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胎儿及婴儿生长模式、气道阻力与学龄期哮喘。

Foetal and infant growth patterns, airway resistance and school-age asthma.

作者信息

Sonnenschein-van der Voort Agnes M M, Gaillard Romy, de Jongste Johan C, Hofman Albert, Jaddoe Vincent W V, Duijts Liesbeth

机构信息

The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.

Department of Pediatrics, Division of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.

出版信息

Respirology. 2016 May;21(4):674-82. doi: 10.1111/resp.12718. Epub 2015 Dec 23.

Abstract

BACKGROUND AND OBJECTIVE

Preterm birth, low birth weight and rapid infant weight gain are associated with increased risks of asthma symptoms in childhood. The underlying mechanism may include persistently higher airway resistance (Rint). The aim of our study was to examine the associations of longitudinally measured foetal and infant growth characteristics with Rint and asthma outcomes in school-age children.

METHODS

This study was embedded in a population-based prospective cohort study in Rotterdam, The Netherlands. Foetal growth was estimated by ultrasound in the second and third trimesters. Infant growth was measured at birth, 3, 6 and 12 months. At age 6 years, Rint was measured, and information about wheezing and asthma was obtained by questionnaires. The number of subjects per analysis differed per available outcome (3954-5066 subjects).

RESULTS

Longitudinal growth analyses showed that school-age children with increased Rint had lower foetal length growth and weight gain, and lower infant length growth. Children with persistent wheezing until age 6 years and physician-diagnosed asthma had a higher Rint compared with children who never wheezed or without asthma (difference z-scores Rint: 0.58 (0.19, 0.97) and 0.55 (0.15, 0.95), respectively).

CONCLUSION

Rint in school-age children is influenced by foetal growth restriction and is associated with asthma outcomes. See article, page 574.

摘要

背景与目的

早产、低出生体重以及婴儿体重快速增加与儿童期哮喘症状风险增加相关。潜在机制可能包括持续较高的气道阻力(Rint)。我们研究的目的是检验纵向测量的胎儿和婴儿生长特征与学龄儿童的Rint及哮喘结局之间的关联。

方法

本研究纳入了荷兰鹿特丹一项基于人群的前瞻性队列研究。在孕中期和孕晚期通过超声估计胎儿生长情况。在出生时、3个月、6个月和12个月测量婴儿生长情况。在6岁时测量Rint,并通过问卷获取喘息和哮喘相关信息。每次分析的受试者数量因可用结局而异(3954 - 5066名受试者)。

结果

纵向生长分析显示,Rint升高的学龄儿童胎儿期身长增长和体重增加较低,婴儿期身长增长也较低。与从未喘息或无哮喘的儿童相比,持续喘息至6岁且经医生诊断为哮喘的儿童Rint较高(Rint的差异z分数分别为:0.58(0.19,0.97)和0.55(0.15,0.95))。

结论

学龄儿童的Rint受胎儿生长受限影响,并与哮喘结局相关。见文章第574页。

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