Front Immunol. 2026 Jul 27;17:1886428. doi: 10.3389/fimmu.2026.1886428. eCollection 2026.
ABSTRACT
OBJECTIVE: This study aims to investigate the impact of different feeding patterns and Mycoplasma pneumoniae (MP) infection on coronary artery lesions (CAL) in children with Kawasaki disease (KD), particularly analyzing whether breastfeeding retains a protective effect against CAL in patients co-infected with MP.
METHODS: A retrospective cohort study was performed, recruiting 388 children diagnosed with KD between January 2020 and January 2025. The participants were categorized into three groups according to feeding status in the first 6 months of life: exclusive breastfeeding (n = 222), partial breastfeeding (n = 76), and formula feeding (n = 90). Of all 388 patients, 88 were MP-positive, and 56 had echocardiography-confirmed CAL. Clinical characteristics and CAL incidence were compared across feeding subgroups. Multivariate logistic regression was applied to assess interaction effects between feeding patterns and MP infection on the risk of CAL development.
RESULTS: Significant intergroup differences were detected in age, proportion of incomplete KD (iKD), and erythrocyte sedimentation rate (ESR) (P < 0.05). The overall CAL incidence was 14.4% (56/388), with no intergroup difference (P = 0.503). Platelet count was identified as an independent risk factor for CAL development (OR = 1.357, 95% CI 1.082-1.702, P = 0.008, per 100 × 109/L increment). Multivariate logistic regression analysis did not reveal a significant interaction between feeding method and MP infection. Within the MP-positive subgroup (n = 88, 14 CAL events), no statistically significant difference in CAL risk was identified between the combined exclusive and partial breastfeeding and formula feeding groups.
CONCLUSION: Among MP-positive KD children in this cohort, we detected no statistically significant inverse association between breastfeeding and CAL risk (OR = 0.906, 95% CI 0.225-3.649). The wide confidence interval reflects considerable statistical uncertainty attributable to the small number of CAL events in this subgroup; therefore, a clinically meaningful protective effect of breastfeeding cannot be ruled out.
PMID:42577342 | PMC:PMC13454092 | DOI:10.3389/fimmu.2026.1886428
