Celedon J C, Litonjua A A, Weiss S T, Gold D R
Channing Laboratory and Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
Pediatrics. 1999 Sep;104(3 Pt 1):495-500. doi: 10.1542/peds.104.3.495.
To examine the relationship between day care attendance and illnesses of the upper and lower respiratory tract in the first year of life.
Prospective birth cohort study.
Children (N = 498) who had at least 1 parent with a history of allergy or asthma were enrolled at birth and followed prospectively for the first year of life. A home visit at 2 to 3 months of age and bimonthly telephone questionnaires were used to obtain information on day care arrangements, home characteristics, respiratory symptoms, and physician-diagnosed illnesses of the upper and lower respiratory tract.
Day care attendance in the first year of life was associated with two or more doctor-diagnosed ear infections (OR: 2.4; 95% CI: 1.7-3.6), three or more parental reports of runny or stuffed nose (OR: 3.2; 95% CI: 1.9-5.5), a doctor's diagnosis of sinusitis (OR: 2.2; 95% CI: 1.1-4.2), and doctor-diagnosed lower respiratory illnesses (croup, bronchitis, bronchiolitis, and pneumonia; OR: 1.6; 95% CI: 1.0-2.4). For children attending day care, exposure to pets in day care, the presence of a rug or carpet in the area where the child slept in day care, and a nonresidential setting for day care all were independent predictors of two or more doctor-diagnosed ear infections.
The results suggest that day care increases the risk of illnesses of the upper and lower respiratory tract in the first year of life for children with a familial history of atopy. Specific environmental exposures within day care, such as the presence of pets or having a rug or carpet in the area where children sleep, may increase the risk of recurrent ear infections in the first year of life among children with familial history of atopy who attend day care.
研究1岁以内儿童日托入托情况与上、下呼吸道疾病之间的关系。
前瞻性出生队列研究。
选取至少1名父母有过敏或哮喘病史的儿童（N = 498），自出生起进行前瞻性随访，为期1年。在儿童2至3个月大时进行家访，并每两个月通过电话问卷收集日托安排、家庭环境、呼吸道症状以及医生诊断的上、下呼吸道疾病等信息。
1岁以内入托与以下情况相关：医生诊断的耳部感染2次或更多（比值比：2.4；95%可信区间：1.7 - 3.6）、父母报告流涕或鼻塞3次或更多（比值比：3.2；95%可信区间：1.9 - 5.5）、医生诊断为鼻窦炎（比值比：2.2；95%可信区间：1.1 - 4.2）以及医生诊断的下呼吸道疾病（哮吼、支气管炎、细支气管炎和肺炎；比值比：1.6；95%可信区间：1.0 - 2.4）。对于入托儿童，日托场所接触宠物、儿童日托睡眠区域有地毯以及日托场所为非居住环境均是医生诊断耳部感染2次或更多的独立预测因素。
结果表明，日托会增加有特应性家族史儿童1岁以内患上下呼吸道疾病的风险。日托场所的特定环境暴露，如接触宠物或儿童睡眠区域有地毯，可能会增加有特应性家族史且入托的儿童1岁以内反复发生耳部感染的风险。
