Kaila Minna, Rautava Päivi, Holmberg-Marttila Doris, Vahlberg Tero, Aromaa Minna, Sillanpää Matti
Clinical Research Centre, Turku University Hospital, Turku, Finland.
BMC Pediatr. 2009 Jul 25;9:46. doi: 10.1186/1471-2431-9-46.
Anxious parents have many concerns about the future health of their atopic infants. Paediatricians and primary care practitioners need to seek knowledge on long-term outcomes in order to cope with the increasing caseload of suspected allergy and the concerns of parents. The aim of the study was to assess suspected and diagnosed allergy in infancy as predictors of allergy and asthma in adolescence.
Families expecting their first baby and making their first visit to a maternity health care clinic in 1986 were selected as the study population in a random sample. There were 1278 eligible study families. The data were provided of the children at the ages of 9 and 18 months and 3, 5, 12, 15 and 18 years by health care professionals, parents, and adolescents (themselves).
At the age of 9 months, the prevalence of allergy suspicions was distinctly higher than that of allergy diagnoses. At the age of five years suspected allergy approaches were nil, and the prevalence of diagnosed allergy was about 9%. During the adolescence, the prevalence of self-reported allergy increases steadily up to the age of 18 years, and that of asthma remains at approximately 5%. Suspected allergy at the age of 9 or 18 months and at the 5 years of age does not predict allergy at adolescence. Compared with non-allergic children, children with definite allergy at the age of 5 were over 8 times more likely to have allergy and nearly 7 times more likely to have asthma in adolescence.
An early ascertained diagnosis of allergy, but not suspicions of allergy, predicts prevailing allergy in adolescence. Efforts need to be focused on accurate diagnosis of early childhood allergies.
焦虑的父母对其特应性婴儿的未来健康有诸多担忧。儿科医生和初级保健从业者需要了解长期预后情况,以应对疑似过敏病例数量的不断增加以及家长的担忧。本研究的目的是评估婴儿期疑似和确诊的过敏情况,作为青少年过敏和哮喘的预测指标。
选择1986年首次前往产妇保健诊所就诊且怀有第一胎的家庭作为随机样本纳入研究人群。共有1278个符合条件的研究家庭。数据由医疗保健专业人员、父母和青少年(本人)提供,涉及儿童9个月、18个月、3岁、5岁、12岁、15岁和18岁时的情况。
9个月大时,疑似过敏的患病率明显高于确诊过敏的患病率。5岁时,疑似过敏的情况几乎不存在,确诊过敏的患病率约为9%。在青少年时期,自我报告的过敏患病率在18岁之前稳步上升,哮喘患病率约为5%。9个月、18个月和5岁时的疑似过敏并不能预测青少年时期的过敏情况。与非过敏儿童相比,5岁时确诊过敏的儿童在青少年时期患过敏的可能性高出8倍多,患哮喘的可能性高出近7倍。
早期确诊的过敏而非疑似过敏可预测青少年时期的普遍过敏情况。需要致力于准确诊断幼儿过敏。