Gladen B C, Rogan W J
Statistics and Biomathematics Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, USA.
Am J Public Health. 1995 Apr;85(4):504-8. doi: 10.2105/ajph.85.4.504.
Worldwide declines in the duration of lactation are cause for public health concern. Higher levels of dichlorodiphenyl dichloroethene (DDE) have been associated with shorter durations of lactation in the United States. This study examined whether this relationship would hold in an agricultural town in northern Mexico.
Two hundred twenty-nine women were followed every 2 months from childbirth until weaning or until the child reached 18 months of age. DDE was measured in breast milk samples taken at birth, and women were followed to see how long they lactated.
Median duration was 7.5 months in the lowest DDE group and 3 months in the highest. The effect was confined to those who had lactated previously, and it persisted after statistical adjustment for other factors. These results are not due to overtly sick children being weaned earlier. Previous lactation lowers DDE levels, which produces an artifactual association, but simulations using best estimates show that an effect as large as that found here would arise through this mechanism only 6% of the time.
DDE may affect women's ability to lactate. This exposure may be contributing to lactation failure throughout the world.
全球母乳喂养时长的下降引发了公共卫生领域的关注。在美国,较高水平的二氯二苯二氯乙烯(DDE)与较短的母乳喂养时长相关。本研究调查了这种关系在墨西哥北部一个农业城镇是否成立。
对229名女性从分娩后开始,每两个月进行一次随访,直至断奶或孩子满18个月。在出生时采集母乳样本测量DDE含量,并跟踪这些女性的母乳喂养时长。
DDE含量最低组的母乳喂养时长中位数为7.5个月,最高组为3个月。这种影响仅限于曾经有过哺乳经历的女性,并且在对其他因素进行统计调整后仍然存在。这些结果并非由于患病儿童更早断奶所致。既往哺乳会降低DDE水平,从而产生一种人为关联,但使用最佳估计值进行的模拟显示,仅通过这种机制产生如此大的影响的概率仅为6%。
DDE可能会影响女性的泌乳能力。这种暴露可能是导致全球母乳喂养失败的原因之一。