Risk of Childhood Asthma in Relation to the Timing of Early Child Care Exposures
Risk of Childhood Asthma in Relation to the Timing of Early Child Care Exposures
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DOI：
10.1016/j.jpeds.2009.06.035
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发表时间：
2009-12-01
影响因子：
5.1
通讯作者：
Heymann, Peter W.
中科院分区：
文献类型：
--
作者：
Gurka, Matthew J.;Blackman, James A.;Heymann, Peter W.
目的探讨早期儿童护理暴露是否影响哮喘的发生风险。研究设计对来自国家儿童健康与发展研究所的939名儿童及其家庭的纵向数据进行了分析。婴儿时期在初级儿童护理机构中接触其他儿童（15个月前）和幼儿期（16-36个月）被评估为15岁时持续或迟发性哮喘的危险因素，通过logistic回归分析。结果当孩子还是蹒跚学步的孩子时，儿童保育环境中的孩子数量与哮喘的几率显著相关，即使在调整了呼吸系统疾病和其他危险因素后（P <0.05）。幼儿期暴露于空气中的儿童越少，到15岁时发生持续性或迟发性哮喘的可能性越高。结论本研究支持幼儿期暴露于其他儿童，尤其是幼儿期暴露于空气中对哮喘的风险具有保护作用的理论。这种影响似乎与报告的呼吸道疾病的数量无关，这表明可能涉及与儿童保育环境中儿童数量有关的其他保护机制。
Objective To examine whether early child care exposure influences the risk for development of asthma.Study design Longitudinal data from 939 children and their families from the National Institute of Child Health and Development Study of Early Child Care and Youth Development were analyzed. Exposure to other children in the primary child care setting as an infant (before 15 months) and as a toddler (16-36 months) were assessed as risk factors for persistent or late-onset asthma by age 15 via logistic regression.Results The number of children in the child-care environment when the child was a toddler was significantly associated with odds of asthma, even after adjusting for respiratory illnesses and other risk factors (P < .05). The fewer the children exposed to as toddlers, the higher the probability of persistent or late-onset asthma by age 15.Conclusions This study supports the theory of a protective effect of exposure to other children at an early age, especially as a toddler, on the risk of asthma. This effect appears to be independent of the number of reported respiratory tract illnesses, suggesting that other protective mechanisms related to the number of children in the child care environment may be involved.