The Generation R Study Group, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands.
Eur J Epidemiol. 2012 Jun;27(6):453-62. doi: 10.1007/s10654-012-9675-9. Epub 2012 Apr 4.
Ethnic disparities in the prevalence of asthma symptoms in children have been described. We evaluated to what extent the association between ethnic background and respiratory symptoms during the first 2 years of life could be explained by the mediating effect of risk factors for respiratory morbidity. The Generation R Study is a multiethnic, population-based birth cohort study. Pre and postnatal risk factors for respiratory morbidity were prospectively assessed by questionnaires. Information about ethnicity was available for 5,684 infants. The associations between ethnic background and lower respiratory symptoms at 12 and 24 months were evaluated with log-binomial regression models. Relative risks and 95 % confidence intervals (RR [95 % CI]) were computed for Cape Verdean, Moroccan, Antillean, Surinamese and Turkish ethnicity with Dutch ethnicity as the reference category. We found an increased risk of lower respiratory symptoms at 24 months in Antillean infants (1.32 [95 % CI 1.12-1.57]) that was mediated by early postnatal exposures (pets keeping, siblings, breastfeeding, daycare attendance, smoke exposure). Turkish infants also had an increased risk of lower respiratory symptoms at 12 and 24 months (1.14 [95 % CI 1.02-1.27] and 1.21 [95 % CI 1.07-1.38], respectively), partly explained by previous morbidity (eczema, infections and upper respiratory symptoms). There were no differences for Cape Verdean, Moroccan or Surinamese, as compared to Dutch infants. Hence, ethnic background was associated with respiratory symptoms during the first 2 years of life and this association was largely explained by mediating effects of known pre and postnatal risk factors for respiratory morbidity.
已描述了儿童哮喘症状的种族差异。我们评估了在生命的头 2 年中，种族背景与呼吸道症状之间的关联在多大程度上可以通过呼吸道发病风险因素的中介作用来解释。Generation R 研究是一项多民族、基于人群的出生队列研究。通过问卷前瞻性评估了呼吸道发病风险的产前和产后危险因素。有 5684 名婴儿的种族信息可用。使用对数二项式回归模型评估了种族背景与 12 个月和 24 个月时下呼吸道症状之间的关联。相对风险和 95％置信区间（RR [95％CI]）是用开普敦、摩洛哥、安的列斯、苏里南和土耳其裔与荷兰裔作为参考类别计算得出的。我们发现，24 个月时安的列斯婴儿的下呼吸道症状风险增加（1.32 [95％CI 1.12-1.57]），这是由产后早期暴露（养宠物、兄弟姐妹、母乳喂养、日托出勤率、吸烟暴露）引起的。土耳其婴儿在 12 个月和 24 个月时也有较高的下呼吸道症状风险（1.14 [95％CI 1.02-1.27]和 1.21 [95％CI 1.07-1.38]），部分原因是先前的发病（湿疹、感染和上呼吸道症状）。与荷兰婴儿相比，开普敦、摩洛哥或苏里南婴儿没有差异。因此，种族背景与生命的头 2 年期间的呼吸道症状有关，而这种关联在很大程度上可以通过呼吸道发病风险的已知产前和产后风险因素的中介作用来解释。
