Perinatal predictors of atopic dermatitis occurring in the first six months of life
Perinatal predictors of atopic dermatitis occurring in the first six months of life
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DOI：
10.1542/peds.113.3.468
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发表时间：
2004-03-01
期刊：
影响因子：
8
通讯作者：
Gillman, MW
中科院分区：
文献类型：
--
作者：
Moore, MM;Rifas-Shiman, SL;Gillman, MW
Objective.以往的研究预测特应性皮炎的样本量有限，变量数量少，或回顾性数据收集。这项前瞻性研究的目的是调查在出生后6个月内发生特应性皮炎的几个围产期预测因素。我们报告了来自1005名母亲和他们的婴儿参与Viva项目的结果，这是一项针对孕妇及其后代的美国队列研究。主要的结果测量是母亲报告的供应商的诊断湿疹或特应性皮炎在前6个月的生活。我们使用多元逻辑回归模型来评估几个同时预测因素与特应性皮炎发病率之间的关系。出生后6个月内异位性皮炎的累积发病率为17.1%。与白色母亲所生婴儿相比，黑人母亲所生婴儿发生特应性皮炎风险的校正比值比（OR）为2.41（95%置信区间[CI]：1.47，3.94），亚裔母亲所生婴儿发生特应性皮炎风险的校正比值比（OR）为2.58（95% CI：1.27，5.24）。男婴的OR为1.76（95% CI：1.24，2.51）。出生时胎龄增加是一个预测因素（OR：1.14; 95%CI：1.02，1.27，每增加1周），但出生体重与胎龄无关。母亲有湿疹病史的婴儿OR为2.67（95%CI：1.74，4.10）;父亲的湿疹病史也具有预测性，尽管母亲的特应性病史比父亲的病史更具预测性。其他几个围产期、社会、喂养和环境变量与特应性皮炎的风险无关。黑人和亚洲人种/种族、男性、出生时胎龄较高、家族遗传性过敏史，尤其是母亲湿疹史，与出生后6个月内发生特应性皮炎的风险增加相关。这些研究结果表明，遗传和产前和围产期的影响是重要的，在这种情况的早期表现。
Objective. Previous studies of predictors of atopic dermatitis have had limited sample size, small numbers of variables, or retrospective data collection. The purpose of this prospective study was to investigate several perinatal predictors of atopic dermatitis occurring in the first 6 months of life.Design. We report findings from 1005 mothers and their infants participating in Project Viva, a US cohort study of pregnant women and their offspring. The main outcome measure was maternal report of a provider's diagnosis of eczema or atopic dermatitis in the first 6 months of life. We used multiple logistic regression models to assess the associations between several simultaneous predictors and incidence of atopic dermatitis.Results. Cumulative incidence of atopic dermatitis in the first 6 months of life was 17.1%. Compared with infants born to white mothers, the adjusted odds ratio ( OR) for risk of atopic dermatitis among infants born to black mothers was 2.41 (95% confidence interval [CI]: 1.47, 3.94) and was 2.58 among infants born to Asian mothers ( 95% CI: 1.27, 5.24). Male infants had an OR of 1.76 ( 95% CI: 1.24, 2.51). Increased gestational age at birth was a predictor ( OR: 1.14; 95% CI: 1.02, 1.27, for each 1-week increment), but birth weight for gestational age was not. Infants born to mothers with a history of eczema had an OR of 2.67 ( 95% CI: 1.74, 4.10); paternal history of eczema also was predictive, although maternal atopic history was more predictive than paternal history. Several other perinatal, social, feeding, and environmental variables were not related to risk of atopic dermatitis.Conclusions. Black and Asian race/ ethnicity, male gender, higher gestational age at birth, and family history of atopy, particularly maternal history of eczema, were associated with increased risk of atopic dermatitis in the first 6 months of life. These findings suggest that genetic and pre- and perinatal influences are important in the early presentation of this condition.