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婴儿期早期固体食物的摄入与 4 岁以下儿童特应性皮炎的发生风险

Early exposure to solid foods and the development of eczema in children up to 4 years of age.

机构信息

Department of Epidemiology and Community Medicine, University of Antwerp, Antwerp, Belgium.

出版信息

Pediatr Allergy Immunol. 2010 Feb;21(1 Pt 1):74-81. doi: 10.1111/j.1399-3038.2009.00899.x. Epub 2009 Jul 1.

Abstract

Early exposure to solid foods in infancy has been associated with the development of allergic diseases. However, scientific evidence for this is conflicting. The aim of this study was to examine the association between early exposure to solid foods in the infant's diet and the development of eczema up to 4 years of age. We conducted an etiologic case-control study nested in the PIPO cohort (Prospective Cohort on the Influence of Perinatal Factors on the Occurrence of Asthma and Allergies). In this cohort data on nutrition, environmental exposures and parent-reported eczema were collected prospectively starting from 5 months pregnancy by means of questionnaires administered during two home visits and semi-annual postal questionnaires. In addition, detailed information on the timing of introduction of solid foods at individual food item level was collected at 1 year of age. Adjusted odds ratios and 95% confidence intervals were computed using logistic regression analysis as a measure of association between eczema and the timing of exposure to solid foods. Early introduction (within the first 4 months) of solid foods was inversely associated with eczema up to 4 years of age (adj OR: 0.49; 95% CI: 0.32-0.74). Moreover, we found that early exposure to solid foods was associated with a reduced risk for eczema only among children with allergic parents (adj OR: 0.35; 95% CI: 0.20-0.63), whereas no significant effect was found among children with non-allergic parents (adj OR: 0.69; 95% CI: 0.37-1.29). The results of this study show that early exposure to solid foods is associated with less parent-reported eczema in children, particularly among children with allergic parents. Therefore, the current study does not support a delayed introduction of solid foods for the prevention of eczema in childhood.

摘要

婴儿早期接触固体食物与过敏性疾病的发展有关。然而,这方面的科学证据存在矛盾。本研究旨在探讨婴儿饮食中早期接触固体食物与 4 岁以内湿疹发展之间的关系。我们进行了一项嵌套在 PIPO 队列中的病因病例对照研究(前瞻性队列研究,研究围产期因素对哮喘和过敏发生的影响)。在该队列中,通过在两次家访和半年度邮寄问卷中进行问卷调查,从怀孕 5 个月开始前瞻性地收集营养、环境暴露和父母报告的湿疹数据。此外,在 1 岁时还详细收集了个体食物固体食物引入时间的信息。使用逻辑回归分析作为衡量湿疹与固体食物暴露时间之间关系的指标,计算调整后的优势比和 95%置信区间。早期(前 4 个月内)引入固体食物与 4 岁以内湿疹呈负相关(调整后的优势比:0.49;95%置信区间:0.32-0.74)。此外,我们发现,只有在有过敏父母的儿童中,早期接触固体食物与湿疹风险降低相关(调整后的优势比:0.35;95%置信区间:0.20-0.63),而在无过敏父母的儿童中,没有发现显著影响(调整后的优势比:0.69;95%置信区间:0.37-1.29)。本研究结果表明,婴儿早期接触固体食物与儿童中父母报告的湿疹较少有关,特别是在有过敏父母的儿童中。因此,目前的研究不支持为预防儿童湿疹而延迟引入固体食物。

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