Henderson J, Sherriff A, Farrow A, Ayres J G
Avon Longitudinal Study of Parents and Children, Dept of Community-based Medicine, 24 Tyndall Ave, University of Bristol, Bristol BS8 1BR, UK.
Eur Respir J. 2008 Mar;31(3):547-54. doi: 10.1183/09031936.00086807. Epub 2007 Oct 24.
The aims of the present study were to assess the effects of maternal use of domestic chemicals during pregnancy on wheezing and lung function in children aged </=8.5 yrs and to explore the potential modifying effect of atopy. In the Avon Longitudinal Study of Parents and Children, a cohort study, a maternal composite household chemical exposure (CHCE) score was derived. Wheezing phenotypes from birth to age 7 yrs were assigned on the basis of reported wheeze. Lung function (forced expiratory volume in one second (FEV(1)), forced vital capacity (FVC), forced midexpiratory flow between 25 and 75% of FVC (FEF(25-75%))) was measured at age 8.5 yrs; and atopy by skin-prick tests at age 7.5 yrs. Multinomial logistic and linear regression models assessed the relationship between wheezing outcomes, lung function and CHCE score, and interactions with atopy. Increased CHCE score was associated with early- (<18 months) and intermediate- (18-30 months) persistent and late-onset (>30 months) wheezing in nonatopic children (adjusted odds ratio per z-score of CHCE (95% confidence interval) 1.41 (1.13-1.76), 1.43 (1.02-2.13) and 1.69 (1.19-2.41), respectively). Increasing CHCE score was associated with decrements in FEV(1) and FEF(25-75%). Higher domestic chemical exposure during pregnancy was associated with persistent wheeze and lung function abnormalities in nonatopic children. This may result from pre-natal developmental effects or post-natal irritant effects on the developing airway, but is unlikely to be mediated through increased hygiene in the home.
本研究的目的是评估孕期母亲使用家用化学品对8.5岁及以下儿童喘息和肺功能的影响，并探讨特应性的潜在调节作用。在一项队列研究——雅芳亲子纵向研究中，得出了一个母亲家庭化学品综合暴露（CHCE）评分。根据报告的喘息情况确定从出生到7岁的喘息表型。在8.5岁时测量肺功能（一秒用力呼气量（FEV₁）、用力肺活量（FVC）、FVC 25%至75%之间的用力呼气中期流速（FEF₂₅₋₇₅%））；在7.5岁时通过皮肤点刺试验检测特应性。多项逻辑回归和线性回归模型评估了喘息结局、肺功能与CHCE评分之间的关系，以及与特应性的相互作用。CHCE评分升高与非特应性儿童的早期（<18个月）和中期（!8 - 30个月）持续性喘息以及迟发性（>30个月）喘息相关（CHCE每增加1个z评分的调整比值比（95%置信区间）分别为1.41（1.13 - 1.76）、1.43（1.02 - 2.13）和1.69（1.19 - 2.41））。CHCE评分增加与FEV₁和FEF₂₅₋₇₅%的降低相关。孕期较高的家用化学品暴露与非特应性儿童的持续性喘息和肺功能异常有关。这可能是由于产前发育影响或产后对发育中气道的刺激作用，但不太可能通过家庭卫生条件改善来介导。
