ENVIRONMENTAL-FACTORS AND SYMPTOMS IN INFANTS AT HIGH-RISK OF ALLERGY
ENVIRONMENTAL-FACTORS AND SYMPTOMS IN INFANTS AT HIGH-RISK OF ALLERGY
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DOI：
10.1136/jech.43.2.125
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发表时间：
1989-06-01
影响因子：
6.3
通讯作者：
VAUGHANWILLIAMS, E
中科院分区：
文献类型：
--
作者：
BURR, ML;MISKELLY, FG;VAUGHANWILLIAMS, E
该研究的目的是确定与婴儿期过敏性疾病相关的六种症状的环境决定因素。婴儿是一项前瞻性随机对照试验的参与者，该试验针对有特应性病史的家庭的喂养方式。在南威尔士的两家妇产医院招募婴儿，并在社区进行为期一年的随访。 519 名婴儿的母亲同意参加，但 36 名婴儿的母亲被排除在外（主要是因为搬回家或未能参加随访），从而使 438 名婴儿留在研究中（253 名男性，230 名女性）。婴儿在 3、6 和 12 个月大时接受随访并检查是否有过敏性疾病的证据。每次检查时，母亲都会被问及婴儿的疾病发作情况，提供的数据涉及（报告和观察到的）湿疹和鼻分泌物，以及（报告的）喘息、长期感冒、腹泻和呕吐。母亲们会写日记，记录前 6 个月的喂养细节。一名护士拜访了所有家庭，采集灰尘样本进行尘螨抗原分析。收集了广泛的社会人口统计数据。研究的所有因素均未显示出与湿疹有令人信服的关系。在多重逻辑回归分析中，母乳喂养似乎可以预防喘息、流鼻涕、感冒、呕吐和腹泻。拥有更多兄弟姐妹会增加长期感冒以及（加上过度拥挤）喘息和流鼻涕的可能性。母亲吸烟和低社会阶层与喘息有关，而室内灰尘抗原则与长期感冒有关。呼吸道症状与喘息有关，室内灰尘抗原与长期感冒有关。呼吸道症状与住房的某些方面有关，但无法与其他社会因素清楚地区分开来。秋季出生的婴儿出现喘息、呕吐腹泻的风险增加。环境因素在确定潜在特应性婴儿出现症状的风险方面发挥着重要作用。这些因素原则上可以被操纵。
The study objective was to identify environmental determinants of six symptoms associated with allergic disease in infancy. Infants were participants in a prospective randomised controlled trial of feeding practices in families with a history of atopy. Infants were recruited in two maternity hosptials in S Wales and followed up in the community for 1 year. Mothers of 519 infants agreed to participate, but 36 were excluded (mainly for moving home or failing to attend for follow-up), leaving 438 in the study (253 male, 230 female). Infants were followed up and examined for evidence of allergic disease at 3, 6 and 12 months. At each examination, mothers were questioned about episodes of illness in the infant, and the data presented relate to (reported and observed) eczema and nasal discharge, and (reported) wheeze, prolonged colds, diarrhoea and vomiting. Mothers kept a diary with details of feeding for the first 6 months. All homes were visted by a nurse who took samples of dust for dust mite antigen analysis. Extensive socio-demographic data were collected. None of the factors studied showed a convincing relationship with eczema. In a multiple logistic regression analysis breast feeding appeared to protect against wheeze, nasal discharge, colds, vomiting and diarrhoea. Having more siblings increased the likelihood of prolonged colds, and (together with overcrowding) of wheeze and nasal discharge. Maternal smoking and low social class were associated with wheeze, and house dust antigen with prolonged colds. Respiratory symptoms were associated with wheeze, and house dust antigen with prolonged colds. Respiratory symptoms were associated with some aspects of housing but these could not be distinguished clearly from other social factors. Babies born in Autumn were at increased risk of wheeze, vomiting diarrhoea. Environmental factors play an important part in determining risk of symptoms in potentially atopic babies. The factors are in principle open to manipulation.