Impaired fetal growth decreases the risk of childhood atopic eczema: a Swedish twin study
Impaired fetal growth decreases the risk of childhood atopic eczema: a Swedish twin study
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DOI：
10.1111/j.1365-2222.2010.03519.x
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发表时间：
2010-07-01
影响因子：
6.1
通讯作者：
Almqvist, C.
中科院分区：
文献类型：
--
作者：
Lundholm, C.;Ortqvist, A. K.;Almqvist, C.
研究发现出生体重与特应性湿疹或过敏性鼻炎（AR）风险之间存在关联，尽管这可能是由于混淆。目的：在控制胎龄（GA）、共享（家族）环境和遗传因素的情况下，我们试图评估胎儿生长与儿童期特应性湿疹或AR风险之间的关系。方法通过对9岁和12岁双胞胎父母的电话采访和登记，收集其特应性湿疹、AR、出生特征和混杂因素等资料。首先，对所有双胞胎（湿疹n=10 132, AR n=10 896）进行队列分析。其次，为了控制遗传和共享环境，对特应性湿疹（n=480）和AR （n=332）不一致的双胞胎进行双双胞胎对照分析。结果异位性湿疹的发生率随出生体重的增加而增加，从出生体重< 2000 g的12.6%增加到出生体重为3500g的17.3%。AR率在7.8% ~ 8.8%之间。在队列分析中，出生体重增加500 g时，特应性湿疹的比值比（OR）为1.62 (95% CI: 1.27-2.06)， AR的比值比为1.00 （95% CI: 0.75-1.33）。在异位性湿疹的双双胞胎对照分析中，出生体重增加500 g时，OR为3.93 (95% CI: 1.55-9.98)，同卵双胞胎和异卵双胞胎之间无显著差异（P=0.84）。结论我们发现胎儿生长与儿童特应性湿疹呈正相关，而非AR，独立于GA，共享环境和遗传因素。这表明胎儿生长影响免疫系统，并支持对早期机制的进一步研究。引自：C. Lundholm， A. K. Ortqvist， P. Lichtenstein， S. Cnattingius和C. Almqvist，临床与实验过敏，2010(40)1044-1053。
P>BackgroundStudies have found associations between birth weight and risk of atopic eczema or allergic rhinitis (AR), although this could be due to confounding.ObjectiveWe sought to evaluate associations between fetal growth and the risk of atopic eczema or AR in childhood, controlling for gestational age (GA), shared (familial) environmental and genetic factors.MethodsData on atopic eczema, AR, birth characteristics and confounders were collected from registers and telephone interviews with the parents of 9- and 12-year-old twins. Firstly, cohort analyses on all twins (eczema n=10 132 and AR n=10 896) were performed. Secondly, to control for genetic and shared environment, co-twin-control analyses were performed in twin pairs discordant for atopic eczema (n=480) and AR (n=332).ResultsThe rate of atopic eczema increased with birth weight, from 12.6% in twin children < 2000 g to 17.3% in children >= 3500 g. The rate of AR varied between 7.8% and 8.8%. In the cohort analyses, the odds ratio (OR) for atopic eczema was 1.62 (95% CI: 1.27-2.06) for 500 g increase in birth weight and 1.00 (95% CI: 0.75-1.33) for AR. In co-twin-control analyses on atopic eczema, OR was 3.93 (95% CI: 1.55-9.98) for 500 g increase in birth weight, with no significant difference between monozygotic and dizygotic twins (P=0.84).ConclusionsWe found a positive association between fetal growth and childhood atopic eczema, but not AR, independent of GA, shared environmental and genetic factors. This indicates fetal growth affects the immune system, and supports further studies on early mechanisms.Cite this as: C. Lundholm, A. K. Ortqvist, P. Lichtenstein, S. Cnattingius and C. Almqvist, Clinical & Experimental Allergy, 2010 (40) 1044-1053.