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儿童早期照护暴露时间与儿童哮喘风险的关系。

Risk of childhood asthma in relation to the timing of early child care exposures.

机构信息

Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA 22908-0717, USA.

出版信息

J Pediatr. 2009 Dec;155(6):781-787.e1. doi: 10.1016/j.jpeds.2009.06.035. Epub 2009 Aug 15.

Abstract

OBJECTIVE

To examine whether early child care exposure influences the risk for development of asthma.

STUDY DESIGN

Longitudinal data from 939 children and their families from the National Institute of Child Health and Development Study of Early Child Care and Youth Development were analyzed. Exposure to other children in the primary child care setting as an infant (before 15 months) and as a toddler (16-36 months) were assessed as risk factors for persistent or late-onset asthma by age 15 via logistic regression.

RESULTS

The number of children in the child-care environment when the child was a toddler was significantly associated with odds of asthma, even after adjusting for respiratory illnesses and other risk factors (P < .05). The fewer the children exposed to as toddlers, the higher the probability of persistent or late-onset asthma by age 15.

CONCLUSIONS

This study supports the theory of a protective effect of exposure to other children at an early age, especially as a toddler, on the risk of asthma. This effect appears to be independent of the number of reported respiratory tract illnesses, suggesting that other protective mechanisms related to the number of children in the child care environment may be involved.

摘要

目的

研究儿童早期入托经历是否会影响哮喘的发病风险。

研究设计

对来自儿童健康发展研究所的 939 名儿童及其家庭的纵向数据进行分析。通过 logistic 回归,将婴儿期(15 个月之前)和幼儿期(16-36 个月)在主要入托环境中与其他儿童接触的情况作为风险因素,评估其对 15 岁时持续性或迟发性哮喘的影响。

结果

幼儿期入托儿童数量与哮喘发病的几率显著相关,即使在调整了呼吸道疾病和其他风险因素后(P<.05)。幼儿期接触的儿童越少,15 岁时持续性或迟发性哮喘的概率越高。

结论

本研究支持了在生命早期(尤其是幼儿期)接触其他儿童对哮喘发病风险具有保护作用的理论。这种保护作用似乎独立于报告的呼吸道疾病数量,这表明与儿童保育环境中儿童数量相关的其他保护机制可能也发挥了作用。

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