Behavior problems antecede the development of wheeze in childhood
Behavior problems antecede the development of wheeze in childhood
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DOI：
10.1164/rccm.200406-791oc
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发表时间：
2005-02-15
影响因子：
24.7
通讯作者：
Custovic, A
中科院分区：
文献类型：
--
作者：
Calam, R;Gregg, L;Custovic, A
基本原理：目前尚不清楚在多大程度上行为问题观察到儿童哮喘发病前哮喘的发展，或者是一个后果的diseases.Objectives：我们调查了心理因素在3岁和随后的发展喘息的5岁在一个早产儿队列研究。在产前招募儿童，进行前瞻性随访，并在3岁和5岁时进行审查。在从未发生过喘鸣的儿童（n = 397）和发生迟发性喘鸣的儿童（3岁后; n = 39）之间比较3岁时显著行为问题的发生率（高于Eyberg儿童行为量表的临床相关截止值）。晚发性喘息儿童在3年时（喘息发作前）更可能高于行为问题的临界值，与从未喘息的儿童相比，强度（23.1% vs. 6.0%，p < 0.001）和问题评分（10.8% vs. 1.3%，p < 0.001）。晚发性喘息的家庭在家庭功能变量上的得分较差，但我们没有发现父母焦虑或抑郁得分增加的证据。在多变量分析中，迟发性喘息的显著和独立相关因素如下：母亲哮喘（比值比[OR] 5.4，95%置信区间[CI] 2.1-13.8，p < 0.001），母亲在孩子3岁时吸烟（OR 3.3，CI 1.2-8.7，p = 0.02），表现力（OR 0.71，CI 0.55-0.9，p = 0.005），3岁时有显著行为问题结论：儿童早期行为问题与儿童发生喘息的危险性增加有关。
Rationale: It is not clear to what extent behavior problems observed in children with asthma antecede asthma development, or are a consequence of the disease.Objectives: We investigated psychologic factors at age 3 years and subsequent development of wheeze by age 5 in an unselected birth cohort study. Children were recruited prenatally, followed prospectively, and reviewed at age 3 and 5 years. The rate of significant behavior problems at age 3 (above the clinically relevant cut-off on the Eyberg Child Behavior Inventory) was compared between children who had never wheezed (n = 397) and those developing late-onset wheezing (after age 3 years; n = 39). Late-onset wheezers were more likely to be above cut-offs for behavior problems at 3 years (before wheeze onset), compared with children who never wheezed, on Intensity (23.1% vs. 6.0%, p < 0.001) and Problem scores (10.8% vs. 1.3%, p < 0.001). Families of late-onset wheezers had poorer scores on family functioning variables, but we found no evidence of increased anxiety or depression scores in parents. In the multivariate analysis, significant and independent associates of late-onset wheeze were as follows: maternal asthma (odds ratio [OR] 5.4, 95% confidence intervals [CI] 2.1-13.8, p < 0.001), maternal smoking when child was 3 years (OR 3.3, CI 1.2-8.7, p = 0.02), expressiveness (OR 0.71, CI 0.55-0.9, p = 0.005), and significant behavior problems at age 3 years (OR 3.5, CI 1.2-9.9, p = 0.02).Conclusions: Behavior problems in early life are associated with increased risk of subsequent development of wheeze.