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母亲维生素D状况与儿童哮喘、喘息和湿疹:一项系统评价与荟萃分析。

Maternal vitamin D status and childhood asthma, wheeze, and eczema: A systematic review and meta-analysis.

作者信息

Wei Zhenzhen, Zhang Jun, Yu Xiaodan

机构信息

MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Pediatr Allergy Immunol. 2016 Sep;27(6):612-9. doi: 10.1111/pai.12593. Epub 2016 Jul 20.

Abstract

BACKGROUND

Maternal vitamin D status has been reported to be associated with childhood allergic diseases. However, this association remains to be fully elucidated.

METHODS

A systematic review and meta-analysis was conducted using prospective cohort studies that examined the association between maternal vitamin D status and childhood allergic diseases including wheeze, eczema and asthma. We searched electronic databases of PubMed, EMBASE, the Cochrane library, the Wanfang (Chinese) database, the VIP (Chinese) database, and Chinese National Knowledge Infrastructure (CNKI) up to August 2014. Odds ratios and 95% confidence intervals (CIs) from individual studies were synthesized using a fixed effects model.

RESULTS

Four studies on the association between maternal vitamin D status and childhood asthma (3666 mother-child pairs), four studies on the association between maternal vitamin D status and childhood wheeze (2225 mother-child pairs) and three papers on the association between maternal vitamin D status and childhood eczema (2172 mother-child pairs) met our inclusion criteria. Maternal vitamin D status during pregnancy was associated with childhood eczema (pooled OR=0.904, 95% CI=0.831-0.983). However, the meta-analysis showed no statistical association between maternal vitamin D status and childhood asthma (pooled OR=0.981, 95% CI=0.944-1.019) or childhood wheeze (pooled OR=0.995, 95% CI=0.982-1.009).

CONCLUSIONS

Our meta-analysis found that lower maternal vitamin D during pregnancy was associated with an increased risk of childhood eczema but was not associated with childhood asthma or wheeze. The role of maternal vitamin D as an important protective factor for the development of childhood eczema remains to be elucidated.

摘要

背景

据报道,母亲的维生素D状况与儿童过敏性疾病有关。然而,这种关联仍有待充分阐明。

方法

采用前瞻性队列研究进行系统评价和荟萃分析,以研究母亲维生素D状况与儿童过敏性疾病(包括喘息、湿疹和哮喘)之间的关联。我们检索了截至2014年8月的PubMed、EMBASE、Cochrane图书馆、万方(中文)数据库、维普(中文)数据库和中国知网(CNKI)等电子数据库。使用固定效应模型综合各研究的比值比和95%置信区间(CI)。

结果

四项关于母亲维生素D状况与儿童哮喘关联的研究(3666对母婴)、四项关于母亲维生素D状况与儿童喘息关联的研究(2225对母婴)以及三项关于母亲维生素D状况与儿童湿疹关联的研究(2172对母婴)符合我们的纳入标准。孕期母亲的维生素D状况与儿童湿疹有关(合并OR=0.904,95%CI=0.831-0.983)。然而,荟萃分析显示母亲维生素D状况与儿童哮喘(合并OR=0.981,95%CI=0.944-1.019)或儿童喘息(合并OR=0.995,95%CI=0.982-1.009)之间无统计学关联。

结论

我们的荟萃分析发现,孕期母亲维生素D水平较低与儿童湿疹风险增加有关,但与儿童哮喘或喘息无关。母亲维生素D作为儿童湿疹发展的重要保护因素的作用仍有待阐明。

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