Environmental associations with eczema in early life
Environmental associations with eczema in early life
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DOI：
10.1046/j.1365-2133.2001.04135.x
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发表时间：
2001-04-01
影响因子：
10.3
通讯作者：
Taylor, AJN
中科院分区：
文献类型：
--
作者：
Harris, JM;Cullinan, P;Taylor, AJN
背景：虽然特应性湿疹（AE）是一种常见的疾病，但对其病因知之甚少。目的探讨饮食和环境因素在2岁前发生AE中的作用。方法从在英国肯特郡阿什福德三家全科医院接受产前保健的连续新怀孕母亲中招募出一组儿童，在出生前从原始队列中获得624名（97%）2岁以下的数据，使用英国AE诊断标准、母亲报告医生诊断的湿疹和母亲报告的湿疹的组成部分来定义AE。感兴趣的暴露是过敏疾病的家族史、饮食和母乳喂养模式、家庭规模和室内家庭过敏原暴露。结果采用英国诊断标准的AE的累计患病率为14%(95%置信区间，CI 11-17%)，母亲报告医生诊断的湿疹的患病率高得多（31%,95% CI 27-35%），几乎一半（45%）的母亲报告他们的孩子曾经患过湿疹（95% CI 41-49%），父母特应性、父母过敏性疾病史与孩子湿疹的关系在母亲中始终强于父亲。随着母亲受教育程度的提高，以及在不那么拥挤的家庭中，湿疹的患病率显著增加，在控制了其他因素后，这种关联仍然显著。结论与环境因素的关联与假设一致，即更拥挤的房屋，更大的家庭规模和出生顺序可能增加早期感染的暴露，可能对湿疹的后续发展提供保护。
Background Although atopic eczema (AE) is a common disease, little is known about its causes.Objectives To investigate the role of dietary and environmental factors associated with the development of AE by the age of 2 years.Methods A cohort of children was recruited before birth from a consecutive series of newly pregnant mothers presenting for antenatal care at three general practices in Ashford, Kent, U.K. Data up to the age of 2 years were available for 624 (97%) of the original cohort, AE was defined using components of the U.K. diagnostic criteria for AE, maternal report of doctor-diagnosed eczema and maternally reported eczema. Exposures of interest were family history of allergic disease, dietary and breastfeeding patterns, family size and exposure to indoor domestic allergens.Results The cumulative prevalence of AE using the U.K. diagnostic criteria was 14% (95% confidence interval, CI 11-17%), The prevalence of maternally reported doctor-diagnosed eczema was much higher (31%, 95% CI 27-35%) and almost half (45%) the mothers reported that their child had ever had eczema (95% CI 41-49%), The relationship between parental atopy, parental history of allergic disease and the child's eczema was consistently stronger for the mothers than the fathers, There was a marked increase in the prevalence of eczema with increasing maternal education and in less crowded homes, associations that remained significant after controlling for other factors.Conclusions The associations with environmental factors are consistent with the hypothesis that more crowded houses, increased family size and birth order, which may possibly increase early exposure to infections, may offer protection from subsequent development of eczema.