Use of Antibiotics during Pregnancy Increases the Risk of Asthma in Early Childhood
Use of Antibiotics during Pregnancy Increases the Risk of Asthma in Early Childhood
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DOI：
10.1016/j.jpeds.2012.09.049
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发表时间：
2013-04-01
影响因子：
5.1
通讯作者：
Bisgaard, Hans
中科院分区：
文献类型：
--
作者：
Stensballe, Lone Graff;Simonsen, Jacob;Bisgaard, Hans
目的探讨妊娠期母亲使用抗生素对早期哮喘和湿疹的影响。研究设计：研究对象来自哮喘母亲所生儿童的哥本哈根哮喘前瞻性研究队列（N = 411）。严重的哮喘加重和湿疹由研究单位的医生诊断。在丹麦国家出生队列（N = 30675）的儿童中寻求重复。哮喘结局是住院治疗和使用吸入皮质类固醇。湿疹是通过一种从临床证实的湿疹病例中发展出来的算法来定义的。在队列研究设计中，所有儿童随访至5岁。哥本哈根儿童哮喘前瞻性研究数据显示，如果母亲在妊娠晚期使用抗生素，哮喘加重的风险增加（风险比1.98 [95% CI 1.08-3.63]）。丹麦国家出生队列证实，如果母亲在怀孕期间使用抗生素，儿童哮喘住院的风险增加（风险比1.17[1.00-1.36]），吸入皮质类固醇（风险比1.18[1.10-1.27]）。在母亲使用抗生素治疗非呼吸道感染的亚组中，孩子患哮喘的风险也增加了。结论：在一项哮喘风险增加的出生队列临床研究中，我们发现哮喘风险增加与母亲使用抗生素相关，并在未选择的国家出生队列和使用抗生素治疗非呼吸道感染的亚组中重复了这一发现。这支持了细菌生态学在产前或围产期生活中对哮喘发展的作用。[J] .中华儿科杂志，2013;32(2):832- 838。
Objectives To investigate the hypothesis that mother's use of antibiotics in pregnancy could influence asthma and eczema in early life.Study design Subjects were included from the Copenhagen Prospective Study on Asthma in Childhood cohort of children born of mothers with asthma (N = 411). Severe asthma exacerbations and eczema were diagnosed by research unit physicians. Replication was sought in children from the Danish National Birth Cohort (N = 30 675). Asthma outcomes were hospitalization and use of inhaled corticosteroids. Eczema was defined by an algorithm developed from cases of clinically verified eczema. All children were followed to age 5 years in a cohort study design.Results The Copenhagen Prospective Study on Asthma in Childhood data showed increased risk of asthma exacerbation (hazard ratio 1.98 [95% CI 1.08-3.63]) if mothers had used antibiotics during third trimester. The Danish National Birth Cohort confirmed increased risk of asthma hospitalization (hazard ratio 1.17 [1.00-1.36]), and inhaled corticosteroids (1.18 [1.10-1.27]) in the children if mothers used antibiotics any time during pregnancy. In the subgroup of mothers using antibiotics for nonrespiratory infection, the children also had increased risk of asthma.Conclusion We found increased risk of asthma associated with maternal antibiotic use in a clinical study of a birth cohort with increased risk of asthma and replicated this finding in an unselected national birth cohort, and in a subgroup using antibiotics for nonrespiratory infections. This supports a role for bacterial ecology in pre- or perinatal life for the development of asthma. (J Pediatr 2013;162:832-8).