Maternal complications and procedures in pregnancy and at birth and wheezing phenotypes in children
Maternal complications and procedures in pregnancy and at birth and wheezing phenotypes in children
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DOI：
10.1164/rccm.200512-1978oc
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发表时间：
2007-01-01
影响因子：
24.7
通讯作者：
Pearce, Neil
中科院分区：
文献类型：
--
作者：
Rusconi, Franca;Galassi, Claudia;Pearce, Neil
理由：人们越来越关注胎儿和早期生命状况对儿童喘息的潜在影响。目的：调查孕期和出生时孕产妇并发症和手术以及幼儿各种喘息表型风险之间的关联。方法：我们研究了 15,609 名 6-7 岁的儿童，他们参加了一项基于人群的研究。由儿童母亲填写标准化问卷。结果：9.5%（1,478）名儿童有短暂性早期喘息，5.4%（884）名儿童有持续性喘息，6.1%（948）名儿童有迟发性喘息。母亲高血压或先兆子痫与所有三种喘息表型的风险增加相关（对于短暂性早期喘息：比值比 [OR]，1.40；95% 置信区间 [95% CI]，1.08-1.82；对于持续性喘息：OR，1.59；95% Cl，1.15-2.19；对于晚发型喘息：OR， 1.47；95％Cl，1.06-2.01）。使用抗生素治疗尿路感染与短暂性早期喘息（OR，1.52；95% Cl，1.16-2.00）相关，而分娩时给予抗生素与短暂性早期喘息（OR，1.21；95% Cl，1.01-1.46）和持续性喘息（OR，1.39；95% Cl，1.16-2.00）相关。 1.10-1.75）。母亲患有糖尿病的孩子也更有可能出现持续性喘息（OR，1.72；95% Cl，0.99-3.00）。羊膜穿刺术/绒毛膜绒毛取样、妊娠期体重增加以及剖宫产均与随后出现的喘息无关。母亲哮喘或特应性并不是所发现关联的影响因素。结论：妊娠和分娩期间的一些母亲并发症可能会增加儿童时期出现不同喘息表型的风险。
Rationale: There is increasing interest in the potential influence of fetal and early life conditions on childhood wheezing. Objectives: To investigate the associations between maternal complications and procedures in pregnancy and at birth and the risk of various wheezing phenotypes in young children.Methods: We studied 15,609 children, aged 6-7 yr, enrolled in a population-based study. Standardized questionnaires were completed by the children's mothers.Results: Of the children, 9.5% (1,478) had transient early wheezing, 5.4% (884) had persistent wheezing, and 6.1% (948) had late-onset wheezing. Maternal hypertension or preeclampsia was associated with an increased risk of all three wheezing phenotypes (for transient early wheezing: odds ratio [OR], 1.40; 95% confidence interval [95% CI], 1.08-1.82; for persistent wheezing: OR, 1.59; 95% Cl, 1.15-2.19; and for late-onset wheezing: OR, 1.47; 95% Cl, 1.06-2.01). Use of antibiotics for urinary tract infections was associated with transient early wheezing (OR, 1.52; 95% Cl, 1.16-2.00), whereas antibiotic administration at delivery was associated with both transient early wheezing (OR, 1.21; 95% Cl, 1.01-1.46) and persistent wheezing (OR, 1.39; 95% Cl, 1.10-1.75). Children who had a mother with diabetes were also more likely to have persistent wheezing (OR, 1.72; 95% Cl, 0.99-3.00). Neither amniocentesis/ chorionic villus sampling, nor weight gain in pregnancy, nor cesarean section was associated with the subsequent development of wheezing. Maternal asthma or atopy was not an effect modifier of the associations found.Conclusions: Some maternal complications during pregnancy and at delivery may increase the risk of developing different phenotypes of wheezing in childhood.