1016/j.ajcnut.2025.01.020. Epub 2025 Jan 23.
Rapid infant growth is positively, and breastfeeding inversely, associated with childhood overweight. However, the interplay has only been sparsely investigated.
We aimed to investigate how exclusive breastfeeding duration modifies the effect of infant growth on childhood overweight.
We included routinely collected data on duration of exclusive breastfeeding and child growth from Aarhus Municipality, Denmark and on maternal health from the patient records at Aarhus University Hospital, 2008-2013. Infant growth was estimated using latent class analysis. Duration of exclusive breastfeeding was grouped as never, ≤4 mo, and >4 mo. Childhood overweight was defined as a body mass index z-score >1 at age 5 to 9 y. We investigated the risk of overweight dependent on infant growth and breastfeeding duration both independently and combined using logistic regression and adjusting for potential confounders.
Among 7074 infants, we identified 3 growth patterns: average, accelerated, and decelerated. No or ≤4 mo of breastfeeding was associated with being overweight at 5 to 9 y (adjusted odds ratio [aOR]: 1.61; 95% confidence interval [CI]: 1.27, 2.03 and aOR: 1.54; 95% CI: 1.28, 1.85, respectively) compared to >4 mo of breastfeeding. Compared with average infant growth, accelerated growth was associated with childhood overweight (aOR: 1.35; 95% CI: 1.01, 1.79). In the combined analysis, accelerated infant growth showed no evidence of being associated with overweight if infants were exclusively breastfed >4 mo (aOR: 1.20; 95% CI: 0.68, 2.10). Decelerated growth was not associated with overweight regardless of exclusive breastfeeding duration, compared with infants with average growth who were exclusively breastfed >4 mo.
Longer duration of exclusive breastfeeding was associated with decreased risk of being overweight, whereas accelerated infant growth was associated with increased risk. Children with accelerated infant growth who were never breastfed had the highest risk of being overweight at 5 to 9 y of age, whereas there was no association if infants were exclusively breastfed >4 mo.
婴儿快速生长与儿童期超重呈正相关，而母乳喂养与之呈负相关。然而，二者之间的相互作用仅得到了较少的研究。
我们旨在研究纯母乳喂养持续时间如何改变婴儿生长对儿童期超重的影响。
我们纳入了丹麦奥胡斯市常规收集的关于纯母乳喂养持续时间和儿童生长的数据，以及2008年至2013年奥胡斯大学医院患者记录中的产妇健康数据。使用潜在类别分析来估计婴儿生长情况。纯母乳喂养持续时间分为从未、≤4个月和>4个月。儿童期超重定义为5至9岁时体重指数z评分>1。我们使用逻辑回归独立并综合研究了依赖于婴儿生长和母乳喂养持续时间的超重风险，并对潜在混杂因素进行了调整。
在7074名婴儿中，我们确定了3种生长模式：平均、加速和减速。与纯母乳喂养>4个月相比，未进行母乳喂养或纯母乳喂养≤4个月与5至9岁时超重相关（调整后的优势比[aOR]：1.61；95%置信区间[CI]：1.27，2.03和aOR：1.54；95%CI：1.28，1.85）。与平均婴儿生长相比，加速生长与儿童期超重相关（aOR：1.35；95%CI：1.01，1.79）。在综合分析中，如果婴儿纯母乳喂养>4个月，加速婴儿生长没有显示出与超重相关的证据（aOR：1.20；95%CI：0.68，2.10）。与纯母乳喂养>4个月的平均生长婴儿相比，减速生长与超重无关，无论纯母乳喂养持续时间如何。
纯母乳喂养持续时间较长与超重风险降低相关，而婴儿加速生长与超重风险增加相关。从未进行母乳喂养的加速生长婴儿在5至9岁时超重风险最高，而如果婴儿纯母乳喂养>4个月则无关联。
