Are adolescents who were breast-fed less likely to be overweight? Analyses of sibling pairs to reduce confounding.
Are adolescents who were breast-fed less likely to be overweight? Analyses of sibling pairs to reduce confounding.
复制标题
母乳喂养的青少年超重的可能性较小吗？
DOI：
10.1097/01.ede.0000152900.81355.00
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Adair,LindaS
中科院分区：
文献类型：
--
作者：
Nelson,MelissaC;Gordon-Larsen,Penny;Adair,LindaS
Background:Cohort analyses suggesting that breast-feeding protects against being overweight have been criticized for inadequately controlling for confounding associated with the self-selection of feeding practices.Methods:Using nationally representative US data from the National Longitudinal Study of Adolescent Health (1994–1996), we performed traditional cohort analyses (n= 11,998) using logistic regression to estimate the relation between breast-feeding and adolescent overweight (body mass index≥ 85 percentile, based on year 2000 CDC growth charts), controlling for known potential confounders. Breast-feeding also was assessed in a subsample of 850 sibling pairs to account for unmeasured genetic and environmental factors.Results:Among girls in the full cohort, the odds of being overweight declined among those who had been breast-fed at least 9 months; odds ratios ranged from 0.90 (95% confidence interval= 0.74–1.09) for< 3 months of breast-feeding to 0.78 (0.64–0.96) for≥ 9 months. A similar effect was seen in boys, although these trends were less consistent. In contrast, an analysis of sibling pairs provided no evidence of breast-feeding effects on weight within discordant trends.Conclusion:Cohort data indicate that odds of being overweight decrease as breast-feeding duration increases, at least among girls. However, sibling analyses suggest that this relationship may not be causal but rather attributable to unmeasured confounding related to mothers’ choice to breast-feed, or to other childhood risk factors for overweight. Our results illustrate the utility of sibling analyses in understanding the true effect of early life exposures (such as breast-feeding) on health outcomes over time, independent of confounding factors that may not be satisfactorily controlled using traditional prospective cohort methods.
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