孕期母体并发症与儿童早期喘息：14 项出生队列的汇总分析。
Maternal complications in pregnancy and wheezing in early childhood: a pooled analysis of 14 birth cohorts.
机构信息
Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Città della Salute e della Scienza University Hospital, CPO Piedmont, Italy, Inserm, Epidemiology of Allergic and Respiratory diseases (EPAR) Department, U707 and UPMC, EPAR UMR-S 707, Medical School Saint-Antoine, Univ6, Sorbonne Universités Paris, France, Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School and EPIUnit - Institute of Public Health, Porto, Portugal, CIBER Epidemiología y Salud Pública (CIBERESP); Subdirección de Salud Pública de Gipuzkoa; Departamento de Sanidad del Gobierno Vasco; Biodonostia, Donostia Ospitalea, Donostia - San Sebastián, Basque Country, Spain, The Generation R Study, Erasmus Medical Center; Department of Epidemiology, Erasmus Medical Center; Department of Pediatrics, Division of Respiratory Medicine and Neonatology, Erasmus Medical Center, Rotterdam, The Netherlands, University of Valencia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP); Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO, Valencia, Spain, Department of Biomedical and Neuromotor Sciences, University of Bologna - Alma Mater Studiorum, Bologna, Italy, Department of Epidemiology, Lazio Regional Health Service, Rome, Italy, Centre for Research in Environmental Epidemiology (CREAL), Barcelona; Hospital del Mar Research Institute (IMIM), Barcelona, Spanish Consortium for Research on Epidemiology (CIBERESP), Barcelona, Spain, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, United Kingdom, Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark, Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, The Netherlands, Department of Medical Microbiology, NUTRIM School for Nutrition, Toxicology and Metabolism
出版信息
Int J Epidemiol. 2015 Feb;44(1):199-208. doi: 10.1093/ije/dyu260. Epub 2015 Jan 27.
BACKGROUND
Evidence on the effect of maternal complications in pregnancy on wheezing in offspring is still insufficient.
METHODS
A pooled analysis was performed on individual participant data from fourteen European birth cohorts to assess the relationship between several maternal pregnancy complications and wheezing symptoms in the offspring. Exposures of interest included hypertension and preeclampsia, diabetes, as well as pre-pregnancy overweight (body mass index between 25 and 29.9) and obesity (body mass index ≥ 30) compared with normal weight (body mass index between 18.5 and 24.9). Outcomes included both ever and recurrent wheezing from birth up to 12-24 months of age. Cohort-specific crude and adjusted risk ratios (RR) were calculated using log-binomial regression models and then pooled using a random effects model.
RESULTS
The study included 85509 subjects. Cohort-specific prevalence of ever wheezing varied from 20.0% to 47.3%, and of recurrent wheezing from 3.0% to 14.3%. Adjusted pooled RR for ever and recurrent wheezing were: 1.02 (95% CI: 0.98-1.06) and 1.20 (95% CI: 0.98-1.47) for hypertensive disorders; 1.09 (95% CI: 1.01-1.18) and 1.23 (95% CI: 1.07-1.43) for preeclampsia; 1.04 (95% CI: 0.97-1.13) and 1.24 (95% CI: 0.86-1.79) for diabetes; 1.08 (95% CI: 1.05-1.11) and 1.19 (95% CI: 1.12-1.26) for overweight; 1.12 (95% CI: 1.08-1.17) and 1.16 (95% CI: 0.97-1.39) for obesity. No heterogeneity was found in RR estimates among the cohorts, except for diabetes and recurrent wheezing (P=0.027).
CONCLUSIONS
Preeclampsia, maternal pre-pregnancy overweight and obesity are associated with an increase risk of wheezing in the offspring.
背景
关于妊娠期间母亲并发症对后代喘息的影响的证据仍然不足。
方法
对来自 14 个欧洲出生队列的个体参与者数据进行汇总分析，以评估几种母亲妊娠并发症与后代喘息症状之间的关系。感兴趣的暴露包括高血压和先兆子痫、糖尿病，以及与正常体重（体重指数在 18.5 到 24.9 之间）相比的孕前超重（体重指数在 25 到 29.9 之间）和肥胖（体重指数≥30）。结果包括从出生到 12-24 个月时的喘息症状。使用对数二项式回归模型计算队列特异性的粗风险比（RR）和调整 RR，然后使用随机效应模型进行汇总。
结果
该研究共纳入了 85509 名受试者。队列特异性的喘息症状发生率分别为：喘息症状发生率为 20.0%到 47.3%，反复性喘息症状发生率为 3.0%到 14.3%。调整后的喘息症状和反复性喘息症状的汇总 RR 分别为：高血压疾病为 1.02（95%CI：0.98-1.06）和 1.20（95%CI：0.98-1.47）；先兆子痫为 1.09（95%CI：1.01-1.18）和 1.23（95%CI：1.07-1.43）；糖尿病为 1.04（95%CI：0.97-1.13）和 1.24（95%CI：0.86-1.79）；超重为 1.08（95%CI：1.05-1.11）和 1.19（95%CI：1.12-1.26）；肥胖为 1.12（95%CI：1.08-1.17）和 1.16（95%CI：0.97-1.39）。除了糖尿病和反复性喘息症状（P=0.027）外，队列之间 RR 估计值没有发现异质性。
结论
先兆子痫、母亲孕前超重和肥胖与后代喘息风险增加有关。
Zotero 插件