经母乳的烟草代谢物暴露和婴儿体重增加:一项基于人群的研究
2016/02/23
摘要
背景:尽管在大量文献中母乳喂养的益处毋庸置疑，经母乳的烟草代谢物暴露的潜在后果的相关信息却很稀少。
目的:目的是首次对经母乳的烟草代谢物暴露与婴儿体重增长的关系进行研究。
方法:我们采用来自美国合作围产期项目的历史数据。母亲分为非吸烟者，轻度吸烟者（1-19支/天），和重度吸烟者 (20+支/天)。留院者的喂养方式在产后留院哺育期观察。我们再根据平均胎龄儿(AGA; N = 23 571) 和小于胎龄儿 (SGA; N = 2552)进行分层分析。我们单独研究了经母乳的烟草代谢物暴露的影响。
结果: 总体而言，母亲吸烟与体重别身高的z评分的改变有剂量效应相关性。体重z评分的改变在重度吸烟者(母乳喂养: 0.53; 95%置信区间 [CI], 0.12-0.94;配方粉喂养: 0.17; 95% CI, 0.03-0.30)的小于胎龄儿中最为显著。经母乳的烟草代谢物暴露与平均胎龄儿的额外体重增加无关。在小于胎龄儿的更小样本中，重度吸烟者的婴儿经母乳的烟草代谢物暴露与临界显著的额外体重增加有相关性 (0.46; 95% CI, 0.00-0.91)。
结论:我们的发现与卫生机构推荐吸烟者哺乳的建议是一致的。然而，重度吸烟者的SGA婴儿经母乳烟草代谢物暴露可能会导致其比其他婴儿增重更快。我们讨论了本发现的实际意义。
（苏欣 审校）
J Hum Lact. 2015 Dec 7. pii: 0890334415619154. [Epub ahead of print]
Exposure to Tobacco Metabolites via Breast Milk and Infant Weight Gain: A Population-Based Study.
Shenassa ED1, Wen X2, Braid S3.
Abstract
BACKGROUND:Although the immutable benefits of breastfeeding are well documented, information on the potential consequences of exposure to tobacco metabolites specifically via breastfeeding is sparse.
OBJECTIVE:The aim was to conduct the first study of the association between exposure to tobacco metabolites specifically through breastfeeding and infant weight gain.
METHODS:We used historical data from the US Collaborative Perinatal Project. Mothers were classified as nonsmokers, light smokers (1-19 cigarettes/day), and heavy (20+ cigarettes/day) smokers. In-hospital feeding type was observed during a nursery stay after delivery. We conducted stratified analyses among average-for-gestational-age (AGA; N = 23 571) and small-for-gestational-age (SGA; N = 2552) infants. We isolated the effect of exposure to tobacco metabolites specifically through breastfeeding.
RESULTS:Overall, maternal smoking was associated with change in weight-for-length z-score in a dose-response manner. Change in weight z-score was most pronounced among SGA infants of heavy smokers (breastfed: 0.53; 95% confidence interval [CI], 0.12-0.94; formula fed: 0.17; 95% CI, 0.03-0.30). Exposure to tobacco metabolites specifically through breastfeeding was not associated with additional weight gain among AGA infants. Among the much smaller sample of SGA infants, exposure specifically through breastfeeding was associated with marginally significant additional weight gain (0.46; 95% CI, 0.00-0.91) among infants of heavy smokers.
CONCLUSION:Our findings are in accord with recommendations by health agencies for smokers to breastfeed. However, SGA infants exposed to tobacco metabolites via breastfeeding by heavy smokers appear to gain weight more rapidly than other infants. Practical implications of our findings are discussed.
J Hum Lact. 2015 Dec 7. pii: 0890334415619154. [Epub ahead of print]
