Day care attendance, respiratory tract illnesses, wheezing, asthma, and total serum IgE level in early childhood
Day care attendance, respiratory tract illnesses, wheezing, asthma, and total serum IgE level in early childhood
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DOI：
10.1001/archpedi.156.3.241
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发表时间：
2002-03-01
影响因子：
--
通讯作者：
Gold, DR
中科院分区：
文献类型：
--
作者：
Celedón, JC;Litonjua, AA;Gold, DR
背景：据推测，日托相关感染可能解释了生命早期日托出勤率与儿童期哮喘之间的负相关关系。目的：研究自出生起随访、父母有特应性病史的儿童中，出生后第一年的日托出勤率或呼吸道疾病与出生后 4 年内的喘息和哮喘之间的关系。结果：出生后第一年的日托出勤率与血清总 IgE 几何平均水平呈负相关。 （日托组为 12.9 [+/- 1 SD = 3.3, 51.4] IU/mL，无日托组为 18.5 [+/- 1 SD = 5.3, 64.7] IU/mL，P=.03）在 2 岁时，但与 2 岁时或之后的喘息没有显着相关。出生第一年内至少患有 1 次医生诊断的下呼吸道疾病与 4 岁时反复喘息（比值比 [OR]，2.0；95% 置信区间 [CI]，1.0-4.1）和哮喘（OR，2.5；95% CI，1.1-5.5）显着相关，但与 3 岁或 3 岁时的任何喘息（不频繁和频繁）无关。年纪大了。出生第一年的上呼吸道疾病（大于或等于 1 次医生诊断的上呼吸道疾病或大于或等于 3 次鼻卡他发作）与 1 岁至 4 岁时的任何喘息（频繁和不频繁）相关，但与 4 岁时的反复喘息或哮喘无关。结论：我们的结果表明，在父母有过敏史的儿童中，保护作用儿童早期就读日托以预防特应性的发生从 2 岁起就开始了，而儿童早期就读日托对喘息的保护作用可能要到 4 岁以后才能观察到。
Background: It has been hypothesized that day care-related infections may explain the inverse relation between day care attendance in early life and asthma in childhood.Objective: To examine the relation between day care attendance or respiratory tract illnesses in the first year of life and wheezing and asthma in the first 4 years of life among children with a parental history of atopy who were followed up from birth.Results: Day care attendance in the first year of life was inversely associated with geometric mean total serum IgE level (12.9 [+/- 1 SD = 3.3, 51.4] IU/mL for day care vs 18.5 [+/- 1 SD = 5.3, 64.7] IU/mL for no day cared P=.03) at 2 years of age but not significantly associated with wheezing at or after 2 years of age. Having at least 1 physician-diagnosed lower respiratory tract illness in the first year of life was significantly associated with recurrent wheezing (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.0-4.1) and asthma (OR, 2.5; 95% CI, 1.1-5.5) at 4 years of age, but not with any wheezing (infrequent and frequent) at 3 years or older. Illnesses of the upper respiratory tract (greater than or equal to1 physician-diagnosed upper respiratory tract illness or greater than or equal to3 episodes of nasal catarrh) in the first year of life were associated with any wheezing (frequent and infrequent) between the ages of 1 and 4 years, but not with recurrent wheezing or asthma at 4 years of age.Conclusions: Our results suggest that among children with a parental history of atopy the protective effect of day care attendance in early life against the development of atopy has begun by 2 years of age, and that a protective effect of day care attendance in early life against wheezing may not be observed until after 4 years of age.