Breastfeeding During Infancy Is Associated With a Lower Future Risk of Pediatric Multiple Sclerosis
Breastfeeding During Infancy Is Associated With a Lower Future Risk of Pediatric Multiple Sclerosis
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DOI：
10.1016/j.pediatrneurol.2017.09.007
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发表时间：
2017-12-01
影响因子：
3.8
通讯作者：
Goldman, Myla D.
中科院分区：
文献类型：
--
作者：
Brenton, J. Nicholas;Engel, Casey E.;Goldman, Myla D.
背景：多发性硬化（MS）的风险受环境和遗传因素的影响。婴儿母乳喂养似乎对一些儿童自身免疫性疾病有保护作用，但其对儿童MS风险的影响尚不清楚。本研究的目的是分析母乳喂养在婴儿期对未来的儿童发病MS的风险的关联。基本程序：36个连续的儿童发病MS患者的生物学母亲完成了一份调查问卷的母乳喂养史和各种出生和人口统计学因素。对照组包括72名在入组前12个月内诊断为偏头痛且脑磁共振成像正常的健康患者。使用治疗权重的逆概率来减少选择偏倚并平衡母乳喂养和非母乳喂养儿童之间的协变量。主要发现：两组的人口统计学（体重指数除外）和出生因素无显著差异。而36%的病例是母乳喂养，71%的对照是母乳喂养（P = 0.001）。病例组母乳喂养的中位持续时间为0周（范围：0至40周），对照组为16周（范围：0至216周）。缺乏婴儿母乳喂养与未来诊断为儿童发病MS相关（比值比= 4.43; 95%置信区间，1.68至11.71; P = 0.003）。在校正协变量（如体重指数和诊断时的年龄）后，这种关联仍然显著。结论：这些数据表明，婴儿母乳喂养的缺乏与儿童发病MS诊断的风险增加有关。
BACKGROUND: Risk of multiple sclerosis (MS) is influenced by environment and genetics. Infant breastfeeding appears protective against some childhood autoimmune disorders, but its impact on risk of MS in childhood is unknown. The objective of this study is to analyze the association of breastfeeding in infancy on future risk of pediatric onset MS. BASIC PROCEDURES: Biological mothers of 36 consecutive pediatric-onset MS patients completed a questionnaire on history of breastfeeding and various birth and demographic factors. The control group consisted of 72 otherwise healthy patients with a diagnosis of migraine and normal brain magnetic resonance imaging obtained less than 12 months before enrollment. Inverse probability of treatment weighting was used to reduce selection bias and balance the covariates between breastfed and non-breastfed children. MAIN FINDINGS: Demographics (with the exception of body mass index) and birth factors were not significantly different between groups. Whereas 36% of cases were breastfed, 71% of controls were breastfed (P = 0.001). The median duration of breastfeeding was 0 weeks (range: 0 to 40 weeks) for cases and 16 weeks (range: 0 to 216 weeks) for controls. Lack of infant breastfeeding was associated with future diagnosis of pediatric-onset MS (odds ratio = 4.43; 95% confidence interval, 1.68 to 11.71; P = 0.003). This association remained significant after correcting for covariates, such as body mass index and age at diagnosis. CONCLUSIONS: These data demonstrate that absence of infant breastfeeding has an association with an increased risk of pediatric-onset MS diagnosis.