Effect of BF at the time of gluten introduction on the development of CD
| Reference | Number of infants/children enrolled | Effect of BF during gluten introduction | Effect size | GRADE score | Bias risk |
|---|---|---|---|---|---|
| Retrospective studies | |||||
| Fälth-Magnusson et al19 | Biopsy-proven CD=72 controls=264 | Protective | OR 0.35 (95% CI 0.17 to 0.66) | 2 | High |
| Ascher et al20 | 85 (8 found to have silent CD at biopsy) | None | NS | 2 | High |
| Peters et al23 | Biopsy-proven CD=143 controls=137 | Protective | OR 0.46 (95% CI 0.27 to 0.78) | 1 | High |
| Prospective studies | |||||
| Ivarsson et al21 | Biopsy-proven CD=627 controls=1254 | Protective | OR 0.55 (95% CI 0.4 to 0.77) | 2 | High |
| Norris et al15 | 1560 (51 developed CD autoimmunity*) | None | OR=1.32 (95% CI 0.76 to 2.28) | 3 | Medium |
| Størdal et al26 | Biopsy-proven CD=324 controls=81 834 | None | BF >1 months after introduction OR 1.17 (95% CI 0.74 to 1.87) BF <1 months after introduction OR 0.65 (95% CI 0.37 to 1.14) | 3 | High |
| Vriezinga et al13 | 944 (105 developed CD autoimmunity,* out of them 77 biopsy-proven overt CD) | None | OR=1.35 (95% CI 0.57 to 4.1) | 4 | Low |
| Lionetti et al12 | 832 (117 developed CD autoimmunity,* out of them 86 biopsy-proven overt CD) | One | CD autoimmunity OR=1.5 (95% CI 0.77 to 3.0) Overt CD OR=1 (95% CI 0.6 to 2.3) | 4 | Low |
| Aronsson et al16 | 6434 (773 developed autoimmunity,* 307 overt biopsy-proven CD) | None | Overt CD OR=1.13 (95% CI 0.88 to 1.46) | 3 | Medium |
*Outcome of CD autoimmunity has been considered the serological positivity of tTG antibodies.
BF, breast feeding; CD, celiac disease; NS, not significant; tTG, tissue transglutaminase.