Birth by cesarean section, allergic rhinitis, and allergic sensitization among children with a parental history of atopy
Birth by cesarean section, allergic rhinitis, and allergic sensitization among children with a parental history of atopy
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DOI：
10.1016/j.jaci.2008.05.007
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发表时间：
2008-08-01
影响因子：
14.2
通讯作者：
Celedon, Juan C.
中科院分区：
文献类型：
--
作者：
Pistiner, Michael;Gold, Diane R.;Celedon, Juan C.
背景：剖腹产可以改变新生儿的免疫反应，增加特应性的风险。研究剖宫产和过敏性疾病之间的关系，在儿童的基础上选择不一致的family.Objective：我们试图研究剖宫产和过敏性疾病之间的关系，在儿童的过敏性疾病的风险。方法：我们研究了432名从出生到9岁的父母有特应性病史的儿童的分娩方式与特应性和过敏性疾病的发展之间的关系。哮喘定义为医生诊断。过敏性鼻炎定义为前一年除感冒外，经医生诊断的过敏性鼻炎和鼻眼症状。如果有1个或多个阳性皮肤试验反应或对常见过敏原的特异性IgE，则认为在学校、年龄存在特应性。采用逐步Logistic回归分析研究剖宫产和interests. Results的结果之间的关系：调整其他协变量后，剖宫产出生的儿童有2倍以上的优势比阴道分娩出生的异位症（优势比，2.1，95%CI，1.1-3.9）。在多变量分析中，剖宫产分娩与变应性鼻炎（比值比，1.8; 95%CI，1.0-3.1）的几率增加显着相关，但与asthene.Conclusions：我们的研究结果表明，剖宫产分娩与过敏性鼻炎和过敏性反应的儿童与父母的哮喘或过敏史。这可以解释为在剖宫产期间缺乏与母体阴道/粪便植物群的接触或减少/不存在分娩。
Background: Cesarean delivery can alter neonatal immune responses and increase the risk of atopy. Studies of the relation between cesarean delivery and allergic diseases in children not selected on the basis of a family history of atopy have yielded inconsistent findings.Objective: We sought to examine the relation between birth by cesarean delivery and atopy and allergic diseases in children at risk for atopy.Methods: We examined the relation between mode of delivery and the development of atopy and allergic diseases among 432 children with a parental history of atopy followed from birth to age 9 years. Asthma was defined as physician-diagnosed. asthma and wheeze in the previous year, and allergic rhinitis was defined as physician-diagnosed allergic rhinitis and naso-ocular symptoms apart from colds in the previous year. Atopy was considered present at school,age if there was 1 or more positive skin test response or specific IgE to common allergens. Stepwise logistic regression was used to study the relation between cesarean delivery and the outcomes of interest.Results: After adjustment for other covariates, children born by cesarean section had 2-fold higher odds of atopy than those born by vaginal delivery (odds ratio, 2.1; 95% CI, 1.1-3.9). In multivariate analyses birth by cesarean section was significantly associated with increased odds of allergic rhinitis (odds ratio, 1.8; 95% CI, 1.0-3.1) but not with asthma.Conclusions: Our findings suggest that cesarean delivery is associated with allergic rhinitis and atopy among children with a parental history of asthma or allergies. This could be explained by lack of contact with the maternal vaginal/fecal flora or reduced/absent labor during cesarean delivery.