生命最初十年中喘息表型的预测因素。

Predictors for wheezing phenotypes in the first decade of life.

作者信息

Midodzi William K, Rowe Brian H, Majaesic Carina M, Saunders L Duncan, Senthilselvan Ambikaipakan

机构信息

Department of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, Alberta, Canada.

出版信息

Respirology. 2008 Jun;13(4):537-45. doi: 10.1111/j.1440-1843.2008.01284.x. Epub 2008 Apr 10.

Abstract

BACKGROUND AND OBJECTIVE

This study examined prenatal, perinatal and early childhood predictors of wheezing phenotypes in the first decade of life.

METHODS

Information on current wheezing, was collected prospectively from five surveys conducted every 2 years over the first decade of life. Five wheezing phenotypes were defined: non-wheezers, preschool, primary-school, intermittent and persistent wheezers. Logistic regression with adjustment for survey design was used to determine the predictors of wheezing phenotypes.

RESULTS

Data on 2711 children were used in the analysis. Early respiratory infection, the child's allergy and parental asthma were significant risk factors for preschool, intermittent and persistent wheeze. The child's allergy and parental asthma had stronger associations with persistent wheeze than with preschool wheeze. Breastfeeding was a significant predictor of both preschool and intermittent wheezing. Daycare attendance was a risk factor for preschool wheeze but a protective factor for primary-school wheezing. Crowding at home was a protective factor for both preschool and primary-school wheeze. Parental smoking was a significant factor for preschool wheeze.

CONCLUSION

This study identified different predictors for each wheezing phenotype with some degree of overlap. The observed differential effects for these conditions raises the possibility that there are different aetiologies for asthma among children.

摘要

背景与目的

本研究调查了生命最初十年中喘息表型的产前、围产期及幼儿期预测因素。

方法

前瞻性收集了在生命最初十年中每两年进行一次的五项调查里有关当前喘息情况的信息。定义了五种喘息表型:非喘息者、学龄前喘息者、小学阶段喘息者、间歇性喘息者和持续性喘息者。采用对调查设计进行校正的逻辑回归分析来确定喘息表型的预测因素。

结果

分析使用了2711名儿童的数据。早期呼吸道感染、儿童过敏及父母哮喘是学龄前、间歇性和持续性喘息的显著危险因素。与学龄前喘息相比,儿童过敏及父母哮喘与持续性喘息的关联更强。母乳喂养是学龄前和间歇性喘息的显著预测因素。入托是学龄前喘息的危险因素,但却是小学阶段喘息的保护因素。家庭拥挤是学龄前和小学阶段喘息的保护因素。父母吸烟是学龄前喘息的显著因素。

结论

本研究确定了每种喘息表型的不同预测因素,且存在一定程度的重叠。这些情况所观察到的不同影响增加了儿童哮喘存在不同病因的可能性。

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