Environmental and Occupational Medicine, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan.
Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan.
Pediatr Allergy Immunol. 2018 Mar;29(2):159-165. doi: 10.1111/pai.12835. Epub 2017 Dec 19.
Children with early-onset atopic dermatitis (AD) are at substantial risk of developing asthma later in life, and identifying the critical window of detrimental exposure is advantageous for implementing preventive actions. The aim of this study was to evaluate the role of exposure to environmental modifiers during pregnancy and early childhood in asthma occurrence in an infantile AD cohort.
Eligible study participants were selected from the Taiwan Birth Cohort Study, which enrolled 24 200 newborns in 2005. We enrolled those cases who had been diagnosed as having AD before 3 years of age and followed them up till age 8. We excluded those ever diagnosed with asthma before AD onset. The dependent variable was defined in terms of whether the participant was diagnosed as having asthma before 8 years of age. We applied logistic regression models to evaluate the risks of exposure to different determinants in asthma occurrence.
A total of 1549 children with AD had completed the 8-year follow-up, and 334 (21.6%) of them had asthma. The results revealed that male sex, lower birth order, maternal asthma history, maternal obesity before pregnancy, and environmental tobacco smoke exposure before 3 years of age were significant risk factors for further development of asthma. Furthermore, food allergy during early life, lower respiratory tract infection, and longer durations of symptomatic AD influenced asthma development later in life.
The findings confirmed the critical determinants for asthma occurrence in infantile AD, which may enable a more personalized approach to the prevention of asthma.
早发性特应性皮炎(AD)患儿在以后的生活中发展为哮喘的风险很大,确定有害暴露的关键窗口有利于采取预防措施。本研究旨在评估妊娠和幼儿期环境修饰剂暴露对婴儿 AD 队列中哮喘发生的作用。
从 2005 年招募的 24200 名新生儿中筛选出符合条件的研究参与者,参与了台湾出生队列研究。我们招募了那些在 3 岁之前被诊断患有 AD 的病例,并对他们进行了 8 岁以下的随访。我们排除了那些在 AD 发病前被诊断为哮喘的病例。因变量定义为参与者在 8 岁之前是否被诊断为哮喘。我们应用逻辑回归模型来评估不同决定因素暴露于哮喘发生的风险。
共有 1549 名患有 AD 的儿童完成了 8 年的随访,其中 334 名(21.6%)患有哮喘。结果表明,男性、较低的出生顺序、母亲哮喘史、妊娠前母亲肥胖和 3 岁前暴露于环境烟草烟雾是进一步发展为哮喘的显著危险因素。此外,婴儿期食物过敏、下呼吸道感染和更长时间的有症状 AD 影响了以后生活中哮喘的发展。
研究结果证实了婴儿 AD 中哮喘发生的关键决定因素,这可能使我们能够采取更个性化的方法预防哮喘。