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母亲孕前体重指数、孕期体重增加与子女特应性皮炎的关系:一项前瞻性队列研究。

Association Between Maternal Pre-Pregnancy Body Mass Index, Gestational Weight Gain, and Offspring Atopic Dermatitis: A Prospective Cohort Study.

机构信息

Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Women's College Research Institute and Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada; Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, RI.

Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

出版信息

J Allergy Clin Immunol Pract. 2019 Jan;7(1):96-102.e2. doi: 10.1016/j.jaip.2018.10.044. Epub 2018 Nov 8.

Abstract

BACKGROUND

Maternal weight status may contribute to the development of atopic disorders in children.

OBJECTIVE

The objective of this study was to assess associations of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with risk of atopic dermatitis (AD) in children.

METHODS

Maternal pre-pregnancy BMI and GWG were assessed by questionnaire through the Growing Up Today Study (GUTS), a prospective cohort study of US children. Mothers reported whether GUTS participants had ever been diagnosed with AD by a clinician in either 1997 or 1999, when GUTS participants were between 10 and 17 years old. We used multivariable logistic regression to estimate the association of BMI and GWG with AD in offspring (expressed as odds ratios [ORs] with 95% CIs).

RESULTS

Among 13,269 GUTS participants, 2,058 (16%) had childhood AD. Higher maternal pre-pregnancy BMI was not associated with AD (P trend = .48). In contrast, GWG was associated with increased AD risk (P trend = .005). Compared with children of mothers who gained 25 to 34 lb, children of mothers who gained 35 to 44 lb (OR, 1.11; 95% CI, 0.98-1.26) and 45 lb or more (OR, 1.23; 95% CI, 1.05-1.43) had an increased risk of AD. These associations appeared stronger with pre-pregnancy BMI greater than 25 (GWG, 35-44 lb: OR, 1.20; 95% CI, 0.84-1.69; GWG, ≥45 lb: OR, 1.57; 95% CI, 1.07-2.31), but the statstical interaction between BMI and GWG was not significant.

CONCLUSIONS

In this study, increased GWG was associated with increased risk of AD in offspring. This supports existing evidence that prenatal exposures contribute to the development of atopic disorders.

摘要

背景

母体体重状况可能会导致儿童发生特应性疾病。

目的

本研究旨在评估母亲孕前体重指数(BMI)和妊娠增重(GWG)与儿童特应性皮炎(AD)风险之间的关系。

方法

通过“今日成长研究(GUTS)”调查问卷评估了母亲孕前 BMI 和 GWG,该研究是一项针对美国儿童的前瞻性队列研究。母亲报告了在 1997 年或 1999 年(当 GUTS 参与者在 10 至 17 岁之间时),GUTS 参与者是否曾被临床医生诊断患有 AD。我们使用多变量逻辑回归来估计 BMI 和 GWG 与后代 AD 的关系(表示为比值比[OR]及其 95%置信区间)。

结果

在 13269 名 GUTS 参与者中,有 2058 名(16%)患有儿童 AD。较高的母亲孕前 BMI 与 AD 无关(P 趋势=.48)。相比之下,GWG 与 AD 风险增加相关(P 趋势=.005)。与母亲体重增加 25-34 磅的儿童相比,母亲体重增加 35-44 磅(OR,1.11;95%CI,0.98-1.26)和增加 45 磅或更多(OR,1.23;95%CI,1.05-1.43)的儿童患 AD 的风险增加。这些关联在孕前 BMI 大于 25 时似乎更强(GWG,35-44 磅:OR,1.20;95%CI,0.84-1.69;GWG,≥45 磅:OR,1.57;95%CI,1.07-2.31),但 BMI 和 GWG 之间的统计学交互作用不显著。

结论

在这项研究中,GWG 的增加与后代 AD 风险的增加有关。这支持了现有的证据,即产前暴露会导致特应性疾病的发生。

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