母乳喂养可降低直至青年期的哮喘发病及IgE致敏风险：瑞典BAMSE队列近4000人纵向研究
2026/03/10
摘要
背景：探讨母乳喂养与哮喘及过敏反应关联性的研究，随访至成年期的证据仍较为不足。
目的：基于瑞典BAMSE纵向队列，探讨纯母乳喂养时长与直至青年期的哮喘发生及免疫球蛋白E（IgE）致敏状态之间的关联。
方法：共纳入3919名具有1岁时母乳喂养问卷数据的参与者。哮喘诊断依据截至24岁的纵向问卷数据确定。血IgE检测分别于4岁、8岁、16岁和24岁进行。采用广义估计方程进行纵向统计分析。
结果：纯母乳喂养≥4个月与24岁前的哮喘患病风险整体降低相关（校正比值比（ORadj）0.75；95% 置信区间（CI）0.64-0.87）。年龄分层分析显示，该保护性关联在12岁前具有统计学意义，但12岁后不再显著。进一步根据哮喘的发病年龄及病程进行表型分析发现，纯母乳喂养≥4个月与早发一过性哮喘呈临界显著性负相关（ORadj = 0.77; 95% CI, 0.58-1.04），与持续性哮喘呈显著负相关（ORadj 0.64；95% CI 0.48-0.84），但与迟发性哮喘无显著关联。此外，母乳喂养亦与IgE致敏总体风险降低相关（ORadj 0.82；95% CI 0.70-0.96）。排除486名在母乳喂养期间出现过喘息和/或湿疹早期症状的儿童后，上述关联均有所增强。
结论：纯母乳喂养≥4个月可降低12岁前的哮喘发生风险及青年前的IgE致敏风险。
关键词：出生队列；母乳喂养；纵向分析
Background: Few studies have investigated the association between breastfeeding and asthma and allergy up to adulthood.
Objective: To examine the development of asthma and immunoglobulin E (IgE) sensitisation up to young adulthood in relation to duration of exclusive breastfeeding in a longitudinal cohort up .
Methods: The study population encompassed participants from a Swedish birth cohort with questionnaire data on breastfeeding at age 1 year (n=3,919). Asthma was based on questionnaire data up to age 24 years. Blood sampling for IgE analyses was performed at 4, 8, 16, and 24 years. Longitudinal analyses were performed with generalised estimating equations.
Results: Exclusive breastfeeding for ≥4 months was associated with overall reduced odds of prevalent asthma up to age 24 years (adjusted odds ratio (ORadj) 0.75, 95% confidence interval (CI) 0.64-0.87). Age-specific analyses showed a statistically significant inverse association with asthma up to age 12 years, but not thereafter. Analysing asthma phenotypes over time resulted in a borderline significant inverse association with early transient asthma and a significant inverse association with persistent asthma (ORadj0.64, 95% CI 0.48-0.84). However, there was no association with late onset asthma. Breastfeeding was overall also inversely associated with IgE sensitisation (ORadj0.82, 95% CI 0.70-0.96). Exclusion of children with early symptoms of wheeze and/or eczema during breastfeeding (n=486), strengthened the associations for both asthma and sensitisation.
Conclusions: Exclusive breastfeeding for ≥4 months was inversely associated with asthma, in particular with disease onset the first 12 years of life, as well as IgE sensitisation up to young adulthood.
Keywords: birth cohort; breastfeeding; longitudinal analysis.
背景：探讨母乳喂养与哮喘及过敏反应关联性的研究，随访至成年期的证据仍较为不足。
目的：基于瑞典BAMSE纵向队列，探讨纯母乳喂养时长与直至青年期的哮喘发生及免疫球蛋白E（IgE）致敏状态之间的关联。
方法：共纳入3919名具有1岁时母乳喂养问卷数据的参与者。哮喘诊断依据截至24岁的纵向问卷数据确定。血IgE检测分别于4岁、8岁、16岁和24岁进行。采用广义估计方程进行纵向统计分析。
结果：纯母乳喂养≥4个月与24岁前的哮喘患病风险整体降低相关（校正比值比（ORadj）0.75；95% 置信区间（CI）0.64-0.87）。年龄分层分析显示，该保护性关联在12岁前具有统计学意义，但12岁后不再显著。进一步根据哮喘的发病年龄及病程进行表型分析发现，纯母乳喂养≥4个月与早发一过性哮喘呈临界显著性负相关（ORadj = 0.77; 95% CI, 0.58-1.04），与持续性哮喘呈显著负相关（ORadj 0.64；95% CI 0.48-0.84），但与迟发性哮喘无显著关联。此外，母乳喂养亦与IgE致敏总体风险降低相关（ORadj 0.82；95% CI 0.70-0.96）。排除486名在母乳喂养期间出现过喘息和/或湿疹早期症状的儿童后，上述关联均有所增强。
结论：纯母乳喂养≥4个月可降低12岁前的哮喘发生风险及青年前的IgE致敏风险。
关键词：出生队列；母乳喂养；纵向分析
(南方医科大学南方医院 倪钰 陈颖 赵海金）
（Inger Kull , Maria Ödling et al.Breastfeeding is inversely associated with asthma and IgE sensitisation up to young adulthood. J Allergy Clin Immunol.2026 Jan 20:S0091-6749(26)00007-2. doi: 10.1016/j.jaci.2025.12.1011.）
Abstract（Inger Kull , Maria Ödling et al.Breastfeeding is inversely associated with asthma and IgE sensitisation up to young adulthood. J Allergy Clin Immunol.2026 Jan 20:S0091-6749(26)00007-2. doi: 10.1016/j.jaci.2025.12.1011.）
Background: Few studies have investigated the association between breastfeeding and asthma and allergy up to adulthood.
Objective: To examine the development of asthma and immunoglobulin E (IgE) sensitisation up to young adulthood in relation to duration of exclusive breastfeeding in a longitudinal cohort up .
Methods: The study population encompassed participants from a Swedish birth cohort with questionnaire data on breastfeeding at age 1 year (n=3,919). Asthma was based on questionnaire data up to age 24 years. Blood sampling for IgE analyses was performed at 4, 8, 16, and 24 years. Longitudinal analyses were performed with generalised estimating equations.
Results: Exclusive breastfeeding for ≥4 months was associated with overall reduced odds of prevalent asthma up to age 24 years (adjusted odds ratio (ORadj) 0.75, 95% confidence interval (CI) 0.64-0.87). Age-specific analyses showed a statistically significant inverse association with asthma up to age 12 years, but not thereafter. Analysing asthma phenotypes over time resulted in a borderline significant inverse association with early transient asthma and a significant inverse association with persistent asthma (ORadj0.64, 95% CI 0.48-0.84). However, there was no association with late onset asthma. Breastfeeding was overall also inversely associated with IgE sensitisation (ORadj0.82, 95% CI 0.70-0.96). Exclusion of children with early symptoms of wheeze and/or eczema during breastfeeding (n=486), strengthened the associations for both asthma and sensitisation.
Conclusions: Exclusive breastfeeding for ≥4 months was inversely associated with asthma, in particular with disease onset the first 12 years of life, as well as IgE sensitisation up to young adulthood.
Keywords: birth cohort; breastfeeding; longitudinal analysis.
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