哮喘联盟

   摘要
   目的：系统性综述母乳喂养与儿童过敏性疾病间的相关性。
   方法：通过预定纳入/剔除标准，PubMed, CINAHL和EMBASE数据库中共89篇文章纳入研究。采用Meta分析对母乳和过敏性结局进行分类。Meta回归探讨异质性。
   结果：母乳喂养的多少（持续时间）与儿童（5-18岁）哮喘风险降低相关，在中/低收入国家尤其如此，同时伴随小于5岁儿童的过敏性鼻炎风险降低，但是这种估计存在高异质性和低质量的特点。只有3-4个月纯母乳喂养与2岁以内儿童的湿疹风险降低有关（估计主要来自方法学质量较低的横断面研究）。母乳喂养与食物过敏间未发现相关性（估计存在高异质性和低质量）。Meta回归发现研究结果间的差异可能与母乳喂养回忆长度、实验设计、国家收入和研究开始日期有关。一些母乳喂养对哮喘的保护效应可能与方法学质量较低研究的回忆偏倚有关。
   结论：有些证据表明母乳喂养对哮喘有保护性作用（5-18岁）。较弱证据表明母乳喂养对≤2岁的湿疹和≤5岁的过敏性鼻炎有保护作用，在低收入国家母乳喂养对哮喘和湿疹的保护作用较强。

 

（苏欣 审校）
Acta Paediatr Suppl. 2015 Dec;104(467):38-53. doi: 10.1111/apa.13132.
 

Breastfeeding and asthma and allergies: a systematic review and meta-analysis.
 

Lodge CJ1,2, Tan DJ1,3, Lau M1, Dai X1, Tham R1, Lowe AJ1,2, Bowatte G1, Allen KJ2,4, Dharmage SC1,2.
 

Abstract
AIM:To systematically review the association between breastfeeding and childhood allergic disease.
METHODS:Predetermined inclusion/exclusion criteria identified 89 articles from PubMed, CINAHL and EMBASE databases. Meta-analyses performed for categories of breastfeeding and allergic outcomes. Meta-regression explored heterogeneity.
RESULTS:More vs. less breastfeeding (duration) was associated with reduced risk of asthma for children (5-18 years), particularly in medium-/low-income countries and with reduced risk of allergic rhinitis ≤5 years, but this estimate had high heterogeneity and low quality. Exclusive breastfeeding for 3-4 months was associated with reduced risk of eczema ≤2 years (estimate principally from cross-sectional studies of low methodological quality). No association found between breastfeeding and food allergy (estimate had high heterogeneity and low quality). Meta-regression found differences between study outcomes may be attributable to length of breastfeeding recall, study design, country income and date of study inception. Some of the protective effect of breastfeeding for asthma may be related to recall bias in studies of lesser methodological quality.
CONCLUSION:There is some evidence that breastfeeding is protective for asthma (5-18 years). There is weaker evidence for a protective effect for eczema ≤2 years and allergic rhinitis ≤5 years of age, with greater protection for asthma and eczema in low-income countries.
 

Acta Paediatr Suppl. 2015 Dec;104(467):38-53. doi: 10.1111/apa.13132.