Association between preterm birth and maternal allergy considering IgE level
Association between preterm birth and maternal allergy considering IgE level
复制标题
DOI：
10.1111/ped.14635
复制
发表时间：
2021-07-14
影响因子：
1.4
通讯作者：
Yamagata, Zentaro
中科院分区：
文献类型：
--
作者：
Kojima, Reiji;Yokomichi, Hiroshi;Yamagata, Zentaro
本研究的目的是通过不同的总免疫球蛋白E （IgE）水平来探讨母亲过敏与早产之间的关系。研究使用了来自日本环境与儿童研究的81791名孕妇的数据，这是一个前瞻性的出生队列研究。母亲的过敏性疾病，包括支气管哮喘（BA）、特应性皮炎（AD）和变应性鼻炎（AR）病史，通过自我填写的问卷获得。在妊娠早期测量血清总IgE水平，并分析医疗记录的产科结果。通过logistic回归检验产妇过敏性疾病与产科结局(包括先兆流产、早产、早期早产（22-33周）和晚期早产（34-36周）之间的关系。按IgE水平进行亚组分析。母体BA和AR与先兆流产和早产风险增加相关，但总IgE水平高与早产风险降低相关。总IgE水平在过敏性疾病与先兆流产和早产之间的相关性差异不大。虽然过敏性疾病和早产之间没有显著关联，但如果总IgE高，AR与早期早产风险降低显著相关（调整优势比为0.60；95%可信区间为0.43-0.86）。有显著证据表明，总IgE水平存在差异（AD和AR对早期早产影响的相互作用的p值分别为0.039和0.015）。过敏对早产的影响可能因总IgE水平而异。
The aim of this study was to explore the association between maternal allergies and preterm birth by different total immunoglobulin E (IgE) levels. Data of 81 791 pregnant women from the Japan Environment and Children's Study, a prospective birth cohort, were used. Maternal allergic diseases, including a history of bronchial asthma (BA), atopic dermatitis (AD), and allergic rhinitis (AR), were obtained by self-administered questionnaires. Total serum IgE levels were measured at the first trimester and obstetrical outcomes from medical records transcripts were analyzed. The association between maternal allergic disease and obstetric outcome, including threatened abortion, preterm labor, early preterm birth (22-33 weeks), and late preterm birth (34-36 weeks), were examined by logistic regression. Subgroup analyses were performed by IgE level. Maternal BA and AR were associated with an increased risk of threatened abortion and preterm labor, but high total IgE level was associated with a decreased risk of preterm labor. There was little difference in associations between allergic disease and threatened abortion and preterm labor by total IgE levels. Although there was no significant association between allergic disease and preterm birth, if total IgE was high, AR was significantly associated with a decreased risk of early preterm birth (adjusted odds ratio, 0.60; 95% confidence interval 0.43-0.86). There was significant evidence for differences associated with total IgE levels (P-values for the interaction of the effects of AD and AR on early preterm birth were 0.039 and 0.015, respectively). The effect of allergy on preterm birth might differ depending on the total IgE level.