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母亲哮喘对婴儿急性呼吸道感染的病因和严重程度的影响。

Influence of maternal asthma on the cause and severity of infant acute respiratory tract infections.

机构信息

Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA.

出版信息

J Allergy Clin Immunol. 2012 May;129(5):1236-42. doi: 10.1016/j.jaci.2012.01.045. Epub 2012 Feb 14.

Abstract

BACKGROUND

Respiratory syncytial virus (RSV) and rhinovirus infections are the most common significant infant respiratory tract illnesses and are associated with increased but differential risks of childhood asthma.

OBJECTIVE

We sought to determine whether maternal asthma is associated with higher odds of infant respiratory tract infection with rhinovirus versus RSV and increased infection severity.

METHODS

Mother-infant dyads were enrolled from 2004-2008 during an infant respiratory tract infection (104 with rhinovirus and 279 with RSV). Mothers were classified into mutually exclusive groups (atopic asthma, nonatopic asthma, and no asthma). We determined viral cause using PCR and the severity of the infant's respiratory tract infection using the bronchiolitis severity score. Adjusted relative odds of maternal asthma with viral cause were calculated by using logistic regression. Proportional odds models assessed the association of maternal asthma and infant infection severity.

RESULTS

Infants with a mother with atopic asthma compared with infants whose mothers did not have asthma were more likely to have rhinovirus versus RSV infection (adjusted odds ratio, 2.42; 95% CI, 1.19-4.90). Similarly, among infants with rhinovirus, having a mother with atopic asthma was associated with increased infection severity (adjusted odds ratio, 3.10; 95% CI, 1.21-7.98). This relationship was not seen among infants with RSV.

CONCLUSIONS

Clinically significant rhinovirus infection during infancy was more strongly associated with having a mother with atopic asthma than clinically significant RSV infection. Having a mother with atopic asthma was associated with increased severity of infant rhinovirus but not RSV infections. Infants with rhinovirus were more likely to have a familial atopic predisposition, which might partly explain the subsequent increased asthma risk.

摘要

背景

呼吸道合胞病毒(RSV)和鼻病毒感染是最常见的婴儿呼吸道重大疾病,且与儿童哮喘的风险增加有关,但风险的差异不同。

目的

我们旨在确定母亲哮喘是否与婴儿呼吸道感染鼻病毒而非 RSV 的几率增加有关,以及与感染严重程度增加有关。

方法

2004-2008 年期间,招募了母婴二人组,在此期间婴儿出现呼吸道感染(104 例鼻病毒和 279 例 RSV)。母亲被分为互斥组(特应性哮喘、非特应性哮喘和无哮喘)。我们使用 PCR 确定病毒病因,使用细支气管炎严重程度评分确定婴儿呼吸道感染的严重程度。使用逻辑回归计算具有病毒病因的母亲哮喘的调整相对优势比。比例优势模型评估了母亲哮喘与婴儿感染严重程度的关系。

结果

与母亲无哮喘的婴儿相比,患有特应性哮喘的母亲的婴儿更有可能患有鼻病毒而非 RSV 感染(调整后的优势比,2.42;95%置信区间,1.19-4.90)。同样,在患有鼻病毒的婴儿中,母亲患有特应性哮喘与感染严重程度增加相关(调整后的优势比,3.10;95%置信区间,1.21-7.98)。但在患有 RSV 的婴儿中未观察到这种关系。

结论

与具有临床意义的 RSV 感染相比,婴儿期的临床显著鼻病毒感染与母亲患有特应性哮喘的关系更强。母亲患有特应性哮喘与婴儿鼻病毒感染严重程度增加有关,但与 RSV 感染无关。患有鼻病毒的婴儿更有可能具有家族性特应性倾向,这可能部分解释了随后哮喘风险增加的原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7413/7172375/7d951fd91f59/gr1_lrg.jpg

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