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出生后第一周使用抗生素与 12 岁时发生特应性哮喘相关。

Antibiotics in the first week of life were associated with atopic asthma at 12 years of age.

机构信息

Department of Paediatrics, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden.

出版信息

Acta Paediatr. 2018 Oct;107(10):1798-1804. doi: 10.1111/apa.14332. Epub 2018 Apr 16.

Abstract

AIM

This study explored the prevalence of atopic and nonatopic asthma in 12-year-old children and whether they were associated with different risk factors. In particular, we wanted to analyse whether receiving antibiotics during the first week of life was associated with asthma at that age.

METHODS

Data were obtained from a longitudinal cohort study of 5654 Swedish children born in 2003. The parents answered questionnaires from the age of six months until 12 years. The response rate at 12 years was 3637/4777 (76%).

RESULTS

At 12 years, 6.4% reported current doctor-diagnosed asthma. Treatment with antibiotics during the first week of life was associated with an increased risk of atopic asthma, with an adjusted odds ratio of 2.2 and 95% confidence interval of 1.2-4.2. Being born small for gestational age was associated with an increased risk of nonatopic asthma, with an adjusted odds ratio of 3.8 and 95% confidence interval of 1.1-13.7. Asthma that only occurred with colds was reported by 28%.

CONCLUSION

Antibiotic treatment during the first week of life was associated with an increased risk of atopic asthma at 12 years, suggesting an immune-mediated effect. Being born small for gestational age increased the risk of nonatopic asthma.

摘要

目的

本研究旨在探讨 12 岁儿童中特应性和非特应性哮喘的流行情况,以及它们是否与不同的危险因素相关。特别是,我们希望分析生命的第一周内使用抗生素是否与该年龄的哮喘有关。

方法

数据来自于 2003 年出生的 5654 名瑞典儿童的纵向队列研究。父母从 6 个月大到 12 岁时回答问卷。12 岁时的应答率为 3637/4777(76%)。

结果

12 岁时,6.4%报告了目前经医生诊断的哮喘。生命的第一周内使用抗生素与特应性哮喘的风险增加相关,调整后的优势比为 2.2,95%置信区间为 1.2-4.2。出生时为小于胎龄儿与非特应性哮喘的风险增加相关,调整后的优势比为 3.8,95%置信区间为 1.1-13.7。仅在感冒时发生的哮喘报告占 28%。

结论

生命的第一周内使用抗生素与 12 岁时特应性哮喘的风险增加有关,提示存在免疫介导的作用。出生时为小于胎龄儿增加了非特应性哮喘的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a56/6175332/8bb433edac47/APA-107-1798-g001.jpg

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