Breastfeeding in the First Days of Life Is Associated With Lower Blood Pressure at 3 Years of Age
出生早期的母乳喂养与3岁时的低血压有关
BY 丹妮
BACKGROUND
Breastfeeding in infancy is associated with lower cardiovascular disease risk in adulthood; however, the amount of breastfeeding required to achieve this benefit is unknown.
婴儿期母乳喂养与成年后较低的心血管疾病风险相关；然而，实现这一益处所需的母乳喂养量尚不清楚
METHODS AND RESULTS
In the CHILD (Canadian Healthy Infant Longitudinal Development) Cohort Study, we analyzed 2382 children with complete data on early life feeding and blood pressure. Infant feeding was documented from hospital records in the first few days of life and reported by mothers throughout infancy. Blood pressure was measured at 3 years of age. Analyses controlled for birth weight, gestational age, socioeconomic status, maternal body mass index, and other potential confounders. We found that nearly all children (2333/2382; 97.9%) were ever breastfed, of whom 98 (4.2%) only briefly received breast milk during their birth hospitalization (“early limited breastfeeding”). At 3 years of age, blood pressure was higher in children who were never breastfed (mean systolic/diastolic 103/60mmHg) compared with those who were ever breastfed (99/58mmHg), including those who received only early limited breastfeeding (99/57mmHg). These differences in systolic blood pressure persisted in adjusted models (ever breastfed: −3.47mmHg, 95% CI, −6.14 to −0.80; early limited breastfeeding: −4.24mmHg, 95% CI, −7.45 to −1.04). Among breastfed children, there was no significant dose-response association according to the duration or exclusivity of breastfeeding. Associations were not mediated by child body mass index.
加拿大健康婴儿纵向发展队列研究中，我们分析了2382名儿童，他们有完整的早期生活喂养和血压数据。婴儿喂养记录分别来源于刚出生时的医院记录和母亲报告的整个婴儿期。三岁时测量血压。该分析控制了出生体重、胎龄、社会经济状况、产妇体重指数和其他潜在混杂因素。我们发现，几乎所有儿童(2333/2382;97.9%)都能接受母乳喂养，但其中仅有98人(4.2%)早期限制母乳喂养，即只能在产妇分娩的住院期间接受母乳喂养。在3岁时，从未接受母乳喂养儿童的血压(103/60 mmHg)高于曾接受母乳喂养的儿童(99/58 mmHg)包括早期限制母乳喂养的儿童(99/57mmHg)。收缩压差异在调整后的模型中仍然存在(母乳喂养:−3.47mmHg 95%[CI]:-6.4--8.0; 早期限制母乳喂养:−4.24mmHg;95%[CI]:7.45-1.04)。在母乳喂养的儿童中，母乳喂养的持续时间和是否纯母乳喂养与血压水平之间没有显著的剂量反应关系。儿童体重指数也不会影响这种关系。
CONCLUSIONS
Although the benefits of sustained and exclusive breastfeeding are indisputable, this study indicates any breastfeeding, regardless of duration or exclusivity, is associated with lower blood pressure at 3 years of age. Further research examining the bioactive components of early breast milk, underlying mechanisms, and long-term associations is warranted.
尽管持续纯母乳喂养的好处是无可争议的，但这项研究表明，是否母乳喂养与3岁时的低血压有关，而与持续时间或是否纯母乳喂养无关。未来有必要进一步研究早期母乳中的生物活性成分，其潜在机制以及与血压水平的长期关联性。
1.患者基本特征
2.婴儿母乳喂养与3岁时血压的关系
3.婴儿母乳喂养与3岁时血压Z分数的关系
4.是否母乳喂养与低血压的关系
5.BMI不会影响影响母乳喂养与血压间关系
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