Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Finland.
Am J Epidemiol. 2010 Jun 15;171(12):1310-6. doi: 10.1093/aje/kwq074. Epub 2010 May 14.
This study examined whether maternal background and perinatal factors were associated with the risk of cow's milk allergy (CMA) in infants up to 2 years of age in a nested case-control study. All children born in 1996-2004 in Finland and diagnosed with CMA by 2006 were identified (n = 16,237). For each case, one matched control was selected. Information on maternal and perinatal factors was derived from the Medical Birth Register. The associations were analyzed by conditional logistic regression. Cesarean section (adjusted odds ratio (OR) = 1.18, 95% confidence interval (CI): 1.10, 1.27) and high maternal age (> or =35 years; adjusted OR = 1.23, 95% CI: 1.11, 1.36) were associated with increased risk, whereas low maternal socioeconomic status (adjusted OR = 0.65, 95% CI: 0.59, 0.71), smoking (adjusted OR = 0.72, 95% CI: 0.67, 0.79), high number of previous deliveries (> or =5; adjusted OR = 0.71, 95% CI: 0.59, 0.86), and multiple pregnancy (adjusted OR = 0.70, 95% CI: 0.60, 0.82) were associated with decreased risk of CMA. In conclusion, maternal background and perinatal factors may play a role in the development of CMA, but further research is needed to clarify these associations and the underpinning biologic mechanisms.
本研究通过巢式病例对照研究,考察了产妇背景和围产期因素与婴儿至 2 岁时发生牛奶过敏(CMA)风险的相关性。在芬兰,1996 年至 2004 年出生的所有儿童,如果在 2006 年之前被诊断出患有 CMA,则将其确定为病例(n=16237)。为每个病例选择一个匹配的对照。产妇和围产期因素的信息来源于医疗出生登记。采用条件逻辑回归分析关联。剖宫产(调整后的比值比(OR)=1.18,95%置信区间(CI):1.10,1.27)和产妇年龄较高(≥35 岁;调整后的 OR =1.23,95%CI:1.11,1.36)与风险增加相关,而产妇社会经济地位较低(调整后的 OR =0.65,95%CI:0.59,0.71)、吸烟(调整后的 OR =0.72,95%CI:0.67,0.79)、多次分娩(≥5 次;调整后的 OR =0.71,95%CI:0.59,0.86)和多胎妊娠(调整后的 OR =0.70,95%CI:0.60,0.82)与 CMA 风险降低相关。总之,产妇背景和围产期因素可能在 CMA 的发生发展中起作用,但需要进一步研究以阐明这些关联及其潜在的生物学机制。