Division of Epidemiology and Biostatistics, The University of Illinois at Chicago School of Public Health, Chicago, IL 60612, USA.
Ann Allergy Asthma Immunol. 2009 Dec;103(6):480-7. doi: 10.1016/S1081-1206(10)60264-5.
Previous studies have suggested that environmental exposures may be related to the development of respiratory symptoms in early life. Intervention studies, however, have not produced consistent findings.
The Peer Education in Pregnancy Study examined the effect of home environment intervention with pregnant women at risk for having children with asthma on the development of respiratory symptoms in their infants.
A total of 383 pregnant women whose unborn child had a first-degree relative with an allergic history were randomized to 1 of 2 intervention groups, both of whom received general health education, smoking cessation advice, and encouragement to breastfeed. In addition, the intensive education group received 3 home visits focused on home environment modification. Home assessment was performed at baseline and after 1 year of follow-up. Respiratory symptoms were identified during the first year of life.
Families in both intervention groups showed significant changes in several environmental factors, with significant differences between the 2 groups in insects other than cockroaches, use of mattress covers, and washing in hot water. Children in the intensive education group had slightly lower incidence rates of respiratory symptoms, but few differences were statistically significant.
The results of this study do not provide strong support for a primary intervention focused on general modification of the home environment during pregnancy for high-risk children. It does not address the effects of more aggressive approaches or of interventions targeting individual environmental factors.
先前的研究表明,环境暴露可能与生命早期呼吸道症状的发展有关。然而,干预研究并未得出一致的结果。
同伴教育在妊娠研究中检查了对有哮喘风险的孕妇进行家庭环境干预对其婴儿呼吸道症状发展的影响。
共有 383 名孕妇,其未出生的孩子有一级亲属有过敏史,他们被随机分配到 2 个干预组中的 1 个,这两组都接受了一般健康教育、戒烟建议和鼓励母乳喂养。此外,强化教育组还接受了 3 次以家庭环境改变为重点的家访。在基线和随访 1 年后进行家庭评估。在生命的第一年确定呼吸道症状。
干预组的家庭在几个环境因素方面都有显著变化,在昆虫(蟑螂除外)、使用床垫套和用热水洗涤方面,两组之间存在显著差异。强化教育组的儿童呼吸道症状发生率略低,但统计学上差异很少。
这项研究的结果并没有为针对高危儿童在怀孕期间进行一般家庭环境改善的主要干预措施提供有力支持。它没有解决更积极的方法或针对个别环境因素的干预措施的影响。