Hou Leying, Shan Shiyi, Lu Keyao, Sun Weidi, Liu Wen, Li Xue, Yuan Changzheng, Song Peige
Center for Clinical Big Data and Statistics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.
Commun Med (Lond). 2025 Mar 25;5(1):86. doi: 10.1038/s43856-025-00806-w.
This study aimed to evaluate the association of lactation duration with incident ischemic heart disease (IHD) and to determine the potential health gains from scaling up breastfeeding practice.
130,147 parous postmenopausal females without IHD were included at baseline (2004-2008) from the China Kadoorie Biobank study. Lactation duration was self-reported and measured as lifetime, per child, and first child, respectively. Incident IHD was identified during follow-up (2004-2015). The dose-response associations between lactation duration and IHD were examined using Cox models with restricted cubic splines. Stratification analyses were conducted by socioeconomic status (SES) and residence. The number of preventable IHD cases was estimated using the population attributable fraction and potential impact fraction in various scenarios.
The study shows that parous postmenopausal females who ever lactated have significantly lower risks of IHD, with adjusted hazard ratios (aHRs) varying from 0.71 (95%CI: 0.63-0.80) to 0.85 (95%CI: 0.75-0.96) for a lifetime, from 0.70 (0.63-0.78) to 0.82 (0.72-0.93) for per-child, and from 0.80 (0.74-0.87) to 0.92 (0.85-0.99) for the first-child, appearing as U-shaped associations. Similar associations are found in females with low SES and urban residence. The scaling up of breastfeeding to near-universal levels could have prevented up to 115,000 new IHD cases among Chinese females aged over 40 years in 2019.
Lactation demonstrates potential benefits in reducing IHD risk, appearing as U-shaped associations among Chinese parous postmenopausal females, especially for those with low SES in urban areas. Scaling up breastfeeding practices serves as a promising strategy for reducing the IHD burden in China.
本研究旨在评估哺乳期长短与缺血性心脏病（IHD）发病之间的关联，并确定扩大母乳喂养对健康的潜在益处。
中国嘉道理生物银行研究在基线期（2004 - 2008年）纳入了130,147名无缺血性心脏病的经产妇绝经后女性。哺乳期通过自我报告获取，分别以终生、每个孩子和第一个孩子的哺乳时间来衡量。在随访期（2004 - 2015年）确定缺血性心脏病发病情况。使用带有受限立方样条的Cox模型检验哺乳期长短与缺血性心脏病之间的剂量反应关系。按社会经济地位（SES）和居住地进行分层分析。在不同情景下，使用人群归因分数和潜在影响分数估计可预防的缺血性心脏病病例数。
研究表明，曾经哺乳的经产妇绝经后女性患缺血性心脏病的风险显著较低，终生哺乳的调整后风险比（aHRs）在0.71（95%CI：(0.63 - 0.80)）至0.85（95%CI：(0.75 - 0.96)）之间，每个孩子哺乳的aHRs在0.70（(0.63 - 0.78)）至0.82（(0.72 - 0.93)）之间，第一个孩子哺乳的aHRs在0.80（(0.74 - 0.87)）至0.92（(0.85 - 0.99)）之间，呈现U型关联。在社会经济地位低和居住在城市的女性中也发现了类似关联。2019年，将母乳喂养扩大到接近普及水平可预防40岁以上中国女性中多达115,000例新发缺血性心脏病病例。
哺乳在降低缺血性心脏病风险方面显示出潜在益处，在中国经产妇绝经后女性中呈现U型关联，尤其是城市中社会经济地位低的女性。扩大母乳喂养是减轻中国缺血性心脏病负担的一项有前景的策略。
