Krzych-Fałta Edyta, Furmańczyk Konrad, Lisiecka-Biełanowicz Mira, Sybilski Adam, Tomaszewska Aneta, Raciborski Filip, Wojas Oksana, Walkiewicz Artur, Samel-Kowalik Piotr, Samoliński Bolesław
Unit of Environmental Hazard Prevention and Allergology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland.
Chair of Applied Mathematics, Faculty of Applied Informatics and Mathematics, Warsaw University of Life Sciences (SGGW), Warsaw, Poland.
Postepy Dermatol Alergol. 2018 Jun;35(3):267-273. doi: 10.5114/ada.2018.76222. Epub 2018 Jun 18.
Cesarean section affects the process of colonization by bacteria transferred from the mother's skin and hospital bacteria, which in turn contributes to development of allergic conditions.
To assess selected risk factors, including the mode of delivery, parity, and the role of genetic factors for the development of allergic rhinitis and bronchial asthma.
The study was conducted in 18,617 respondents aged 6-7, 13-14, and 20-44 years who completed the ECRHS II and ISSAC questionnaires. Thirty percent of the study population underwent complementary assessments in the form of skin-prick tests, serum IgE levels, lung function tests, and peak nasal inspiratory flow (PNIF). The study is a part of the Epidemiology of Allergic Disorders in Poland (ECAP) study conducted in 8 areas in Poland (Warsaw, Lublin, Bialystok, Gdansk, Poznan, Wroclaw, Katowice, Krakow, and two rural areas - Zamosc and Krasnystaw counties).
Respondents diagnosed with allergic rhinitis were at a significantly higher risk of inheriting the allergic condition if their mother (OR = 2.17; 95% CI: 1.98-2.39, = 2.00 × 10) or father (OR = 2.20; 95% CI: 1.96-2.47; = 2.00 × 10) suffers from this allergy. Conversely, in the group diagnosed with bronchial asthma, the highest risk of an inherited allergy was observed in situations where maternal (OR = 2.00; 95% CI: 1.57-2.55; = 1.69 × 10) or paternal (OR = 1.94; 95% CI: 1.42-2.66; = 3.61 × 10) grandparent was affected. Moreover, the risk of developing allergic rhinitis depended on the mode of delivery: i.e. it was higher for a Cesarean section (OR = 1.20; 95% CI: 1.01-1.43; = 0.04) than vaginal delivery (OR = 0.88; 95% CI: 0.78-0.99; = 0.03). The higher the number of siblings, the lower the risk of allergic rhinitis.
Allergy risk factors, especially those predisposing to allergic rhinitis, include not only genetic factors but also the mode of delivery: vaginal delivery or Cesarean section.
剖宫产会影响来自母亲皮肤的细菌和医院细菌的定植过程,这反过来又会促使过敏性疾病的发展。
评估包括分娩方式、产次以及遗传因素在变应性鼻炎和支气管哮喘发展中的作用等选定的风险因素。
该研究针对18617名年龄在6 - 7岁、13 - 14岁和20 - 44岁的受访者进行,他们完成了欧洲社区呼吸健康调查第二轮(ECRHS II)和国际儿童哮喘及变应性疾病研究(ISSAC)问卷。30%的研究人群接受了以皮肤点刺试验、血清IgE水平、肺功能测试和鼻吸气峰流量(PNIF)形式的补充评估。该研究是在波兰8个地区(华沙、卢布林、比亚韦斯托克、格但斯克、波兹南、弗罗茨瓦夫、卡托维兹、克拉科夫以及两个农村地区——扎莫希奇县和克拉斯尼斯陶县)开展的波兰过敏性疾病流行病学(ECAP)研究的一部分。
被诊断为变应性鼻炎的受访者,如果其母亲(比值比[OR] = 2.17;95%置信区间[CI]:1.98 - 2.39;P = 2.00×10)或父亲(OR = 2.20;95% CI:1.96 - 2.47;P = 2.00×10)患有这种过敏症,那么他们遗传该过敏症的风险显著更高。相反,在被诊断为支气管哮喘的人群中,在母亲(OR = 2.00;95% CI:1.57 - 2.55;P = 1.69×10)或父亲(OR = 1.94;95% CI:1.42 - 2.66;P = 3.61×10)的祖父母受影响的情况下,观察到遗传过敏症的风险最高。此外,患变应性鼻炎的风险取决于分娩方式:即剖宫产(OR = 1.20;95% CI:1.01 - 1.43;P = 0.04)的风险高于阴道分娩(OR = 0.88;95% CI:0.78 - 0.99;P = 0.03)。兄弟姐妹数量越多,患变应性鼻炎的风险越低。
过敏风险因素,尤其是那些易患变应性鼻炎的因素,不仅包括遗传因素,还包括分娩方式:阴道分娩或剖宫产。