Tobacco smoke exposure and allergic sensitization in children: A propensity score analysis
Tobacco smoke exposure and allergic sensitization in children: A propensity score analysis
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DOI：
10.1111/j.1440-1843.2012.02201.x
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发表时间：
2012-10-01
期刊：
影响因子：
6.9
通讯作者：
Wegienka, Ganesa
中科院分区：
文献类型：
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作者：
Havstad, Suzanne L.;Johnson, Christine Cole;Wegienka, Ganesa
背景与目的：环境烟草烟雾(ETS)对儿童过敏性疾病发生的影响，目前尚有相互矛盾的证据。研究表明，这种关系因母亲的疾病史而异。我们使用严格的倾向性评分方法，使用出生队列的数据来评估这种关系。方法：来自韦恩县健康、环境、过敏和哮喘纵向研究的662名儿童，我们通过23岁儿童的皮肤点刺试验(SPT+)或至少一种特异性免疫球蛋白E(IgE+)=0.35(sIgE+)来评估早期ETS与随后变态反应的关系。与标准多变量回归模型进行比较的是倾向性得分估计，然后是完全和最近邻匹配。结果：在无母亲过敏性疾病史的儿童中，ETS与儿童过敏反应呈正相关，SPT+的调整优势比(AOR)为2.32(95%可信区间(CI)：1.284.22)，sIgE+的调整优势比(AOR)为2.53(95%CI：1.434.48)。在有阳性母体史的儿童中，SPT+和sIgE+的AOR分别为0.56(95%CI：0.241.32)和0.43(95%CI：0.200.91)。结论：使用倾向计分方法严格控制混杂因素，发现接触ETS可降低有阳性母亲病史的儿童过敏的风险。对于23岁的无母亲病史的儿童，早期ETS与过敏反应的发展有很强的相关性。
Background and objective: There is conflicting evidence of the effect of environmental tobacco smoke (ETS) on the development of allergic diseases in children. Studies have shown that this relationship differs depending on maternal history of the disease. We employed the rigour of propensity score methods to assess this relationship using data from a birth cohort. Methods: Using n = 662 children from the Wayne County Health, Environment, Allergy and Asthma Longitudinal Study, we assessed the relationship between early-life ETS and subsequent allergic sensitization via a positive skin prick test (SPT+) or at least one specific immunoglobulin E (IgE) = 0.35 (sIgE+) in children aged 23 years. Propensity score estimation followed by full and nearest neighbour matching was compared with standard multivariable regression models. Results: Among children without a maternal history of allergic disease, ETS was positively associated with allergic sensitization in children with an adjusted odds ratio (aOR) for SPT+ of 2.32 (95% confidence interval (CI): 1.284.22) and the aOR for sIgE+ was 2.53 (95% CI: 1.434.48). Contrarily, for children with a positive maternal history, the aOR for SPT+ and sIgE+ was 0.56 (95% CI: 0.241.32) and 0.43 (95% CI: 0.200.91), respectively. Conclusions: Using propensity score methods to rigorously control for confounding factors, ETS exposure was found to reduce the risk of allergic sensitization in children with a positive maternal history. There is a strong association between early-life ETS and the development of allergic sensitization for children aged 23 years without maternal history.