Pole Jason D, Mustard Cameron A, To Teresa, Beyene Joseph, Allen Alexander C
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada M5T 3M7.
J Pregnancy. 2010;2010:789748. doi: 10.1155/2010/789748. Epub 2010 Jun 15.
This study was designed to test the hypothesis that fetal exposure to corticosteroids in the antenatal period is an independent risk factor for the development of asthma in early childhood with little or no effect in later childhood. A population-based cohort study of all pregnant women who resided in Nova Scotia, Canada, and gave birth to a singleton fetus between 1989 and 1998 was undertaken. After a priori specified exclusions, 80,448 infants were available for analysis. Using linked health care utilization records, incident asthma cases developed after 36 months of age were identified. Extended Cox proportional hazards models were used to estimate hazard ratios while controlling for confounders. Exposure to corticosteroids during pregnancy was associated with a risk of asthma in childhood between 3-5 years of age: adjusted hazard ratio of 1.19 (95% confidence interval: 1.03, 1.39), with no association noted after 5 years of age: adjusted hazard ratio for 5-7 years was 1.06 (95% confidence interval: 0.86, 1.30) and for 8 or greater years was 0.74 (95% confidence interval: 0.54, 1.03). Antenatal steroid therapy appears to be an independent risk factor for the development of asthma between 3 and 5 years of age.
胎儿在孕期接触皮质类固醇是儿童早期患哮喘的独立危险因素，而对儿童后期影响甚微或无影响。我们对居住在加拿大新斯科舍省、于1989年至1998年间分娩单胎胎儿的所有孕妇进行了一项基于人群的队列研究。经过事先指定的排除标准后，共有80448名婴儿可供分析。利用关联的医疗保健利用记录，确定了36个月龄后发生的哮喘病例。在控制混杂因素的同时，使用扩展的Cox比例风险模型来估计风险比。孕期接触皮质类固醇与3至5岁儿童患哮喘的风险相关：调整后的风险比为1.19（95%置信区间：1.03，1.39），5岁以后未发现关联：5至7岁儿童的调整后风险比为1.06（95%置信区间：0.86，1.30），8岁及以上儿童的调整后风险比为0.74（95%置信区间：0.54，1.03）。产前类固醇治疗似乎是3至5岁儿童患哮喘的独立危险因素。
