Bernsen Roos M D, de Jongste Johan C, van der Wouden Johannes C
Department of General Practice, Erasmus MC--University Medical Center Rotterdam, Rotterdam, The Netherlands.
Pediatr Allergy Immunol. 2003 Dec;14(6):464-9. doi: 10.1046/j.0905-6157.2003.00108.x.
This study was carried out to disentangle the independent relations of birth order and sibship size with the presence of asthma, allergy and eczema. In a retrospective study, 700 families in the Netherlands were selected with index children born in 1988-90. Data were extracted from reports of health examinations at the age of 6 years of these children and their siblings. Birth order, and not sibship size, appeared to be a strong risk factor for allergy (excluding eczema). Children with higher birth order had a lower risk of allergy compared with first-borns (adjusted odds ratios: 0.43, 0.26 and 0.05 for second-, third- and fourth- or higher borns, respectively; p < 0.0001). Allergy including eczema also had a significant relation with birth order (p = 0.01). For asthma there appeared no clear relation with birth order. For asthma a non-significant relationship with sibship size (adjusted for birth order) was found (p = 0.06): first-born children in small sibships were more at risk than those in larger sibships. For allergy and eczema no such trend was observed. In conclusion, birth order is inversely related to the risk of allergy, independent of the size of the sibship.
本研究旨在厘清出生顺序和同胞数量与哮喘、过敏及湿疹之间的独立关系。在一项回顾性研究中，选取了荷兰700个家庭，其索引儿童出生于1988年至1990年。数据取自这些儿童及其兄弟姐妹6岁时的健康检查报告。出生顺序而非同胞数量似乎是过敏（不包括湿疹）的一个重要风险因素。与头胎相比，出生顺序较高的儿童过敏风险较低（调整后的优势比：二胎、三胎及四胎或更高胎次分别为0.43、0.26和0.05；p<0.0001）。包括湿疹在内的过敏与出生顺序也有显著关系（p = 0.01）。哮喘与出生顺序似乎没有明显关系。对于哮喘，发现与同胞数量（经出生顺序调整）存在非显著关系（p = 0.06）：同胞数量少的头胎儿童比同胞数量多的头胎儿童风险更高。对于过敏和湿疹，未观察到这种趋势。总之，出生顺序与过敏风险呈负相关，与同胞数量无关。
