母亲和围产期因素对儿童后续哮喘住院的影响：来自牛津病历关联研究的证据。
Influence of maternal and perinatal factors on subsequent hospitalisation for asthma in children: evidence from the Oxford record linkage study.
机构信息
Unit of Health-Care Epidemiology, Department of Public Health, University of Oxford, Old Road Campus, Old Road, Oxford OX3 7LF, UK.
出版信息
BMC Pulm Med. 2010 Mar 16;10:14. doi: 10.1186/1471-2466-10-14.
BACKGROUND
There is much interest in the possibility that perinatal factors may influence the risk of disease in later life. We investigated the influence of maternal and perinatal factors on subsequent hospital admission for asthma in children.
METHODS
Analysis of data from the Oxford record linkage study (ORLS) to generate a retrospective cohort of 248 612 records of births between 1970 and 1989, with follow-up to records of subsequent hospital admission for 4 017 children with asthma up to 1999.
RESULTS
Univariate analysis showed significant associations between an increased risk of admission for asthma and later years of birth (reflecting the increase in asthma in the 1970s and 1980s), low social class, asthma in the mother, unmarried mothers, maternal smoking in pregnancy, subsequent births compared with first-born, male sex, low birth weight, short gestational age, caesarean delivery, forceps delivery and not being breastfed. Multivariate analysis, identifying each risk factor that had a significant effect independently of other risk factors, confirmed associations with maternal asthma (odds ratio (OR) 3.1, 95% confidence interval 2.7-3.6), male sex (versus female, 1.8, 1.7-2.0), low birth weight (1000-2999 g versus 3000-3999 g, 1.2, 1.1-1.3), maternal smoking (1.1, 1.0-1.3) and delivery by caesarean section (1.2; 1.0-1.3). In those first admitted with asthma under two years old, there were associations with having siblings (e.g. second child compared with first-born, OR 1.3, 1.0-1.7) and short gestational age (24-37 weeks versus 38-41 weeks, 1.6, 1.2-2.2). Multivariate analysis confined to those admitted with asthma aged six years or more, showed associations with maternal asthma (OR 3.8, 3.1-4.7), age of mother (under 25 versus 25-34 at birth, OR 1.16, 1.03-1.31; over 35 versus 25-34, OR 1.4, 1.1-1.7); high social class was protective (1 and 2, compared with 3, 0.72; 0.63-0.82). Hospital admission for asthma in people aged over six was more common in males than females (1.4; 1.2-1.5); but, by the teenage years, the sex ratio reversed and admission was more common in females than males.
CONCLUSION
Several maternal characteristics and perinatal factors are associated with an elevated risk of hospital admission for asthma in the child in later life.
背景
人们对围产期因素可能影响生命后期疾病风险的可能性很感兴趣。我们调查了母亲和围产期因素对儿童随后哮喘住院的影响。
方法
对牛津记录链接研究（ORLS）的数据进行分析，生成了一个 1970 年至 1989 年出生的 248612 例记录的回顾性队列，随访至 1999 年有 4017 例哮喘儿童的后续住院记录。
结果
单变量分析显示，哮喘住院风险与出生后年份的增加（反映了 20 世纪 70 年代和 80 年代哮喘的增加）、社会阶层较低、母亲哮喘、未婚母亲、母亲妊娠期间吸烟、与第一胎相比随后的分娩、男性、低出生体重、早产、剖宫产、产钳分娩和未母乳喂养之间存在显著关联。多变量分析，确定了每个具有独立于其他危险因素的显著影响的风险因素，确认了与母亲哮喘（比值比（OR）3.1，95%置信区间 2.7-3.6）、男性（与女性相比，1.8，1.7-2.0）、低出生体重（1000-2999 克与 3000-3999 克，1.2，1.1-1.3）、母亲吸烟（1.1，1.0-1.3）和剖宫产（1.2；1.0-1.3）相关。在两岁以下首次因哮喘入院的儿童中，与有兄弟姐妹（例如，与第一胎相比，第二胎，OR1.3，1.0-1.7）和早产（24-37 周与 38-41 周，1.6，1.2-2.2）有关。多变量分析仅限于年龄在 6 岁及以上因哮喘入院的患者，与母亲哮喘（OR3.8，3.1-4.7）、母亲年龄（出生时<25 岁与 25-34 岁，OR1.16，1.03-1.31；>35 岁与 25-34 岁，OR1.4，1.1-1.7）有关；高社会阶层具有保护作用（1 级和 2 级与 3 级相比，0.72；0.63-0.82）。6 岁以上人群因哮喘住院的男性多于女性（1.4；1.2-1.5）；但到了青少年时期，性别比例逆转，女性比男性更常见。
结论
一些母亲特征和围产期因素与儿童生命后期哮喘住院风险增加有关。
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