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母亲患有哮喘是否会改变产前接触对乙酰氨基酚对学龄前儿童喘息的影响?

Is the effect of prenatal paracetamol exposure on wheezing in preschool children modified by asthma in the mother?

作者信息

Garcia-Marcos L, Sanchez-Solis M, Perez-Fernandez V, Pastor-Vivero M D, Mondejar-Lopez P, Valverde-Molina J

机构信息

Arrixaca University Children's Hospital, Murcia, Spain.

出版信息

Int Arch Allergy Immunol. 2009;149(1):33-7. doi: 10.1159/000176304. Epub 2008 Nov 26.

Abstract

BACKGROUND

There seems to be an association between paracetamol consumption during late pregnancy and the prevalence of wheezing in infancy and childhood. The aim of the present study is to determine whether the aforementioned association is modified by the presence of asthma in the mother.

METHODS

A total of 1,741 children aged 3-5 years from an epidemiological survey performed in the province of Murcia (Spain) were included in the analysis. Data on paracetamol consumption (never, at least once during pregnancy or at least once per month during pregnancy), wheezing symptoms in the offspring (according to the International Study of Asthma and Allergies in Childhood protocol) and the presence of asthma in the mother, together with other known risk factors for asthma, were obtained by means of a questionnaire.

RESULTS

The mean age of the children was 4.08 +/- 0.8 years and 51.1% were males. The overall prevalence of current wheezing was 20.2%. The frequency of paracetamol usage was similar among asthmatic and non-asthmatic mothers, and only a small proportion of them took this drug at least once a month (13.8% of asthmatics and 11.0% of non-asthmatics). Compared to the mothers who never took paracetamol, there was a significant association between the mother having taken paracetamol at least once per month during pregnancy and the offspring suffering from wheezing at preschool age, but only among non-asthmatic mothers (odds ratio 1.94, 95% confidence interval 1.34-2.79 vs. odds ratio 1.05, 95% confidence interval 0.21-5.08). This association was maintained after controlling for potential confounders (odds ratio 1.74, 95% confidence interval 1.15-2.61).

CONCLUSIONS

The frequent usage of paracetamol during pregnancy is associated with the prevalence of wheezing in offspring during preschool years. Asthma in the mother might modify this association.

摘要

背景

妊娠晚期服用对乙酰氨基酚与婴幼儿期喘息患病率之间似乎存在关联。本研究的目的是确定上述关联是否会因母亲患有哮喘而改变。

方法

分析纳入了来自西班牙穆尔西亚省一项流行病学调查的1741名3至5岁儿童。通过问卷调查获取了对乙酰氨基酚的服用数据(从未服用、孕期至少服用过一次或孕期每月至少服用一次)、后代的喘息症状(根据儿童哮喘和过敏国际研究方案)、母亲是否患有哮喘以及其他已知的哮喘风险因素。

结果

儿童的平均年龄为4.08±0.8岁,51.1%为男性。当前喘息的总体患病率为20.2%。哮喘母亲和非哮喘母亲对乙酰氨基酚的使用频率相似,且只有一小部分母亲每月至少服用一次这种药物(哮喘母亲中有13.8%,非哮喘母亲中有11.0%)。与从未服用对乙酰氨基酚的母亲相比,孕期每月至少服用一次对乙酰氨基酚的母亲与学龄前后代喘息之间存在显著关联,但仅在非哮喘母亲中如此(比值比1.94,95%置信区间1.34 - 2.79,而比值比1.05,95%置信区间0.21 - 5.08)。在控制潜在混杂因素后,这种关联仍然存在(比值比1.74,95%置信区间1.15 - 2.61)。

结论

孕期频繁使用对乙酰氨基酚与学龄前后代喘息患病率相关。母亲患有哮喘可能会改变这种关联。

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