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儿童时期环境暴露与新发和缓解过敏性疾病的关系:波兰母婴队列研究。

Early life environmental exposure in relation to new onset and remission of allergic diseases in school children: Polish Mother and Child Cohort Study.

机构信息

From the Department of Pediatrics and Allergy, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Pol.

Department of Social and Preventive Medicine, Medical University of Lodz, Lodz, Pol.

出版信息

Allergy Asthma Proc. 2019 Sep 1;40(5):329-337. doi: 10.2500/aap.2019.40.4237.

Abstract

This study was based on data from the Polish Mother and Child Cohort Study. The aim was to study associations between home environment factors and allergic diseases at 1 year of life and new onset and remission of children's allergy diagnosis at ages 7-9 years. Children's health status was assessed at ∼12 months of age and then at ages between 7-9 years by using a questionnaire administered to the mothers. Children were assessed by pediatrician/allergists. The patients, who were 7-9 years old, underwent skin-prick tests. Exposure to tobacco smoke was evaluated with a questionnaire addressed to parents and/or caregivers and cotinine measurements were taken of mother's saliva during pregnancy and in children's urine at ages 7-9 years. Incidence and remission were calculated by comparing symptoms in the first year of life with symptoms at 7-9 years. We studied the associations among demographic data, home environment, and new onset and remission of food allergy, atopic dermatitis, and asthma and allergic rhinitis in logistic regression analysis. All associations were adjusted for independent risk factors of dependent variables. Data from 211 participants were included in the analysis. During the first year of life, food allergy was the most common symptom (39%), followed by atopic dermatitis (35%) and asthma (12%). When comparing diagnoses at ages 7-9 years with the first year of life, food allergy had decreased by as much as 18.6%, atopic dermatitis decreased by as much as 23.8%, and asthma decreased by as much as 8%, whereas asthma and allergic rhinitis had increased from 6% to 14.8%. More frequent house cleaning negatively correlated with the new onset of atopic dermatitis and of asthma and allergic rhinitis. Hypersensitivity to seasonal allergens and mites and to any other allergen positively correlated with new onset of food allergy, atopic dermatitis, and asthma and allergic rhinitis. Parental atopy positively correlated with the new onset of asthma and negatively correlated with asthma remission. Analysis of our findings indicated that new onset and/or remission of allergic diseases was linked with hypersensitivity to house-dust mites in children who were polysensitized and with parental atopy. In addition, children who had food allergy, allergic rhinitis, or atopic dermatitis at the age of 1 year had more of a chance developing other atopic disease (except asthma) at ages 7-9 years and less of a chance of having a remission of the disease.

摘要

这项研究基于波兰母婴队列研究的数据。目的是研究家庭环境因素与 1 岁时过敏性疾病的关系,以及 7-9 岁儿童过敏诊断的新发和缓解情况。在 12 个月大左右以及 7-9 岁时,通过向母亲发放问卷来评估儿童的健康状况。由儿科医生/过敏症专家对儿童进行评估。7-9 岁的患儿接受皮肤点刺试验。通过向父母和/或照顾者发放问卷和检测母亲在怀孕期间以及儿童在 7-9 岁时尿液中的可替宁来评估儿童接触烟草烟雾的情况。通过比较儿童生命第一年的症状与 7-9 岁的症状,计算发病率和缓解率。我们在逻辑回归分析中研究了人口统计学数据、家庭环境与食物过敏、特应性皮炎、哮喘和过敏性鼻炎的新发和缓解之间的关系。所有关联均针对因变量的独立风险因素进行调整。211 名参与者的数据被纳入分析。在生命的第一年,食物过敏是最常见的症状(39%),其次是特应性皮炎(35%)和哮喘(12%)。当将 7-9 岁的诊断与生命的第一年进行比较时,食物过敏减少了 18.6%,特应性皮炎减少了 23.8%,哮喘减少了 8%,而哮喘和过敏性鼻炎增加了 6%至 14.8%。更频繁的房屋清洁与特应性皮炎和哮喘及过敏性鼻炎的新发呈负相关。对季节性过敏原和尘螨及任何其他过敏原的过敏反应与食物过敏、特应性皮炎和哮喘及过敏性鼻炎的新发呈正相关。父母过敏与哮喘的新发呈正相关,与哮喘的缓解呈负相关。对我们研究结果的分析表明,过敏疾病的新发和/或缓解与儿童多敏化时对屋尘螨的过敏反应以及父母过敏有关。此外,1 岁时患有食物过敏、过敏性鼻炎或特应性皮炎的儿童在 7-9 岁时更有可能患上其他特应性疾病(除哮喘外),而疾病缓解的可能性更小。

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