Gastric suction at birth associated with long-term risk for functional intestinal disorders in later life
Gastric suction at birth associated with long-term risk for functional intestinal disorders in later life
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DOI：
10.1016/j.jpeds.2003.12.035
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发表时间：
2004-04-01
影响因子：
5.1
通讯作者：
Jacobson, B
中科院分区：
文献类型：
--
作者：
Anand, KJS;Runeson, B;Jacobson, B
目的验证出生时的有害刺激可能会增加日后发生心身或功能障碍的风险。研究设计采用兄弟姐妹对照的配对病例对照研究。研究人员检索了494名母亲的后代的出生记录，这些母亲在无并发症怀孕后，生育了两个或两个以上出生体重至少为2500克的孩子，如果至少有一个孩子暴露于围产期并发症或出生窒息。在他们的后代（N = 1110）中，108例因功能性肠道症状住院的病例从全国医院出院记录中确定。其中96例与116例未受影响的兄弟姐妹对照。结果1110例患者的功能性肠道症状发生率（9.5%）高于普通人群(3.4%,chi（2) = 124, P < 10(-6)）。出生时吸胃的发生率高于其兄弟姐妹（22.9%比11.2%）。暴露于围产期创伤或出生窒息的病例和对照组的数量没有差异。多因素logistic回归分析显示，出生时吸胃与以后生活中的功能性肠道疾病相关（优势比2.99；95%可信区间1.32-6.79;P = 0.009），而母体、围产期或其他混杂变量无显著性差异。结论出生时吸胃引起的有害刺激可促进长期内脏超敏反应和认知超警觉性的发展，导致日后功能性肠道疾病的患病率增加。
Objective To test the hypothesis that noxious stimulation at birth may increase the long-term risk for developing psychosomatic or functional disorders during later life.Study design Matched case-control study using sibling controls. The birth records were retrieved for the offspring of 494 mothers who, after uncomplicated pregnancies, had delivered two or more children with birth weights at least 2500 g, if at least one child was exposed to a perinatal complication or birth asphyxia. Among their offspring (N = 1110), the 108 cases hospitalized for functional intestinal symptoms were identified from nationwide hospital discharge records. Of these, 96 cases were compared with 116 unaffected sibling controls.Results Functional intestinal symptoms occurred more commonly among the 1110 subjects (9.5%) than in the general population (3.4%, chi(2) = 124, P < 10(-6)). Gastric suction at birth occurred more frequently among the cases compared with their siblings (22.9% vs 11.2%). There were no differences in the number of cases and controls exposed to perinatal trauma or birth asphyxia. Multivariate logistic regression analyses showed that gastric suction at birth was associated with functional intestinal disorders during later life (odds ratio, 2.99; 95% confidence interval, 1.32-6.79; P = .009), whereas maternal, perinatal, or other confounding variables were not significant.Conclusions Noxious stimulation caused by gastric suction at birth may promote the development of long-term visceral hypersensitivity and cognitive hypervigilance, leading to an increased prevalence of functional intestinal disorders in later life.