Prenatal antibiotic use, caesarean delivery and offspring's food protein‐induced enterocolitis syndrome: A National Birth Cohort ( <scp>JECS</scp> )
Prenatal antibiotic use, caesarean delivery and offspring's food protein‐induced enterocolitis syndrome: A National Birth Cohort ( <scp>JECS</scp> )
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产前抗生素使用、剖腹产和后代食物蛋白诱发的小肠结肠炎综合征：全国出生队列 ( <scp>JECS</scp> )
DOI：
10.1111/cea.14286
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Ohya Yukihiro
中科院分区：
文献类型：
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作者：
Yamamoto‐Hanada Kiwako;Pak Kyongsun;Saito‐Abe Mayako;Sato Miori;Miyaji Yumiko;Mezawa Hidetoshi;Nishizato Minaho;Yang Limin;Kumasaka Natushiko;Nomura Ichiro;Ohya Yukihiro
致编辑：食物蛋白诱导的小肠结肠炎综合征（FPIES）是一种非免疫球蛋白E （IgE）介导的胃肠道食物超敏反应，表现为呕吐、腹泻，导致急性脱水、低血容量性休克和嗜睡，或持续腹泻和/或间歇性呕吐，导致体重减轻，慢性期发育不良。1 FPIES患病率可能有所增加，2但围产期FPIES的危险因素尚未得到很好的记录。Katz等人发现，由牛奶引起的婴儿FPIES在剖腹产中比阴道分娩更常见。他们没有检查牛奶以外的其他诱因。此外，其他因素尚未报道。FPIES是一种胃肠道疾病，因此疾病主要集中在胃肠道器官。我们假设肠道调节因素，如母体乳酸菌的摄入、酸奶的摄入、抗生素的使用和产前剖腹产可能会影响出生后婴儿FPIES的发生。这项一般出生队列研究是一项全国性、多中心、前瞻性研究：日本环境与儿童研究（JECS） 4，由日本环境省资助。从2011年1月到2014年3月，我们招募了103060名孕妇和51239名参与研究的父亲。入选标准如下：(1)孕妇；(2)在可预见的未来居住在研究区域；(3)预计在2011年8月1日至2014年中期交付；(4)理解日语的能力。在JECS中总共登记了104,062份记录/胎儿记录。照顾者回答了关于怀孕期间的孩子和家庭以及1、6和18个月大的孩子的问卷。我们提取了与产前期相关的医疗图表信息。对于孕妇在孕期的用药情况，我们在孕期进行了面对面的访谈。研究项目办公室负责数据管理。本研究使用了2019年10月发布的固定数据集“jecs-ta-201901930”，包括病历记录数据、实验室数据和问卷调查数据。JECS的注册是大学医院医疗信息网（UMIN000030786）。JECS是根据日本涉及人体受试者的医学和健康研究伦理准则进行的。JECS方案由环境部流行病学研究机构审查委员会和所有参与机构的伦理委员会发布并批准。100910001)。我们获得了所有参与者的书面知情同意书。我们评估了婴儿FPIES发作、急性FPIES的累积患病率，以及18个月时由护理人员问卷回答的FPIES护理人员报告5作为本研究的结果变量。我们评估了母体乳酸菌摄入量、酸奶摄入量、抗生素使用、产前剖宫产作为暴露变量。我们使用经过验证的日本版食物频率问卷（FFQ） 6在妊娠中期/晚期（MT2）对母体乳酸菌摄入量和酸奶摄入量进行调查。对于怀孕期间的乳酸菌摄入量和怀孕期间的酸奶摄入量，计算了整个人群摄入频率的每个变量的四分位数，并使用了新的变量，低于第一个四分位数（25% ile）点的摄入类别为0，高于第一个四分位数的摄入类别为1。产前抗生素使用是通过孕妇在怀孕期间的访谈和医疗记录转录确定的。
To the Editor, Food protein-induced enterocolitis syndrome (FPIES) is a nonimmunoglobulin E (IgE) mediated gastrointestinal food hypersensitivity that manifests as vomiting, diarrhoea, leading to dehydration, hypovolemic shock and lethargy in the acute setting, or continuous diarrhoea and/or intermittent vomiting, leading to weight loss, failure to thrive in the chronic phase. 1 FPIES prevalence may have increased, 2 but risk factors for FPIES during the perinatal period have not been well documented yet. Katz et al. 3 found infant FPIES caused by cow's milk was more common with caesarean than vaginal delivery. They did not examine other triggers except cow's milk. Furthermore, other factors have not been reported. FPIES is a gastrointestinal disorder, so the disease is focused on the gastrointestinal organ. We hypothesized that gut modulating factors such as maternal lactic acid bacteria intake, yogurt intake, antibiotic use and caesarean delivery during the prenatal period might affect the consequent onset of infant FPIES after birth. This general birth cohort was a national, multicentre, prospective study: the Japan Environment and Children's Study (JECS) 4 funded by the Ministry of the Environment, Japan. We enrolled a general population of 103,060 pregnancies and 51,239 pregnancies with participating fathers from January 2011 to March 2014. Eligibility criteria were as follows:(1) currently pregnant;(2) living in the Study Area for the foreseeable future;(3) expected delivery between 1 August 2011 and mid-2014; and (4) ability to understand the Japanese language. In total, 104,062 records/foetal records were enrolled in the JECS. Caregivers answered questionnaires regarding their child and family during pregnancy and children aged 1, 6 and 18 months. We extracted medical chart information related to the prenatal period. For maternal medication use during the prenatal period, we had an interview face to face during the pregnancy. The study Programme Office performed the data management. The present study used the fixed data set “jecs-ta-201901930,” released in October 2019, including medical record transcriptions data, laboratory data and questionnaire data. The registry of the JECS is the University Hospital Medical Information Network (UMIN000030786). The JECS was conducted based on the Ethical Guidelines for Medical and Health Research Involving Human Subjects in Japan. The JECS protocol was released and approved by the Ministry of the Environment'sInstitutional Review Board on Epidemiological studies and the Ethics Committees of all participating institutions (no. 100910001). We obtained written informed consent from all participants. We assessed the cumulative prevalence of infant's FPIES episode, acute FPIES, and FPIES caregiver's report at 18 months answered by caregiver's questionnaires 5 as the outcome variables for this study. We evaluated maternal lactic acid bacteria intake, yogurt intake, antibiotic use, caesarean delivery during the prenatal period as the exposure variables. We used the validated Japanese version Food Frequency Questionnaire (FFQ) 6 during the second/third trimester (MT2) for maternal lactic acid bacteria intake and yogurt intake. For Lactobacillus intake during pregnancy and yogurt intake during pregnancy, the quartile points of each variable for frequency of intake were calculated for the entire population analysed, and the new variables were used, with 0 for intake categories below the first quartile (25% ile) point and 1 for intake categories above the first quartile point. Prenatal antibiotic use was identified from the maternal interview during pregnancy and medical record transcriptions …