Mode of delivery and risk of allergic rhinitis and asthma
Mode of delivery and risk of allergic rhinitis and asthma
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DOI：
10.1067/mai.2003.34
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发表时间：
2003-01-01
影响因子：
14.2
通讯作者：
Westergaard, T
中科院分区：
文献类型：
--
作者：
Bager, P;Melbye, M;Westergaard, T
背景：假设剖宫产可能通过剥夺胎儿和新生儿接触母体微生物群的机会而增加发生过敏性疾病的风险。此外，有人认为复杂的分娩方式可能与哮喘风险增加有关。目的：本研究的目的是研究剖宫产和其他复杂的分娩方式是否与变应性鼻炎或哮喘风险增加有关。方法：从1973-1977年期间出生在丹麦的9722名参加1997-2001年国家队列研究的单胎妇女中获得有关自报过敏性鼻炎、曾经哮喘、目前哮喘和职业的信息。这些妇女的分娩方式（自然分娩、剖宫产、真空抽吸或其他复杂的分娩方式，如旋转/牵引或使用产钳）、胎龄、出生体重和出生时体长的信息可从丹麦出生医疗登记册获得。关于胎次和产妇年龄的资料来自丹麦民事登记系统。结果：与自然分娩相比，剖宫产变应性鼻炎的优势比（ORs）为1.16 (95% Cl, 0.90 ~ 1.49)，其他复杂分娩方式的优势比为1.06 （95% Cl, 0.85 ~ 1.32）。剖宫产及其他复杂分娩方式的哮喘与自然分娩相比，其相应的or分别为1.33 （95% Cl, 1.02-1.74）和1.18 (95% CI, 0.94-1.49)，当前哮喘与自然分娩相比的or分别为1.22 （95% Cl, 0.87-1.73）和1.26 （95% Cl, 0.94-1.68）。结论：我们的研究结果不支持剖宫产或其他复杂分娩方式与变应性鼻炎发生有关的假设。然而，这可能与哮喘的发生呈正相关，尤其是剖宫产，这不能用胎龄、出生体重、体重指数、胎次、母亲年龄或职业来解释。
Background: It has been hypothesized that cesarean section might increase the risk of developing allergic disease by depriving the fetus and newborn of exposure to maternal microflora. Furthermore, it has been suggested that complicated modes of delivery might be associated with an increased risk of asthma.Objective: The purpose of this investigation was to study whether cesarean section and other complicated modes of delivery are associated with an increased risk of allergic rhinitis or asthma.Methods: Information on self-reported allergic rhinitis, asthma ever, current asthma, and occupation was obtained from 9722 singleton women born in Denmark during the period 1973-1977 who participated in a national cohort study during the period 1997-2001. For these women, information was available on mode of delivery (spontaneous delivery, cesarean section, vacuum extraction, or other complicated mode of delivery, such as rotation/traction or use of forceps), gestational age, birth weight, and length at birth from the Danish Medical Birth Register. Information on parity and maternal age was obtained from the Danish Civil Registration System.Results: The odds ratios (ORs) of allergic rhinitis were 1.16 (95% Cl, 0.90-1.49) for cesarean section and 1.06 (95% Cl, 0.85-1.32) for other complicated modes of delivery in comparison with spontaneous delivery. The corresponding ORs of asthma ever were 1.33 (95% Cl, 1.02-1.74) and 1.18 (95% CI, 0.94-1.49) for cesarean section and other complicated modes of delivery, respectively, and the ORs of current asthma were 1.22 (95% Cl, 0.87-1.73) and 1.26 (95% Cl, 0.94-1.68), respectively, in comparison with spontaneous delivery.Conclusions: Our findings do not support the hypothesis that cesarean section or other complicated modes of delivery are associated with the development of allergic rhinitis. However, there might be a positive association with development of asthma-in particular, for cesarean section-that was not explained by gestational age, birth weight, ponderal index, smallness for gestational age, parity, maternal age, or occupation.