Prematurity as a risk factor for asthma in preadolescent children.
Prematurity as a risk factor for asthma in preadolescent children.
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早产是青春期前儿童哮喘的危险因素。
DOI：
10.1016/s0022-3476(05)81692-0
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发表时间：
1993
期刊：
影响因子：
--
通讯作者：
Martinez,FD
中科院分区：
文献类型：
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作者：
vonMutius,E;Nicolai,T;Martinez,FD
有关早产儿长期呼吸道症状的信息很少。我们研究了未经选择的9至11岁学龄儿童。向父母分发了一份自填式调查问卷。儿童接受了肺功能测试、冷空气挑战和皮肤刺激性试验。出生体重≤为2500g的儿童胎龄为37周，有5%的父母报告了这一情况。早产女孩有明显更多的当前哮喘(优势比(OR)2.6；95%可信区间(CI)1.4，4.7；P<；0.0 5)，反复喘息(OR 1.7；95%CI 1.1，2.7；P<；0.001)，反复气短(OR 2.4；95%CI 1.5，3.9；P<；0.001)，以及经常运动咳嗽(OR 1.8；95%CI 1.1，2.9；P<；P<；0.05)，特别是如果她们出生后需要机械通风的话。男孩身上则没有这样的差异。需要机械通气的早产儿(OR3.7；95%Cl2.2，6.4；p<；0.0001)比足月出生的儿童有哮喘家族史。早产儿肺功能的不同测量结果可能显示出显著的下降。在多变量回归分析中对混杂因素进行控制后，这些结果仍然显著。在对冷空气和干燥空气的高反应性或特应性致敏方面，两组之间没有发现差异。我们的结论是，哮喘家族史可能使早产儿患上更严重的呼吸道疾病。女孩出现的呼吸道症状和肺功能下降可能反映了严重新生儿呼吸系统疾病幸存者的肺功能异常。
Information on long-term respiratory symptoms in prematurely born children is scanty. We studied an unselected population of 9- to 11-year-old schoolchildren. A self-administered questionnaire was distributed to the parents. Children underwent lung function testing, cold air challenge, and skin prick tests. A gestational age <37 weeks in children with a birth weight ≤2500 gm was reported by 5% of the parents. Premature girls had significantly more current asthma (odds ratio (OR) 2.6; 95% confidence interval (CI) 1.4, 4.7;p<0.05), recurrent wheezing (OR 1.7; 95% Cl 1.1, 2.7;p<0.001), recurrent shortness of breath (OR 2.4; 95% Cl 1.5, 3.9;p<0.001), and frequent cough with exercise (OR 1.8; 95% Cl 1.1, 2.9;p<0.05) than term girls, especially if they required mechanical ventilation after birth. No such differences could be shown in boys. More prematurely born children who required mechanical ventilation (OR 3.7;95% Cl 2.2, 6.4;p<0.0001) had a family history of asthma than children born at term. Significant decrements could be demonstrated for different measurements of lung function in premature girls. These results remained significant after control for confounders in a multivariate regression analysis. No difference was found between groups for bronchial hyperresponsiveness to cold, dry air or for atopic sensitization. We conclude that a family history of asthma may predispose premature children to more severe respiratory disease. Respiratory symptoms and decrements in lung function seen in girls may reflect abnormalities of lung function in survivors of severe neonatal respiratory disease.