Influence of maternal asthma on the cause and severity of infant acute respiratory tract infections
Influence of maternal asthma on the cause and severity of infant acute respiratory tract infections
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DOI：
10.1016/j.jaci.2012.01.045
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发表时间：
2012-05-01
影响因子：
14.2
通讯作者：
Hartert, Tina V.
中科院分区：
文献类型：
--
作者：
Carroll, Kecia N.;Gebretsadik, Tebeb;Hartert, Tina V.
背景：呼吸道合胞病毒（RSV）和鼻病毒感染是最常见的婴儿呼吸道疾病，与儿童哮喘风险增加有关，但存在差异。目的：我们试图确定母亲哮喘是否与婴儿呼吸道感染鼻病毒和RSV的较高几率以及感染严重程度增加有关。方法：2004-2008年，在婴儿呼吸道感染期间（104例鼻病毒感染和279例RSV感染）对母婴进行了研究。母亲被分为相互排斥的组（特应性哮喘、非特应性哮喘和无哮喘）。我们用聚合酶链反应确定病毒引起的原因，用毛细支气管炎严重程度评分确定婴儿呼吸道感染的严重程度。采用logistic回归计算母亲哮喘与病毒性病因的校正相对危险度。比例优势模型评估了母亲哮喘和婴儿感染严重程度的关联。结果：母亲患有特应性哮喘的婴儿与母亲没有哮喘的婴儿相比更容易感染鼻病毒和RSV（校正优势比，2.42;95% CI, 1.19-4.90）。同样，在感染鼻病毒的婴儿中，母亲患有特应性哮喘与感染严重程度增加相关（校正优势比为3.10；95% CI为1.21-7.98）。这种关系在感染呼吸道合胞病毒的婴儿中未见。结论：婴儿期临床显著的鼻病毒感染与母亲患有特应性哮喘的相关性高于临床显著的呼吸道合胞病毒感染。患有特应性哮喘的母亲与婴儿鼻病毒感染的严重程度增加有关，但与呼吸道合胞病毒感染无关。携带鼻病毒的婴儿更有可能有家族性特应性倾向，这可能部分解释了随后哮喘风险增加的原因。[J] .中华过敏杂志，2012;29:1236- 1242。
Background: Respiratory syncytial virus (RSV) and rhinovirus infections are the most common significant infant respiratory tract illnesses and are associated with increased but differential risks of childhood asthma.Objective: We sought to determine whether maternal asthma is associated with higher odds of infant respiratory tract infection with rhinovirus versus RSV and increased infection severity.Methods: Mother-infant dyads were enrolled from 2004-2008 during an infant respiratory tract infection (104 with rhinovirus and 279 with RSV). Mothers were classified into mutually exclusive groups (atopic asthma, nonatopic asthma, and no asthma). We determined viral cause using PCR and the severity of the infant's respiratory tract infection using the bronchiolitis severity score. Adjusted relative odds of maternal asthma with viral cause were calculated by using logistic regression. Proportional odds models assessed the association of maternal asthma and infant infection severity.Results: Infants with a mother with atopic asthma compared with infants whose mothers did not have asthma were more likely to have rhinovirus versus RSV infection (adjusted odds ratio, 2.42; 95% CI, 1.19-4.90). Similarly, among infants with rhinovirus, having a mother with atopic asthma was associated with increased infection severity (adjusted odds ratio, 3.10; 95% CI, 1.21-7.98). This relationship was not seen among infants with RSV.Conclusions: Clinically significant rhinovirus infection during infancy was more strongly associated with having a mother with atopic asthma than clinically significant RSV infection. Having a mother with atopic asthma was associated with increased severity of infant rhinovirus but not RSV infections. Infants with rhinovirus were more likely to have a familial atopic predisposition, which might partly explain the subsequent increased asthma risk. (J Allergy Clin Immunol 2012;129:1236-42.)