Timing of Solid Food Introduction in Relation to Atopic Dermatitis and Atopic Sensitization: Results From a Prospective Birth Cohort Study
Timing of Solid Food Introduction in Relation to Atopic Dermatitis and Atopic Sensitization: Results From a Prospective Birth Cohort Study
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引入固体食物的时机与特应性皮炎和特应性过敏相关：前瞻性出生队列研究的结果
DOI：
10.1542/peds.2004-2521
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发表时间：
2006
期刊：
影响因子：
8
通讯作者：
J. Heinrich
中科院分区：
文献类型：
--
作者：
A. Zutavern;I. Brockow;B. Schaaf;G. Bolte;A. von Berg;U. Diez;M. Borte;O. Herbarth;H. Wichmann;J. Heinrich
OBJECTIVE.预防性喂养指南建议延迟引入固体食物以预防特应性疾病。这方面的科学证据很少。本研究调查了延迟引入固体（过去4个月或6个月）是否可以防止特应性皮炎（AD）和特应性致敏的发展，当考虑反向因果关系时。方法.在一项正在进行的出生队列研究中，对2612名2岁婴儿的数据进行了分析。每半年收集一次有关饮食、症状和AD诊断的信息，并在2岁时收集有关特定免疫球蛋白E水平的信息。结果在出生后4个月内引入固体食物可降低症状性AD的几率，但对于医生诊断的AD、医生诊断和症状性AD合并的AD或特应性致敏则无此作用。推迟引进超过6个月的生活是没有保护性的定义AD或特应性过敏。也没有证据表明延迟引入固体对特应性父母的儿童的AD和特应性致敏具有保护作用。有明确的证据表明，早期皮肤或过敏症状与固体物质的引入之间存在反向因果关系。结论.这项研究没有发现证据支持延迟引入固体超过6个月的生活，以预防AD和特应性致敏。我们不能排除在生命的前4个月推迟引入固体可能会提供一些保护。在进行、分析和解释关于这一主题的队列研究时，必须考虑避免反向因果关系的措施。
OBJECTIVE. Prophylactic feeding guidelines recommend a delayed introduction of solid foods for the prevention of atopic diseases. Scientific evidence for this is scarce. This study investigates whether a delayed introduction of solids (past 4 months or 6 months) is protective against the development of atopic dermatitis (AD) and atopic sensitization when considering reverse causality. METHODS. Data from 2612 infants in an ongoing birth cohort study were analyzed at 2 years of age. Information on diet and on symptoms and diagnoses of AD was collected semiannually, and information on specific immunoglobulin E levels was collected at 2 years of age. RESULTS. Solid food introduction past the first 4 months of life decreased the odds of symptomatic AD but not for doctor-diagnosed AD, combined doctor-diagnosed and symptomatic AD, or atopic sensitization. Postponing the introduction beyond the sixth month of life was not protective in relation to either definition of AD or atopic sensitization. There was also no evidence for a protective effect of a delayed introduction of solids on AD and atopic sensitization in children of atopic parents. There was clear evidence for reverse causality between early skin or allergic symptoms and the introduction of solids. CONCLUSIONS. This study does not find evidence supporting a delayed introduction of solids beyond the sixth month of life for the prevention of AD and atopic sensitization. We cannot rule out that delaying the introduction of solids for the first 4 months of life might offer some protection. Measures to avoid reverse causality have to be considered in the conduction, analysis, and interpretation of cohort studies on the topic.