Age-specific associations of early daycare, older siblings, severe airway infection, and preterm birth with subsequent atopic diseases
Age-specific associations of early daycare, older siblings, severe airway infection, and preterm birth with subsequent atopic diseases
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DOI：
10.1111/pai.13771
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发表时间：
2022-04-01
影响因子：
4.4
通讯作者：
Horimukai, Kenta
中科院分区：
文献类型：
--
作者：
Nagasaki, Tadao;Tabuchi, Takahiro;Horimukai, Kenta
背景婴儿期感染和发育适应对儿童期不同年龄的特应性相关疾病患病率的影响尚未完全确定。本研究旨在检查哮喘、过敏性鼻炎/结膜炎和特应性皮炎与早期感染相关因素（即，日托、年长的兄弟姐妹和严重的气道感染）和发育适应（即，早产和体重快速增加）。方法在这项纵向队列研究（n = 47，015）中，对儿童进行了0.5至11年的随访。潜在的风险和保护因素，包括0.5岁时的日托，存在哥哥姐姐，0.5-1.5年期间因感冒/支气管炎/细支气管炎/肺炎住院史，早产，以及前2.5年体重快速增加，使用多变量logistic回归进行评估，并对潜在的混杂因素进行调整。结果在5.5-9岁时，观察到幼儿日托与哮喘之间的保护性关联，10年后消失。在整个儿童期，早期日托和年长的兄弟姐妹患过敏性鼻炎/结膜炎之间也存在保护性关联。然而，早期日托和特应性皮炎之间的关联被发现在儿童时期是危险的。相反，早期因感冒/支气管炎/细支气管炎/肺炎住院的生活史被确定为发生哮喘和过敏性鼻炎/结膜炎的风险因素。早产是儿童哮喘的重要危险因素。结论不同年龄段儿童早期日托、严重呼吸道感染、早产与特应性疾病的关系存在差异。
Background The effects of infection and developmental adaptations in infancy on the prevalence of subsequent atopy-related diseases at different ages during childhood are not fully determined. This study aims to examine the similarities and differences in the age-specific association of asthma, allergic rhinitis/conjunctivitis, and atopic dermatitis with early-life infection-related factors (i.e., daycare, older siblings, and severe airway infection) and developmental adaptations (i.e., preterm birth and rapid weight gain) in children. Methods In this longitudinal cohort study (n = 47,015), children were followed from 0.5 to 11 years. The potential risks and protective factors, including daycare attendance at 0.5 years, existence of older siblings, history of hospitalization due to cold/bronchitis/bronchiolitis/pneumonia during 0.5-1.5 years, preterm birth, and rapid weight gain in the first 2.5 years, were assessed using multivariable logistic regression with adjustments for potential confounders. Results A protective association was observed between early-life daycare attendance and asthma at 5.5-9 years, which disappeared after 10 years. A protective association was also noted throughout childhood between early daycare attendance and older siblings with allergic rhinitis/conjunctivitis. However, the association between early daycare and atopic dermatitis was found to be risky during childhood. In contrast, the early-life history of hospitalization owing to cold/bronchitis/bronchiolitis/pneumonia was identified to be a risk factor for developing both asthma and allergic rhinitis/conjunctivitis. Preterm birth was a significant risk factor for childhood asthma. Conclusion Different age-specific patterns were demonstrated in the relationship between early daycare, severe airway infection, preterm birth, and atopy-related diseases in childhood.