新生儿短期接触牛奶对特应性疾病发展影响的随机对照试验
Randomised controlled trial of brief neonatal exposure to cows' milk on the development of atopy.
作者信息
de Jong M H, Scharp-van der Linden V T, Aalberse R C, Oosting J, Tijssen J G, de Groot C J
机构信息
Department of Paediatrics, Emma Children's Hospital, Academic Medical Center (AMC), University of Amsterdam, Netherlands.
出版信息
Arch Dis Child. 1998 Aug;79(2):126-30. doi: 10.1136/adc.79.2.126.
OBJECTIVE
To determine the effect of brief early exposure to cows' milk on atopy in the first 2 years of life.
DESIGN
Double blind, placebo controlled, randomised feeding intervention trial (Bokaal study).
SETTING
Dutch midwifery practices.
PARTICIPANTS
1533 breast fed neonates.
INTERVENTION
Exposure to cows' milk protein (n = 758) or a protein free placebo (n = 775) during the first 3 days of life.
MAIN OUTCOME MEASURES
Clinical atopic disease and any positive radioallergosorbent (RAST) tests at 1 year of age.
RESULTS
Atopic disease in the first year was found in 10.0% (cows' milk) v 9.3% (placebo) of the children, with a relative risk of 1.07; in the second year, atopic disease was found in 9.6% v 10.2%, respectively, with a relative risk of 0.94. Per protocol analysis showed similar results. Any RAST positive test was found in 9.4% (cows' milk) v 7.9% (placebo) of children, with a relative risk of 1.19. Stratified analysis for high family risk of allergy showed a doubled incidence of atopic disease but no effect from the intervention.
CONCLUSION
Early and brief exposure to cows' milk in breast fed children does not increase the risk of atopic disease in the first 2 years.
目的
确定出生后前两年短期早期接触牛奶对特应性疾病的影响。
设计
双盲、安慰剂对照、随机喂养干预试验（博卡尔研究）。
地点
荷兰助产机构。
参与者
1533名母乳喂养的新生儿。
干预措施
出生后前3天接触牛奶蛋白（n = 758）或无蛋白安慰剂（n = 775）。
主要观察指标
1岁时的临床特应性疾病和任何阳性放射变应原吸附试验（RAST）。
结果
第一年，牛奶组儿童患特应性疾病的比例为10.0%，安慰剂组为9.3%，相对风险为1.07；第二年，牛奶组和安慰剂组患特应性疾病的比例分别为9.6%和10.2%，相对风险为0.94。符合方案分析显示了相似的结果。儿童中，任何RAST阳性试验的比例在牛奶组为9.4%，安慰剂组为7.9%，相对风险为1.19。对高过敏家族风险进行分层分析显示，特应性疾病的发病率翻倍，但干预措施没有效果。
结论
母乳喂养儿童早期短期接触牛奶不会增加出生后前两年患特应性疾病的风险。
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