Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK.
Matern Child Health J. 2013 Aug;17(6):1119-29. doi: 10.1007/s10995-012-1114-8.
To assess the impact of parental asthma on risk of pre-term birth (PTB) and intrauterine growth restriction, and their subsequent association with childhood asthma. Three sequential cross-sectional surveys were conducted in 1993 (3,746), 1998 (1,964) and 2006 (1,074) in the same 15 schools among 5-11 year old children in Merseyside using the same respiratory health questionnaire completed by parents (sample size in brackets). Between 1993 and 2006, prevalence of PTB varied between 12.4 and 15.2 %, and of small for gestational age (SGA or growth restricted) babies between 2.1 and 4.6 %, and maternal asthma prevalence between 8.1 and 13.4 %. For the combined surveys mothers with asthma were more likely to have a PTB than non-asthmatic mothers (OR 1.39, 95 % CI 1.10-1.95, p < 0.001), and in the 2006 survey were more likely to have an SGA baby. 40.9 % of PTBs of asthmatic mothers developed doctor diagnosed asthma compared to 34.3 % for term babies (adjusted OR 1.65, 1.34-2.04, p < 0.001). The corresponding estimates for the symptom triad of cough, wheeze and breathlessness were 19.4 and 17.6 % (adjusted OR 1.78, 0.79-3.98). Conversely SGA babies were less likely to develop doctor diagnosed asthma (adjusted OR 0.49, 0.27-0.90, p < 0.021), or the symptom triad of cough, wheeze and breathlessness (adjusted OR 0.22, 0.05-0.97, p < 0.043), whether or not the mother was asthmatic. Maternal asthma is an independent risk factor for PTB which predisposes to childhood asthma. Intrauterine growth restriction was protective against childhood asthma.
为了评估父母哮喘对早产（PTB）和宫内生长受限的影响，以及它们随后与儿童哮喘的关联。在默西塞德郡的 15 所学校中，对 5-11 岁儿童进行了三项连续的横断面调查，分别于 1993 年（3746 人）、1998 年（1964 人）和 2006 年（1074 人）进行，使用相同的由父母填写的呼吸健康问卷（括号内为样本量）。在 1993 年至 2006 年间，PTB 的患病率在 12.4%至 15.2%之间，小于胎龄儿（SGA 或生长受限）的患病率在 2.1%至 4.6%之间，母亲哮喘的患病率在 8.1%至 13.4%之间。对于合并调查，患有哮喘的母亲比非哮喘母亲更有可能早产（OR 1.39，95%CI 1.10-1.95，p<0.001），并且在 2006 年的调查中，更有可能有 SGA 婴儿。40.9%的哮喘母亲所生的早产儿被诊断为哮喘，而足月婴儿的这一比例为 34.3%（调整后的 OR 1.65，1.34-2.04，p<0.001）。咳嗽、喘息和呼吸困难三联征的相应估计值为 19.4%和 17.6%（调整后的 OR 1.78，0.79-3.98）。相反，SGA 婴儿不太可能被诊断为哮喘（调整后的 OR 0.49，0.27-0.90，p<0.021），也不太可能出现咳嗽、喘息和呼吸困难三联征（调整后的 OR 0.22，0.05-0.97，p<0.043），无论母亲是否患有哮喘。母亲哮喘是早产的独立危险因素，使儿童易患哮喘。宫内生长受限对儿童哮喘有保护作用。
