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卡介苗接种与魁北克免疫与健康出生队列儿童哮喘之间的关联。

Association Between Bacillus Calmette-Guérin Vaccination and Childhood Asthma in the Quebec Birth Cohort on Immunity and Health.

作者信息

El-Zein Mariam, Conus Florence, Benedetti Andrea, Menzies Dick, Parent Marie-Elise, Rousseau Marie-Claude

出版信息

Am J Epidemiol. 2017 Aug 1;186(3):344-355. doi: 10.1093/aje/kwx088.

Abstract

We estimated the association between bacillus Calmette-Guérin (BCG) vaccination and childhood asthma in a birth cohort using administrative databases, and we determined the impact of adjusting for potential confounders collected from a subset of the cohort members. Data were collected in 2 waves: 1) Administrative data for 76,623 individuals (stage 1) was gathered from the Quebec Birth Cohort on Immunity and Health (1974-1994), including BCG vaccination status, perinatal and sociodemographic characteristics, and use of health services for asthma; and 2) self-reported asthma risk factors were collected in 2012 by telephone interviews with 1,643 participants (stage 2) using a balanced 2-stage sampling design. We estimated odds ratios and 95% confidence intervals for asthma using logistic regression and correcting for the known sampling fractions from stage 1 to stage 2, overall and sex-stratified. In total, 35,612 (46.5%) individuals were BCG vaccinated, and 5,870 (7.7%) had asthma. The final odds ratio, integrating results from both stages of sampling, was 0.95 (95% confidence interval: 0.87, 1.04). Results did not differ according to sex (P for interaction = 0.327). To our knowledge, this is the largest study ever conducted on this topic, and using the best possible comprehensive adjustment for confounders, we found no association between BCG vaccination and asthma.

摘要

我们利用行政数据库估计了出生队列中卡介苗(BCG)接种与儿童哮喘之间的关联,并确定了对从队列成员子集中收集的潜在混杂因素进行调整的影响。数据收集分两个阶段进行:1)从魁北克免疫与健康出生队列(1974 - 1994年)收集了76,623人的行政数据(第一阶段),包括卡介苗接种状况、围产期和社会人口学特征以及哮喘医疗服务使用情况;2)2012年通过电话访谈对1,643名参与者采用平衡两阶段抽样设计收集了自我报告的哮喘危险因素(第二阶段)。我们使用逻辑回归并校正从第一阶段到第二阶段已知的抽样比例,总体和按性别分层估计哮喘的比值比和95%置信区间。总共有35,612人(46.5%)接种了卡介苗,5,870人(7.7%)患有哮喘。整合两个抽样阶段结果的最终比值比为0.95(95%置信区间:0.87, 1.04)。结果在性别上无差异(交互作用P = 0.327)。据我们所知,这是有史以来关于该主题开展的最大规模研究,并且通过对混杂因素进行尽可能全面的调整,我们发现卡介苗接种与哮喘之间无关联。

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