背景:细支气管炎是婴儿疾病的主要原因,很少有已知的可改变的风险因素。母乳喂养可以降低严重细支气管炎的风险,但是排他性与部分母乳喂养伴严重细支气管炎尚不清楚。
目的:评估排他性与在0-2.9个月期间部分母乳喂养,婴儿期毛细支气管炎住院。
方法:我们进行了一项病例对照研究,作为多中心气道研究合作的两个前瞻性美国队列的二次分析。在2011-2014年期间因毛细支气管炎住院的婴儿的17个中心研究中纳入了病例(n=921)。在2013-2014年和2017年期间,对照纳入了一项健康婴儿的五中心研究(n=719)。通过家长访谈收集0-2.9个月大的母乳喂养史。在母乳喂养的婴儿中,独家与协会使用多变量logistic回归模型对部分母乳喂养伴毛细支气管炎住院的几率进行了估计,并对人口学变量进行了校正。父母哮喘病史,和早期生活暴露。作为次要分析,我们估计独家协会,主要的,和偶尔的母乳喂养与没有母乳喂养与毛细支气管炎住院的可能性。
结果:在1640名婴儿中,纯母乳喂养的患病率在病例中为187/921(20.3%),对照组为275/719(38.3%).独家vs.部分母乳喂养与毛细支气管炎住院几率降低48%相关(校正比值比[OR]0.52,95%置信区间[CI]0.39,0.69).在次要分析中,独家vs.无母乳喂养与毛细支气管炎住院几率降低58%相关(OR0.42,95%CI0.23,0.77),而主要母乳喂养(OR0.77,95%CI0.37,1.57)和偶尔母乳喂养(OR0.98,95%CI0.57,1.69)与细支气管炎住院几率显著降低无关.
结论:独家母乳喂养对毛细支气管炎住院有很强的保护性关联。
Bronchiolitis is a major cause of infant illness, with few known modifiable risk factors. Breast feeding may reduce risk of severe bronchiolitis, but the association of exclusive vs. partial breast feeding with severe bronchiolitis is unclear.
To estimate the association of exclusive vs. partial breast feeding during ages 0-2.9 months with bronchiolitis hospitalisation during infancy.
We conducted a
case-control study as a secondary analysis of two prospective US cohorts in the Multicenter Airway Research Collaboration. Cases were enrolled in a 17-centre study of infants hospitalised for bronchiolitis during 2011-2014 (n = 921). Controls were enrolled in a five-centre study of healthy infants during 2013-2014 and 2017 (n = 719). Breast feeding history during ages 0-2.9 months was collected by parent interview. Among breastfed infants, the association of exclusive vs. partial breast feeding with odds of bronchiolitis hospitalisation was estimated using a multivariable logistic regression model adjusted for demographic variables, parental asthma history, and early-life exposures. As a secondary analysis, we estimated the associations of exclusive, predominant, and occasional breast feeding vs. no breast feeding with the odds of bronchiolitis hospitalisation.
Among 1640 infants, the prevalence of exclusive breast feeding was 187/921 (20.3%) among cases and 275/719 (38.3%) among controls. Exclusive vs. partial breast feeding was associated with 48% reduced odds of bronchiolitis hospitalisation (adjusted odds ratio [OR] 0.52, 95% confidence interval [CI] 0.39, 0.69). In the secondary analysis, exclusive vs. no breast feeding was associated with 58% reduced odds of bronchiolitis hospitalisation (OR 0.42, 95% CI 0.23, 0.77), whereas predominant breast feeding (OR 0.77, 95% CI 0.37, 1.57) and occasional breast feeding (OR 0.98, 95% CI 0.57, 1.69) were not associated with meaningfully reduced odds of bronchiolitis hospitalisation.
Exclusive breast feeding had a strong protective association against bronchiolitis hospitalisation.