Perinatal risk factors for sensitization, atopic dermatitis and wheezing during the first year of life (PIPO study)
Perinatal risk factors for sensitization, atopic dermatitis and wheezing during the first year of life (PIPO study)
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DOI：
10.1111/j.1365-2222.2005.02254.x
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发表时间：
2005-06-01
影响因子：
6.1
通讯作者：
Stevens, WJ
中科院分区：
文献类型：
--
作者：
Hagendorens, MM;Bridts, CH;Stevens, WJ
目的探讨围产期环境因素对新生儿早期致敏、异位性皮炎及围产期喘息的影响。方法通过问卷调查收集关于妊娠相关因素、父母过敏史、环境因素和婴儿1岁之前的临床病程的信息，作为前瞻性出生队列研究（关于围产期因素对哮喘和过敏发生的影响的前瞻性研究[PIPO研究]）的一部分。匡蒂结果810例婴幼儿中有107例（13%）出现早期致敏。多元回归分析显示父亲特异性IgE是女儿早期致敏的危险因素（调整后的比值比（ORadj）2.21（95%置信区间（CI）1.10 - 4.49）; P=0.03），而在男孩中，日托对早期致敏具有保护作用（ORadj 0.38（95% CI 0.20 - 0.71）; P=0.001）。195/792名婴儿（25%）发生了特应性皮炎。母亲体内的特异性IgE（ORadj 1.52（95% CI 1.06 - 2.19）; P=0.02），在婴儿中（ORadj 4.20（95% CI 2.63 - 6.68）; P < 0.001）均为异位性皮炎发生的危险因素，而出生后接触猫与特应性皮炎呈负相关（ORadj 0.68（0.47 - 0.97）; P=0.03）。出生后暴露于香烟烟雾（ORadj 3.31（95% CI 1.79 - 6.09）; P < 0.001）和日托出勤率（ORadj 1.96（95% CI 1.18 - 3.23）; P=0.009）与早期喘息显著相关，结论父亲致敏和日托对婴儿致敏的影响具有性别依赖性。母体致敏易患特应性皮炎，而出生后接触猫有保护作用。
Objective To evaluate the influence of perinatal environmental factors on early sensitization, atopic dermatitis and wheezing during the. first year.Methods Information on pregnancy-related factors, parental atopic history, environmental factors and the clinical course of the infant until age one was gathered by questionnaires, as part of a prospective birth cohort study (Prospective study on the Influence of Perinatal factors on the Occurrence of asthma and allergies [PIPO-study]). Quanti. cation of total and specific IgE was performed in 810 children and their parents.Results Early sensitization was found in 107/810 (13%) of the infants. Multiple regression analysis showed that specific IgE in fathers was a risk factor for early sensitization in their daughters ( adjusted odds ratios (ORadj) 2.21 (95% confidence interval (CI) 1.10 - 4.49); P=0.03), whereas in boys, day care attendance was shown to be protective for early sensitization (ORadj 0.38 (95% CI 0.20 - 0.71); P=0.001). Atopic dermatitis occurred in 195/792 infants (25%). Specific IgE in the mother (ORadj 1.52 ( 95% CI 1.06 - 2.19); P=0.02) and in the infant (ORadj 4.20 ( 95% CI 2.63 - 6.68); P < 0.001) were both risk factors for the occurence of atopic dermatitis, whereas postnatal exposure to cats was negatively associated with atopic dermatitis (ORadj 0.68 ( 0.47 - 0.97); P=0.03). Postnatal exposure to cigarette smoke (ORadj 3.31 ( 95% CI 1.79 - 6.09); P < 0.001) and day care attendance (ORadj 1.96 (95% CI 1.18 - 3.23); P=0.009) were significantly associated with early wheezing, which occurred in 25% (197/795) of the infants.Conclusion The effect of paternal sensitization and day care attendance on sensitization is gender dependent. Maternal sensitization predisposes for atopic dermatitis, whereas postnatal exposure to cats had a protective effect.