目的 探讨益生菌联合母乳喂养对剖宫产新生儿肠道菌群定植及过敏性疾病发生风险的影响。 方法 前瞻性选取新乡市中心医院2018年1月—2020年1月收治的行剖宫产产妇及新生儿176例，并对新生儿随访5年。根据喂养方式的不同，分为母乳喂养组和联合组（母乳喂养联合益生菌），比较两组随访结果的差异。 结果 母乳喂养组88例，失访13例；联合组88例，失访7例。联合组2岁、3岁、4岁、5岁时粪便中乳酸杆菌、双歧杆菌，以及血免疫球蛋白（immunoglobulin, Ig）A、IgM、IgG水平均高于母乳喂养组（P<0.05）。联合组3岁、4岁、5岁时身高和体重均高于母乳喂养组（P<0.05）。联合组过敏性疾病总发生率低于母乳喂养组（P<0.05）。5岁时，联合组精细运动评分高于母乳喂养组（P<0.05）。多因素logistic回归模型分析结果显示，益生菌联合母乳喂养为剖宫产新生儿发生过敏性疾病的保护因素（OR=0.267，P<0.05），而有过敏性疾病家族史是影响剖宫产新生儿发生过敏性疾病的危险因素（OR=3.611，P<0.05）。 结论 益生菌联合母乳喂养应用于剖宫产新生儿，对新生儿肠道菌群具有积极作用，促进肠道益生菌生长，提高新生儿的免疫力，降低过敏性疾病发生风险。

Objective To investigate the effects of probiotics combined with breastfeeding on intestinal colonization and the risk of allergic diseases in cesarean-delivered newborns. Methods A prospective cohort of 176 cesarean-delivered mothers and newborns admitted to Xinxiang Central Hospital from January 2018 to January 2020 was enrolled, and the newborns were followed for 5 years. According to feeding practice, infants were divided into a breastfed group and a combined group (breastfeeding plus probiotics). Follow-up outcomes were compared between groups. Results Eighty-eight infants were enrolled in each group; 13 were lost to follow-up in the breastfed group and 7 in the combined group. At ages 2, 3, 4, and 5 years, fecal Lactobacillus and Bifidobacterium levels were higher in the combined group than in the breastfed group (P<0.05). Serum immunoglobulin (Ig) A, IgM, and IgG levels were higher in the combined group than in the breastfed group (P<0.05). At ages 3, 4, and 5 years, height and weight were higher in the combined group (P<0.05). The overall incidence of allergic diseases was lower in the combined group than in the breastfed group (P<0.05). At age 5 years, fine motor scores were higher in the combined group (P<0.05). In multivariable logistic regression, the combination of probiotics and breastfeeding was a protective factor for allergic diseases (OR=0.267, P<0.05), whereas family history of allergic diseases was a risk factor (OR=3.611, P<0.05). Conclusions Among cesarean-delivered newborns, the combination of probiotics and breastfeeding positively modulates the gut microbiota, promotes the growth of beneficial bacteria, enhances immunity, and reduces the risk of allergic diseases.