Hospitalization for RSV bronchiolitis before 12 months of age and subsequent asthma, atopy and wheeze: A longitudinal birth cohort study
Hospitalization for RSV bronchiolitis before 12 months of age and subsequent asthma, atopy and wheeze: A longitudinal birth cohort study
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DOI：
10.1111/j.1399-3038.2005.00298.x
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发表时间：
2005-08-01
影响因子：
4.4
通讯作者：
Thomas, HM
中科院分区：
文献类型：
--
作者：
Henderson, J;Hilliard, TN;Thomas, HM
一些流行病学研究报告了婴儿期呼吸道合胞病毒（RSV）细支气管炎后儿童反复出现喘息和哮喘的情况。与过敏性致敏的关系尚不清楚，最近的证据表明特应性和 RSV 感染在哮喘的发展过程中存在相互作用。来自大型、基于人口的出生队列（雅芳父母和儿童纵向研究）的数据被用来根据儿童是否在前 12 个月内因 RSV 证实的细支气管炎入院来比较儿童的结局。考虑的结果是两个年龄（30-42 个月和 69-81 个月）的 12 个月喘息患病率、91 个月时医生诊断的哮喘的累积患病率以及 7 岁时皮肤点刺试验定义的特应性。使用多变量逻辑回归模型来计算针对潜在混杂因素调整后的结果的优势比。共有 150 名婴儿（占队列的 1.1%）在出生后 12 个月内因 RSV 细支气管炎入院。 30-42 个月时，RSV 组喘息患病率为 28.1%，对照组为 13.1%，69-81 个月时，喘息患病率为 22.6% vs. 9.6%。 91 个月时，RSV 组哮喘累积患病率为 38.4%，对照组为 20.1%。 7 岁时，RSV 组的 14.6% 和对照组的 20.7% 发现了特应性。 RSV 细支气管炎与 30-42 个月（比值比 [95% CI] 2.3 [1.3, 3.9]）和 69-81 个月（OR 3.5 [1.8, 6.6]）之间的喘息相关，并且与 91 个月时哮喘的累积患病率（OR 2.5 [1.4, 4.3]）相关，但与特应性无关（OR 0.7） [0.2，1.7]）。在基于人群的出生队列中，RSV 细支气管炎与随后的喘息和哮喘相关，但与 7 岁时出现特应性无关。
Several epidemiological studies have reported recurrent wheezing and asthma in children after respiratory syncytial virus (RSV) bronchiolitis in infancy. The relationship with allergic sensitization is less clear and recent evidence suggests an interaction between atopy and RSV infection in the development of asthma. Data from a large, population-based, birth-cohort (Avon Longitudinal Study of Parents and Children) were used to compare outcomes of children according to whether or not they had been admitted to hospital in the first 12 months with RSV-proven bronchiolitis. Outcomes considered were 12-month prevalence of wheeze at two ages (between 30-42 and 69-81 months), cumulative prevalence of doctor-diagnosed asthma at 91 months and skin prick test defined atopy at 7 yr. Multivariable logistic regression models were used to calculate odds ratios for outcomes adjusted for potential confounders. A total of 150 infants (1.1% of the cohort) were admitted to hospital within 12 months of birth with RSV bronchiolitis. The prevalence of wheezing was 28.1% in the RSV group and 13.1% in controls at 30-42 months and 22.6% vs. 9.6% at 69-81 months. The cumulative prevalence of asthma was 38.4% in the RSV group and 20.1% in controls at 91 months. Atopy was found in 14.6% of the RSV group and in 20.7% of controls at 7 yr. RSV bronchiolitis was associated with subsequent wheezing between 30-42 (Odds ratio [95% CI] 2.3 [1.3, 3.9]) and 69-81 months (OR 3.5 [1.8, 6.6]) and with the cumulative prevalence of asthma at 91 months (OR 2.5 [1.4, 4.3]) but not with atopy (OR 0.7 [0.2, 1.7]). In a population-based birth cohort, RSV bronchiolitis was associated with subsequent wheezing and asthma but not with the development of atopy by age 7 yr.