Protective effect of breastfeeding on Kawasaki disease: A systemic review and meta-analysis

IF 2.3 4区医学 Q2 PEDIATRICS Pediatrics and Neonatology Pub Date : 2024-09-01 DOI:10.1016/j.pedneo.2024.03.001

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Abstract

Background

Previous research has indicated a negative correlation between exclusive breastfeeding and the incidence of Kawasaki disease (KD). However, the validation of this discovery through meta-analytical studies has been lacking. Furthermore, uncertainties persist regarding whether breastfeeding reduces the risk of coronary artery lesions (CAL) or resistance to intravenous immunoglobulin (IVIG).

Methods

A systematic exploration of the MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, and ClinicalTrials.gov databases was conducted to identify longitudinal or randomized controlled trials investigating the efficacy of breastfeeding in preventing KD. The primary focus was on the incidence of KD, with secondary emphasis placed on the incidence of CAL and IVIG resistance. Data were pooled using a frequentist-restricted maximum-likelihood random-effects model.

Results

Of the 179 potentially eligible studies identified, five (n = 1,982,634) were included. The analysis revealed a significantly lower risk of KD (expressed as odds ratio, with 95% confidence intervals and p-values) in comparisons between exclusive breastfeeding and formula feeding (0.62, 0.43−0.91, p = 0.014), exclusive breastfeeding/partial breastfeeding and formula feeding (0.66, 0.46− 0.96, p = 0.03), and exclusive breastfeeding and partial breastfeeding/formula feeding (0.81, 0.74− 0.90, p < 0.01). However, no significant difference was observed in the risk of developing KD when comparing partial breastfeeding to formula feeding exclusively. Regarding secondary outcomes, no statistically significant difference was found in the risk of CAL or IVIG resistance across any comparison formats.

Conclusions

Our study suggests that breastfeeding correlated with a reduced risk of KD but not with a reduced risk of CAL or IVIG resistance. These findings advocate for the implementation of breastfeeding policies in clinical practice.

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母乳喂养对川崎病的保护作用：系统回顾与荟萃分析。

背景以前的研究表明，纯母乳喂养与川崎病（KD）的发病率呈负相关。然而，这一发现尚未通过荟萃分析研究得到验证。此外，关于母乳喂养是否会降低冠状动脉病变（CAL）的风险或对静脉注射免疫球蛋白（IVIG）的抵抗力，仍存在不确定性。方法：对MEDLINE、Cochrane对照试验中央注册中心（CENTRAL）、PubMed、EMBASE和ClinicalTrials.gov数据库进行了系统性探索，以确定调查母乳喂养对预防KD疗效的纵向或随机对照试验。试验的主要重点是 KD 的发病率，其次是 CAL 和 IVIG 抗药性的发病率。结果在确定的 179 项可能符合条件的研究中，有 5 项（n=1,982,634）被纳入。分析结果显示，在纯母乳喂养和配方奶粉喂养（0.62，0.43-0.91，p = 0.014）、纯母乳喂养/部分母乳喂养和配方奶粉喂养（0.66，0.46- 0.96，p = 0.03）以及纯母乳喂养和部分母乳喂养/配方奶粉喂养（0.81，0.74- 0.90，p <0.01）之间的比较中，KD风险明显较低（以几率比表示，含95%置信区间和p值）。然而，部分母乳喂养与完全配方奶喂养相比，患 KD 的风险没有明显差异。结论我们的研究表明，母乳喂养与 KD 风险的降低有关，但与 CAL 或 IVIG 耐药风险的降低无关。这些发现提倡在临床实践中实施母乳喂养政策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatrics and Neonatology PEDIATRICS-

CiteScore

3.10

自引率

0.00%

发文量

170

审稿时长

48 days

期刊介绍： Pediatrics and Neonatology is the official peer-reviewed publication of the Taiwan Pediatric Association and The Society of Neonatology ROC, and is indexed in EMBASE and SCOPUS. Articles on clinical and laboratory research in pediatrics and related fields are eligible for consideration.