母乳喂养对妊娠期糖尿病母亲子代儿童期超重的影响

目的：通过对妊娠期糖尿病（GDM）母亲子代的随访，探讨母乳喂养是否可以降低GDM子代发生超重的风险性。方法：对2003年1月至2009年12月GDM母亲子代1189例进行随访，采用logistic回归分析出生后0～3月母乳喂养方式及母乳喂养持续时间对GDM子代超重发生风险的影响。结果：在对孕前BMI、孕期增重、孕期血糖水平、性别、出生体重、年龄及父亲体重等混杂因素进行校正后，0～3月纯母乳喂养组GDM子代儿童期超重发生风险低于人工喂养组（OR：0.479，95%CI：0.256～0.897）；接受0～3月母乳喂养、4～6月母乳喂养及大于6月母乳喂养GDM子代儿童期超重发生风险均低于人工喂养组（分别OR：0.456，95%CI：0.233～0.827；OR：0.29，95%CI：0.103～0.817；OR：0.534，95%CI：0.280～0.970）；接受4～6月母乳喂养GDM子代儿童期超重发生风险低于0～3月母乳喂养组（OR：0.372，95%CI：0.129～0.874）；而接受母乳喂养时间<6月与接受母乳喂养时间≥6月与GDM子代儿童期超重发生风险无相关性（OR：0.769，95%CI：0.4701～1.258）。结论：出生后0～3月母乳喂养，尤其是纯母乳喂养可以降低GDM子代发生超重的风险，且在出生后6月内，随着母乳喂养时间的增加，GDM子代超重发生风险降低，而出生6月以后，延长母乳喂养时间可能并不能降低超重的发生风险。

Effect of breastfeeding on childhood overweight in the offspring of mothers with gestational diabetes mellitus

Objective To investigate whether breastfeeding can reduce the risk of childhood overweight in the offspring of mothers with gestational diabetes mellitus(GDM).Methods Follow-up was performed on 1189 offspring of mothers with GDM between January 2003 and December 2009.The influence of the manner and duration of breastfeeding between 0 to 3 months after birth on the risk of childhood overweight in the offspring of mothers with GDM was analyzed by logistic regression.Results After correcting confounding factors such as pre-pregnancy BMI,gestational weight gain,gestational blood sugar,sex,birth weight,age and farther′s body weight,it was found that the risk of childhood overweight in the offspring who received exclusive breastfeeding during the first 3 months after birth was lower than in the artificial feeding group(OR: 0.479,95%CI:0.256-0.897).Offspring who were breastfed for 0 to 3 months,4 to 6 months and over 6 months had a lower risk of childhood overweight than the artificial feeding group(OR: 0.456,95%CI:0.233-0.827;OR: 0.29,95%CI: 0.103-0.817;OR: 0.534,95%CI: 0.280-0.970),offspring who were breastfed for 4 to 6 months had a lower risk of childhood overweight than those who were breastfed for 0 to 3 months(OR: 0.372,95%CI : 0.129-0.874),and offspring who were breastfed for more than 6 months did not show significantly lower risk of overweight than those who were breastfed for less than 6 months(OR: 0.769,95%CI: 0.470-1.258).Conclusions Within 3 months of birth,breastfeeding,especially exclusively,may reduce the risk of childhood overweight in the offspring of mothers with GDM.Within 6 months of birth,the risk of childhood overweight decreases as the duration of breastfeeding increases,but prolonging the duration of breastfeeding cannot necessarily reduce the risk of childhood overweight after postnatal six months.