Environmental Health Center, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
Ann Allergy Asthma Immunol. 2018 Mar;120(3):292-299. doi: 10.1016/j.anai.2017.12.009.
Perinatal factors are suspected to have a significant impact on the development of asthma; however, sufficiently powered studies have not been performed to investigate this issue.
To evaluate whether perinatal factors and other risk factors have an independent or combined effect on the development of asthma.
This study involved 3,770 children (mean age 9.1 years, range 5.68-12.16 years; 51.9% boys) who were enrolled in the Elementary School Student Cohort (2009-2014) in Ulsan University Hospital (Ulsan, Korea). Subjects were divided into an asthma group (n = 514) and a non-asthma group (n = 3,256).
Multivariate analyses showed that early life (within first week) oxygen therapy (adjusted odds ratio [aOR] 1.864, 95% confidence interval [CI] 1.156-3.004) and breastfeeding (aOR 0.763, 95% CI 0.606-0.960) were 2 significant perinatal factors influencing the development of asthma. Environmental tobacco smoke (aOR 1.634, 95% CI 1.298-2.058) and parental allergic disease (aOR 1.882, 95% CI 1.521-2.328) also were identified as risk factors. Using subgroup analyses, combined effects on asthma development were observed between perinatal factors (early life oxygen therapy and breastfeeding) and other risk factors (vicinity to major roadway [traffic-related air pollution], environmental tobacco smoke, parental allergic disease, and atopy).
Early life oxygen therapy and breastfeeding were identified as 2 important perinatal factors influencing the development of asthma. Furthermore, these factors showed combined effects with other risk factors (environmental tobacco smoke, traffic-related air pollution, parental allergic disease, and atopy) on the development of asthma.
围产期因素被怀疑对哮喘的发展有重大影响，但尚未进行足够有力的研究来调查这一问题。
评估围产期因素和其他危险因素是否对哮喘的发展有独立或联合作用。
这项研究涉及 3770 名儿童（平均年龄 9.1 岁，范围 5.68-12.16 岁；51.9%为男孩），他们参加了蔚山大学医院（韩国蔚山）的小学生队列研究（2009-2014 年）。研究对象分为哮喘组（n=514）和非哮喘组（n=3256）。
多变量分析显示，生命早期（第一周内）的氧疗（调整后的优势比[aOR] 1.864，95%置信区间[CI] 1.156-3.004）和母乳喂养（aOR 0.763，95%CI 0.606-0.960）是影响哮喘发展的 2 个重要围产期因素。环境烟草烟雾（aOR 1.634，95%CI 1.298-2.058）和父母的过敏疾病（aOR 1.882，95%CI 1.521-2.328）也被确定为危险因素。使用亚组分析，围产期因素（生命早期氧疗和母乳喂养）与其他危险因素（靠近主要道路[交通相关空气污染]、环境烟草烟雾、父母过敏疾病和特应性）之间观察到对哮喘发展的联合效应。
生命早期的氧疗和母乳喂养被确定为影响哮喘发展的 2 个重要围产期因素。此外，这些因素与其他危险因素（环境烟草烟雾、交通相关空气污染、父母过敏疾病和特应性）一起对哮喘的发展具有联合作用。
