Determinants of the Incidence of Childhood Asthma: A Two-Stage Case-Control Study
Determinants of the Incidence of Childhood Asthma: A Two-Stage Case-Control Study
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DOI：
10.1093/aje/kwn309
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发表时间：
2009-01-15
影响因子：
5
通讯作者：
Blais, Lucie
中科院分区：
文献类型：
--
作者：
Martel, Marie-Josee;Rey, Evelyne;Blais, Lucie
关于儿童哮喘的潜在危险因素有大量的文献。据作者所知，还没有研究者试图在单一的研究环境中理清这些决定因素的影响。作者旨在评估47个潜在因素（产前、围产期和儿童期）对儿童10岁以内哮喘发展的独立影响。从加拿大出生队列26265名儿童（1990-2002）中，进行了一项两期病例对照研究。在第一阶段，从3个管理数据库中选择每个病例20个对照。在第二阶段，选定的母亲邮寄问卷，以评估其他决定因素。儿童哮喘风险增加的因素包括：既往支气管肺疾病和儿童特应性皮炎诊断>= 1、出生后给氧、出生后6个月内使用抗生素、男性、怀孕期间哮喘、怀孕期间使用抗生素、母亲接受社会援助、父亲哮喘和兄弟姐妹哮喘。保护作用包括在怀孕期间使用鼻内皮质类固醇，有一个燃木壁炉，在索引日期之前家里有宠物，母乳喂养和日托服务。这项研究允许作者在一个单一的环境中，在产前、围产期和儿童期评估的47个预测因素中确定儿童哮喘最具影响力的决定因素。
Extensive literature exists on potential risk factors for childhood asthma. To the authors' knowledge, no investigators have yet attempted to disentangle the effects of those determinants within a single study setting. The authors aimed to evaluate the independent effects of 47 potential determinants (from the prenatal, perinatal, and childhood periods) of asthma development in children within the first 10 years of life. From a Canadian birth cohort of 26,265 children (1990-2002), a 2-stage case-control study was conducted. In the first stage, 20 controls per case were selected from 3 administrative databases. In the second stage, selected mothers were mailed questionnaires for assessment of additional determinants. Increased risks of childhood asthma were found for >= 1 previous diagnosis of bronchopulmonary disease and atopic dermatitis in the child, oxygen administration after birth, prescription of antibiotics within the first 6 months of life, male gender, asthma during pregnancy, use of antibiotics during pregnancy, maternal receipt of social aid, paternal asthma, and asthma in siblings. Protective effects included use of intranasal corticosteroids during pregnancy, having a wood-burning fireplace, having pets in the home prior to the index date, breastfeeding, and day-care attendance. This study allowed the authors to identify, within a single setting, the most influential determinants of childhood asthma among 47 predictors assessed for the prenatal, perinatal, and childhood periods.