Breastfeeding and the risk for diarrhea morbidity and mortality.
Breastfeeding and the risk for diarrhea morbidity and mortality.
复制标题
母乳喂养以及腹泻发病率和死亡率的风险。
DOI：
10.1186/1471-2458-11-s3-s15
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发表时间：
2011-04-13
影响因子：
4.5
通讯作者：
Black RE
中科院分区：
文献类型：
--
作者：
Lamberti LM;Fischer Walker CL;Noiman A;Victora C;Black RE
在发展中国家，0-5个月大的婴儿缺乏纯母乳喂养和6-23个月大的儿童没有纯母乳喂养与腹泻发病率和死亡率增加有关。我们估计了不同水平的母乳喂养暴露对腹泻发病率、腹泻患病率、腹泻死亡率、全因死亡率和因腹泻疾病住院的保护作用。我们系统地回顾了从1980年到2009年发表的所有文献，评估了不理想的母乳喂养水平是选定的腹泻发病率和死亡率结果的风险因素。我们进行了随机效应荟萃分析，根据结果和年龄类别生成汇集的相对风险。我们发现了大量证据证明母乳喂养对预防腹泻发病率、患病率、住院率、腹泻死亡率和全因死亡率的保护作用。对18项研究的随机效应荟萃分析结果表明，不同水平的母乳喂养对婴儿有不同程度的保护作用，其中0-5个月的婴儿纯母乳喂养和6-23个月大的婴儿和幼儿的任何母乳喂养的保护作用最大。具体地说，在0-5个月大的婴儿中，非母乳喂养导致腹泻死亡的风险高于纯母乳喂养(RR：10.52)，而在6-23个月的儿童中，非母乳喂养导致腹泻死亡的风险更高(RR：2.18)。我们的发现支持世界卫生组织目前的建议，即在生命的前6个月进行纯母乳喂养，作为儿童生存的关键干预措施。我们的研究结果也强调了母乳喂养在婴儿出生后头两年预防腹泻发病率和死亡率的重要性。
Lack of exclusive breastfeeding among infants 0-5 months of age and no breastfeeding among children 6-23 months of age are associated with increased diarrhea morbidity and mortality in developing countries. We estimate the protective effects conferred by varying levels of breastfeeding exposure against diarrhea incidence, diarrhea prevalence, diarrhea mortality, all-cause mortality, and hospitalization for diarrhea illness. We systematically reviewed all literature published from 1980 to 2009 assessing levels of suboptimal breastfeeding as a risk factor for selected diarrhea morbidity and mortality outcomes. We conducted random effects meta-analyses to generate pooled relative risks by outcome and age category. We found a large body of evidence for the protective effects of breastfeeding against diarrhea incidence, prevalence, hospitalizations, diarrhea mortality, and all-cause mortality. The results of random effects meta-analyses of eighteen included studies indicated varying degrees of protection across levels of breastfeeding exposure with the greatest protection conferred by exclusive breastfeeding among infants 0-5 months of age and by any breastfeeding among infants and young children 6-23 months of age. Specifically, not breastfeeding resulted in an excess risk of diarrhea mortality in comparison to exclusive breastfeeding among infants 0-5 months of age (RR: 10.52) and to any breastfeeding among children aged 6-23 months (RR: 2.18). Our findings support the current WHO recommendation for exclusive breastfeeding during the first 6 months of life as a key child survival intervention. Our findings also highlight the importance of breastfeeding to protect against diarrhea-specific morbidity and mortality throughout the first 2 years of life.