Department of Medicine, Stanford University, Palo Alto, CA, USA.
J Allergy Clin Immunol. 2011 May;127(5):1173-9. doi: 10.1016/j.jaci.2011.02.023. Epub 2011 Mar 24.
Previous studies of the association between gestational age or birth weight and allergic rhinitis in later life have had various limitations, including the inability to estimate risk among subjects born extremely preterm or to examine specific contributions of gestational age and fetal growth.
We sought to determine whether gestational age at birth independent of fetal growth is associated with allergic rhinitis medication prescription in a national cohort of young adults.
We conducted a national cohort study of 630,090 infants born in Sweden from 1973 through 1979 including 27,953 born preterm (<37 weeks) and followed for prescription of nasal corticosteroids and oral antihistamines in 2005-2009 (age, 25.5-37.0 years). Medication data were obtained from all outpatient and inpatient pharmacies throughout Sweden.
The overall prevalence of nasal corticosteroid and oral antihistamine prescription was 16.3% and 16.8%, respectively, which is similar to the reported prevalence of allergic rhinitis in this population. Low gestational age at birth was associated with a decreased risk of nasal corticosteroid and oral antihistamine prescription in young adulthood after adjusting for fetal growth and other potential confounders. For subjects born extremely preterm (23-28 weeks), adjusted odds ratios were 0.70 (95% CI, 0.51-0.96) for nasal corticosteroid prescription and 0.45 (95% CI, 0.27-0.76) for both nasal corticosteroid and oral antihistamine prescription relative to those born at full term.
These findings suggest that low gestational age at birth independent of fetal growth is associated with a decreased risk of allergic rhinitis in young adulthood, possibly because of a protective effect of earlier exposure to pathogens.
此前关于胎龄或出生体重与晚年变应性鼻炎之间关联的研究存在各种局限性，包括无法估计极早产儿发生风险，以及无法考察胎龄和胎儿生长对其的具体影响。
我们旨在确定出生时的胎龄是否独立于胎儿生长与一个全国性的青年人群队列中的变应性鼻炎药物处方相关。
我们开展了一项全国性队列研究，纳入了 1973 年至 1979 年期间在瑞典出生的 630090 名婴儿，其中 27953 名婴儿为早产儿（<37 周），并随访其在 2005 年至 2009 年期间处方鼻用皮质类固醇和口服抗组胺药的情况（年龄 25.5-37.0 岁）。药物数据来自瑞典所有的门诊和住院药房。
总体上鼻用皮质类固醇和口服抗组胺药的处方率分别为 16.3%和 16.8%，与该人群中变应性鼻炎的报告发生率相似。出生时胎龄较低与青年期时鼻用皮质类固醇和口服抗组胺药处方风险降低相关，这一关联在调整了胎儿生长和其他潜在混杂因素后仍然存在。对于出生极早早产儿（23-28 周），与足月出生者相比，鼻用皮质类固醇和同时使用鼻用皮质类固醇和口服抗组胺药的校正比值比分别为 0.70（95%CI，0.51-0.96）和 0.45（95%CI，0.27-0.76）。
这些发现提示出生时胎龄较低且独立于胎儿生长与青年期时变应性鼻炎风险降低相关，这可能是由于更早接触病原体的保护作用。
