基于DOHaD理论的儿童OSA生命早期危险因素及预测模型研究

我国近5%的儿童患有阻塞性呼吸暂停（OSA），该病对儿童体格、面容发育以及神经、心血管、内分泌等多系统有严重不良影响。根据健康与疾病的发育起源（DOHaD）理论，生命早期尤其是最初1000天对儿童近远期健康至关重要。我们前期也发现围产因素会影响子代健康。因此亟待评估生命早期（胎儿期至2岁）因素对儿童OSA的影响，制定早期防治OSA的策略。.本项目拟开展双向性队列研究，通过电子病历和问卷调查回顾性收集母亲孕产信息、儿童出生至2岁的体格发育和喂养等信息，前瞻性随访3-6岁学龄前儿童OSA发生情况，探索生命早期因素与儿童OSA的关联性，筛选儿童OSA的危险因素，采用Logistic回归模型、BP神经网络模型构建风险预测模型并验证，分析儿童肥胖在生命早期因素与儿童OSA关系中的中介效应。提供儿童OSA的生命早期危险因素预警识别策略，为制定预防为主、防治结合的儿童OSA早期健康管理政策提供科学依据。

Nearly 5% of children in China suffer from obstructive sleep apnea (OSA), which is associated with poor physical and facial development as well as neurocognitive, cardiovascular, and endocrine disturbances in childhood. The concept of Developmental Origin of Health and Diseases (DOHaD) highlights the importance of early life, especially the first 1000 days, to children’s health. We found perinatal factors jeopardize children’s health. It is necessary to examine whether early life (from conception to the two years of life) factors predict childhood OSA, and then to develop strategies for early life prevention of OSA..We plan to conduct an ambispective cohort study, through retrospectively collecting information on maternal pregnancy and child feeding and growth from birth to age two by electronic medical records and questionnaires and prospectively screening OSA in preschool children aged 3-6 years. We will estimate the associations between early life factors and childhood OSA, generalize predictive models of OSA in childhood by Logistic regression model and BP neural network model, and distinguish the mediating effect of childhood obesity in the causal relationships of early life exposures on childhood OSA. We aim to provide strategies to identify children with high risk for OSA at early stage, and to provide scientific evidence for the development of early health management policy of OSA in children.