Municipal Health Service Fryslân, Leeuwarden, The Netherlands.
Pediatr Allergy Immunol. 2010 Aug;21(5):823-30. doi: 10.1111/j.1399-3038.2009.00971.x. Epub 2009 Nov 13.
There is conflicting evidence for the relationship between parental socioeconomic position and their children's asthma. The aim of this study was to investigate relationships between parental education and respiratory symptoms in their children, distinguishing atopic and non-atopic symptoms. A cross-sectional survey among 3262 elementary school children (age 8-13) was performed; data on parental education were obtained for 3213 children. Parents completed a questionnaire on their child's allergic and respiratory symptoms, and potential explanatory variables including family history, indoor environment, and the child's medical history. Subsets of children were tested for atopy (n = 1983), lung function (n = 2325), and airway hyperresponsiveness (AHR) (n = 880). Logistic regression was used to assess relationships of health outcomes with parental education. A high parental education was associated with an increased risk of atopic sensitization to indoor allergens (OR 1.31, 95% CI 1.02; 1.69). Studied explanatory variables did not influence the relationship. In contrast, a high parental education protected children from wheeze (OR 0.77, 95% CI 0.61; 0.97). This only applied to non-atopic wheeze (OR 0.65, 95% CI 0.43; 0.99) and not to atopic wheeze (OR 0.89, 95% CI 0.60; 1.31). The protection from non-atopic wheeze in children of highly educated parents declined after adjustment for household smoking and breastfeeding (OR 0.96, 95% CI 0.58; 1.57). Similar results were observed for non-atopic and atopic rhinitis. We conclude that children from highly educated parents are protected from non-atopic respiratory symptoms, which is largely explained by a lower rate of household smoking and a higher rate of breastfeeding.
父母的社会经济地位与子女哮喘之间的关系存在相互矛盾的证据。本研究旨在调查父母教育程度与子女呼吸症状之间的关系，区分特应性和非特应性症状。对 3262 名小学生（8-13 岁）进行了横断面调查；对 3213 名儿童获得了父母教育程度的数据。父母为子女填写了一份关于过敏和呼吸症状的问卷，以及包括家族史、室内环境和儿童病史在内的潜在解释变量。对一部分儿童进行了特应性测试（n=1983）、肺功能测试（n=2325）和气道高反应性（AHR）测试（n=880）。使用逻辑回归评估健康结果与父母教育程度的关系。高父母教育程度与室内过敏原特应性致敏的风险增加相关（OR 1.31，95%CI 1.02；1.69）。研究的解释变量并未影响这种关系。相反，高父母教育程度保护儿童免受喘息（OR 0.77，95%CI 0.61；0.97）。这仅适用于非特应性喘息（OR 0.65，95%CI 0.43；0.99），而不适用于特应性喘息（OR 0.89，95%CI 0.60；1.31）。在调整家庭吸烟和母乳喂养后，高学历父母子女中非特应性喘息的保护作用下降（OR 0.96，95%CI 0.58；1.57）。非特应性和特应性鼻炎也观察到类似的结果。我们的结论是，高学历父母的子女受到非特应性呼吸症状的保护，这主要归因于家庭吸烟率较低和母乳喂养率较高。
