Arif Ahmed A, Veri Shelby D
Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA.
J Asthma. 2019 Oct;56(10):1056-1061. doi: 10.1080/02770903.2018.1515224. Epub 2018 Oct 1.
: The purpose of the study was to examine the relationship of maternal complications during pregnancy and prenatal exposures with childhood asthma among low-income families in Karachi, Pakistan. : Parents/guardians of children with and without asthma visiting a charity hospital were enrolled. Information about prenatal and perinatal exposures was collected. Univariable and multiple stepwise logistic regression analysis were conducted to explore the relationship of socio-demographic, maternal complications during pregnancy, access to prenatal care, and exposure to animals and pests while pregnant with childhood asthma. : Maternal symptoms of nocturnal cough (adjusted OR [aOR = 2.87, 95% CI = 1.60-5.14) and wheezing (aOR = 5.57, 95% CI = 2.32-13.37) during pregnancy significantly increased the odds of childhood asthma. The family history of asthma or hay fever, also elevated the odds of childhood asthma (adjusted OR [aOR] = 5.86 (3.03-11.34). The odds of asthma among children whose mothers received prenatal care by Dai, an unskilled health worker, were significantly elevated. Lastly, prenatal exposure to rats/mice and contact with goats while pregnant was significantly associated with childhood asthma. Whereas, prenatal exposure to cows/cattle reduces the odds of childhood asthma. : This study identified important maternal and prenatal risk factors for childhood asthma, the majority of which are avoidable. Appropriate steps are needed to create awareness about the prenatal risk factors in this population.
该研究的目的是调查巴基斯坦卡拉奇低收入家庭中孕期母亲并发症及产前暴露因素与儿童哮喘之间的关系。纳入了在一家慈善医院就诊的哮喘患儿及非哮喘患儿的父母/监护人。收集了有关产前和围产期暴露的信息。进行单变量和多步逻辑回归分析,以探讨社会人口统计学因素、孕期母亲并发症、获得产前护理的情况以及孕期接触动物和害虫与儿童哮喘之间的关系。孕期母亲夜间咳嗽症状(调整后比值比[aOR]=2.87,95%置信区间[CI]=1.60-5.14)和喘息症状(aOR=5.57,95%CI=2.32-13.37)会显著增加儿童患哮喘的几率。哮喘或花粉热家族史也会增加儿童患哮喘的几率(调整后OR[aOR]=5.86(3.03-11.34))。母亲由非专业卫生工作者“代”提供产前护理的儿童患哮喘的几率显著升高。最后,孕期接触大鼠/小鼠以及与山羊接触与儿童哮喘显著相关。而孕期接触奶牛/母牛会降低儿童患哮喘的几率。本研究确定了儿童哮喘重要的母亲和产前风险因素,其中大多数是可以避免的。需要采取适当措施,提高该人群对产前风险因素的认识。