使用統合迴歸探討早期餵養對嬰幼兒期過敏性疾病發展的影響

Using Meta-regression to Explore the Impact of Early Feeding on the Development of Allergic Disease in Infants and Early Childhood

劉俐彤(Li-Tong Liu)

指導教授 ： 張玉坤

淡江大學/理學院/數學學系碩士班/碩士(2021年)

https://doi.org/10.6846/TKU.2021.00817

摘要

因此，本研究的目的就是經由蒐集嬰兒早期餵養方式與嬰幼兒發生過敏性疾病相關的文章，再以統合分析中的統合迴歸期望能探究早期餵養方式是否在過敏性疾病的發展中有重要作用。我們同時亦嘗試找出哪些特定的產婦相關因子與發育中嬰兒的免疫系統有關，因而影響過敏性疾病的發生。
　　我們總共蒐集到28篇探討有關早期餵養方式與過敏性疾病相關的文章。其中喘鳴(Wheezing)共有16筆、氣喘(Asthma)有18筆、異位性皮膚炎(Atopy)有35筆、過敏症(Allergic)有22筆。經由統合迴歸分析後發現，早期餵養方式對於過敏性疾病的發展是有一定的影響力。但餵養方式對不同過敏指標有不一樣的結果，其中早期嬰兒的餵養方式會影響嬰幼兒發生“氣喘”過敏性指標的風險，純配方奶餵養因資料過少而無法判斷。進一步分析發現，經調整發表年代與父母任一有過敏性疾病史所佔百分比因素效應後，早期用混和方式餵養的嬰幼兒發生氣喘之風險比純母乳餵養嬰幼兒發生氣喘之風險來的高。而影響過敏性疾病的主要產婦相關因素有:發表年代、性別、母親懷孕抽菸、二手菸...等因子。

關鍵字

統合迴歸 ； 過敏性疾病 ； 嬰幼兒早期餵養

並列摘要

We generally believe that breastfeeding is the most suitable way to provide infant nutrition. The World Health Organization also urges people to feed their babies with exclusively breast milk for at least six months. However, along with the rapid progress in medicine and society, there were some studies showed that exclusive breastfeeding is a risk factor for allergic diseases in infants and young children.
Accordingly, the purpose of this study is to collect articles about the relationship between the infant’s early feeding methods and the allergic diseases. And then, using the meta analyses and/or meta regression to explore whether infant’s early feeding methods play an important role in the development of allergic diseases. We also try to find out which specific maternal-related factors are related to the baby’s immune system and affecting the occurrences of allergic diseases.
We collected a total of 28 published articles explored the relationship between infant’s early feeding and development of allergic diseases. Among them, there were 16 papers related to wheezing, 18 papers related to asthma, 35 papers related to atopy, and 22 papers related to Allergic. The results of meta regressions showed that early feeding methods have a certain influence on the development of allergic diseases. However, for different allergy indicators, the impacts of feeding methods were different. Among them, the early infant feeding method will affect the risk of "asthma" in infants and young children. The impact of exclusive formula milk feeding was not conclusive due to too little data. The results of further analysis showed that, after adjusting for the effects of publication year and the percentage of any parent with a history of allergic diseases, the risk of asthma in mixed feeding infants is higher than that in infants fed exclusively breast milk. The maternal-related factors that affecting the development of allergic diseases were: publication year, gender, smoking during pregnancy, passive smoking, …et al.

並列關鍵字

Mata-regression ； Allergic diseases ； early infant feeding

參考文獻

1. Arshad SH, Matthews S, Gant C, Hide DW. Effect of allergen avoidance on development of allergic disorders in infancy. Lancet 1992; 339:1493–1497.

2. Bergmann RL, Diepgen TL, Kuss O et al. Breastfeeding duration is a risk factor for atopic eczema. Clin Exp Allergy 2002; 32:205–9.

3. Burgess SW, Dakin CJ, O’Callaghan MJ. Breastfeeding does not increase the risk of asthma at 14 years. Pediatrics 2006; 117:e787–92.

4. Chandra RK. Five-year follow-up of high-risk infants with family history of allergy who were exclusively breast-fed or fed partial whey hydrolysate, soy, and conventional cow’s milk formulas. J Pediatr Gastroenterol Nutr 1997; 24:380–388.

5. Chen H-Y, Chang Y-C (2014), “Meta-Analysis of Stratus OCT Glaucoma Diagnostic Accuracy”, Optometry and Vision Science, V91 (n.9, Sep.), p.1129-1139.