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4岁儿童母乳喂养持续时间与心脏结构和功能的关联。

Association of breastfeeding duration with cardiac structure and function in 4 years old.

作者信息

Wang Zhi, Yang Ling, Du Bowen, Wang Hualin, Xu Caifang, Wang Qianchuo, Li Zhuoyan, Xu Zhikang, Wang Hui, Sun Kun, Wang Jian

机构信息

Department of Pediatric Cardiology, Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine, Yangpu District, No.1665, Kongjiang Road, Shanghai, 200092, China.

Institute for Developmental and Regenerative Cardiovascular Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.

出版信息

Eur J Clin Nutr. 2025 Jun 14. doi: 10.1038/s41430-025-01623-z.

Abstract

BACKGROUND

Breast milk is an important source of nutrition for infant development. But few studies have investigated the relationship between breastfeeding duration and children's cardiac structure and function.

OBJECTIVES

To assess the association of the duration of breastfeeding in infancy with cardiac structures and functions in 4-year-old children.

METHODS

The study analyzed data from 891 mother-offspring pairs in the Shanghai Birth Cohort (SBC) with complete 4-year follow-up and breastfeeding questionnaires. It excluded children with congenital heart defects or missing echocardiography data at age 4. Breastfeeding duration, including exclusive and mixed feeding, was categorized into three groups (<6months, 6-12months, >12months) based on questionnaires at 3 days, 24 days, 6, 12, and 24 months. Echocardiographic data were measured following 2010 American Society of Echocardiography recommendations.

RESULTS

The results showed that: compared to 4-year-old children who were breastfed for less than 6 months, those breastfed for more than 6 months had bigger left atrial and ventricular volume, including increased left atrial diastolic volume [LAVd (β: 2.09, 95% CI: 1.35, 2.83)], left atrial systolic volume [LAVs (β: 0.92, 95% CI: 0.53, 1.3)], left ventricular diastolic volume [LVEDV (β: 2.00, 95% CI: 0.36, 3.62)] and systolic volume [LVESV (β: 0.87, 95% CI: 0.17, 1.57)]. Children breastfed over 12 months showed similar cardiac structural changes as those breastfed 6-12 months. These findings were more pronounced in girls and low birthweight children.

CONCLUSIONS

Four-year-old children who were breastfed for six months or more had increased left heart volume, and this association was influenced by gender and birthweight.

摘要

背景

母乳是婴儿发育的重要营养来源。但很少有研究调查母乳喂养持续时间与儿童心脏结构和功能之间的关系。

目的

评估婴儿期母乳喂养持续时间与4岁儿童心脏结构和功能之间的关联。

方法

该研究分析了上海出生队列(SBC)中891对母婴的数据,这些数据有完整的4年随访和母乳喂养问卷。研究排除了患有先天性心脏病或4岁时缺少超声心动图数据的儿童。根据3天、24天、6个月、12个月和24个月时的问卷,母乳喂养持续时间(包括纯母乳喂养和混合喂养)被分为三组(<6个月、6 - 12个月、>12个月)。超声心动图数据的测量遵循2010年美国超声心动图学会的建议。

结果

结果显示:与母乳喂养少于6个月的4岁儿童相比,母乳喂养超过6个月的儿童左心房和心室容积更大,包括左心房舒张末期容积[LAVd(β:2.09,95%CI:1.35,2.83)]、左心房收缩末期容积[LAVs(β:0.92,95%CI:0.53,1.3)]、左心室舒张末期容积[LVEDV(β:2.00,95%CI:0.36,3.62)]和收缩末期容积[LVESV(β:0.87,95%CI:0.17,1.57)]增加。母乳喂养超过12个月的儿童与母乳喂养6 - 12个月的儿童表现出相似的心脏结构变化。这些发现在女孩和低出生体重儿童中更为明显。

结论

母乳喂养6个月或更长时间的4岁儿童左心容积增加,这种关联受性别和出生体重的影响。

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