The impact of pre- and postnatal exposures on allergy related diseases in childhood: a controlled multicentre intervention study in primary health care
The impact of pre- and postnatal exposures on allergy related diseases in childhood: a controlled multicentre intervention study in primary health care
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DOI：
10.1186/1471-2458-13-123
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发表时间：
2013-02-08
影响因子：
4.5
通讯作者：
Oien, Torbjorn
中科院分区：
文献类型：
--
作者：
Dotterud, Christian Kvikne;Storro, Ola;Oien, Torbjorn
背景：众所周知，烟草暴露、室内气候和饮食等环境因素与过敏相关疾病的发生有关。目的是确定怀孕和婴儿期接触这些因素的改变对 2 岁时过敏相关疾病发病率的影响。方法：招募来自非选定母亲群体的儿童参加一项初级卫生保健的对照、多中心干预研究。干预措施包括增加母亲和婴儿的 n-3 PUFA 和油性鱼类摄入量、减少父母吸烟以及减少怀孕期间和儿童出生后 2 年内的室内湿度。在 2 岁时收集有关基线数据和暴露以及健康状况的问卷。结果：与对照组相比，干预队列中母亲和父亲的吸烟率在 2 岁时大约减半。干预组儿童中 n-3 PUFA 补充剂和油性鱼类的摄入量有所增加。室内湿度无明显变化。哮喘发病率的优势比为 0.72（95% CI，0.55-0.93；NNTb 53），使用哮喘药物的优势比为 0.75（95% CI，0.58-0.96）。女孩哮喘的比值比为 0.41（95% CI 0.24-0.70；NNTb 32），男孩为 0.93（95% CI 0.68-1.26）。喘息和特应性皮炎没有显着变化。结论：怀孕期间和幼儿期减少烟草暴露和增加油性鱼类的摄入量可能有效降低2岁时哮喘的发病率。对男孩和女孩的不同影响表明哮喘的病理生理学可能取决于儿童的性别。
Background: Environmental factors such as tobacco exposure, indoor climate and diet are known to be involved in the development of allergy related diseases. The aim was to determine the impact of altered exposure to these factors during pregnancy and infancy on the incidence of allergy related diseases at 2 years of age.Methods: Children from a non-selected population of mothers were recruited to a controlled, multicenter intervention study in primary health care. The interventions were an increased maternal and infant intake of n-3 PUFAs and oily fish, reduced parental smoking, and reduced indoor dampness during pregnancy and the children's first 2 years of life. Questionnaires on baseline data and exposures, and health were collected at 2 years of age.Results: The prevalence of smoking amongst the mothers and fathers was approximately halved at 2 years of age in the intervention cohort compared to the control cohort. The intake of n-3 PUFA supplement and oily fish among the children in the intervention cohort was increased. There was no significant change for indoor dampness. The odds ratio for the incidence of asthma was 0.72 (95% CI, 0.55-0.93; NNTb 53), and 0.75 for the use of asthma medication (95% CI, 0.58-0.96). The odds ratio for asthma among girls was 0.41 (95% CI 0.24-0.70; NNTb 32), and for boys 0.93 (95% CI 0.68-1.26). There were no significant change for wheeze and atopic dermatitis.Conclusion: Reduced tobacco exposure and increased intake of oily fish during pregnancy and early childhood may be effective in reducing the incidence of asthma at 2 years of age. The differential impact in boys and girls indicates that the pathophysiology of asthma may depend on the sex of the children.