Bisgaard Hans, Loland Lotte, Holst Klaus K, Pipper Christian B
Copenhagen Prospective Studies on Asthma in Childhood, Danish Pediatric Asthma Center, Health Sciences, University of Copenhagen, Copenhagen University Hospital, Hellerup, Denmark.
J Allergy Clin Immunol. 2009 Mar;123(3):651-7, 657.e1-4. doi: 10.1016/j.jaci.2008.11.036. Epub 2009 Jan 18.
Neonatal lung function is suspected to be associated with wheezy disorders, but little is known about risk factors for the early lung function.
To study prenatal determinants of neonatal lung function.
This is a clinical, prospective birth cohort study of 411 newborns, the Copenhagen Prospective Study on Asthma in Childhood, in a single-center research clinic dedicated solely to this longitudinal birth cohort study. Lung function was determined at 1 month of age by infant spirometry (the raised volume rapid thoraco-abdominal compression technique) and bronchial responsiveness to methacholine by transcutaneous oxygen measurements. Risk factor analyses included anthropometrics; demographics; socioeconomic factors; parental atopic history; previous deliveries; exposures during the third trimester to the mother's smoking, alcohol, and medicines; third trimester pregnancy complications including mother's asthma status; and mode of delivery.
Lung function was determined in 404 neonates, age 6 weeks. Neonates with body mass index in the upper quartile had 14% lower baseline forced expiratory volume at 0.5 second, and neonates of mothers smoking during the third trimester had 7% lower baseline forced expiratory volume at 0.5 second. Sex or parental atopic disease did not affect the neonatal lung function and bronchial responsiveness. Maternal intake of paracetamol during the third trimester was associated with doubling of the bronchial responsiveness in the neonates, but the statistical significance may have been driven by outliers. Bronchial responsiveness exhibited a parabola development with tripling of bronchial responsiveness reaching the nadir at 3 months of age, but this needs replication in a study with repetitive measurements within individuals.
High body mass index in newborns and mothers smoking is associated with reduced neonatal lung function. This suggests that the association between body proportion and wheezing disorders may be a result of shared genes or prenatal nutrition.
新生儿肺功能被怀疑与喘息性疾病有关，但关于早期肺功能的危险因素知之甚少。
研究新生儿肺功能的产前决定因素。
这是一项针对411名新生儿的临床前瞻性出生队列研究，即哥本哈根儿童哮喘前瞻性研究，在一个仅致力于此项纵向出生队列研究的单中心研究诊所进行。在1月龄时通过婴儿肺量计（升高容积快速胸腹按压技术）测定肺功能，并通过经皮氧测量法测定对乙酰甲胆碱的支气管反应性。危险因素分析包括人体测量学指标、人口统计学指标、社会经济因素、父母特应性病史、既往分娩情况、孕晚期母亲吸烟、饮酒和用药情况、孕晚期妊娠并发症（包括母亲哮喘状态）以及分娩方式。
对404名6周龄的新生儿进行了肺功能测定。体重指数处于上四分位数的新生儿0.5秒用力呼气量基线值低14%，孕晚期母亲吸烟的新生儿0.5秒用力呼气量基线值低7%。性别或父母特应性疾病不影响新生儿肺功能和支气管反应性。孕晚期母亲服用对乙酰氨基酚与新生儿支气管反应性加倍有关，但统计学意义可能受异常值影响。支气管反应性呈抛物线型发展，在3月龄时支气管反应性增至三倍并达到最低点，但这需要在一项对个体进行重复测量的研究中进行验证。
新生儿高体重指数和母亲吸烟与新生儿肺功能降低有关。这表明身体比例与喘息性疾病之间的关联可能是共享基因或产前营养的结果。
