National Research Council of Italy, Institute for Biomedical Research and Innovation, 90146 Palermo, Italy.
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90100 Palermo, Italy.
Int J Environ Res Public Health. 2020 Jul 14;17(14):5087. doi: 10.3390/ijerph17145087.
Prenatal smoking exposure and early-life respiratory infections are major determinants of asthma during childhood. We investigate the factors influencing allergic sensitization (AS), asthma, and lung function in children and the balance between individual and environmental characteristics at different life stages. 1714 children aged 7-16 years and living in southern Italy were investigated using a parental questionnaire, skin prick tests, and spirometry. We found 41.0% AS prevalence: among children without parental history of asthma, male sex, maternal smoking during pregnancy (MatSmoke), and acute respiratory diseases in the first two years of life (ARD2Y) were significant risk factors for AS. MatSmoke was associated (OR = 1.79) with ARD2Y, and this association was influenced by sex. ARD2Y was, in turn, a significant risk factor (OR = 8.53) for childhood current asthma, along with AS (OR up to 3.03) and rhinoconjuctivitis (OR = 3.59). Forced mid-expiratory flow (FEF) was negatively affected by ARD2Y, with a sex-related effect. Thus, males exposed to MatSmoke had significantly lower FEF than unexposed males. Despite the difficulty of discriminating among the complex interactions underlying the development of allergic respiratory diseases, ARD2Y appears to strongly influence both asthma and lung function during childhood. In turn, ARD2Y is influenced by prenatal exposure to tobacco smoke with a sex-dependent effect.
产前吸烟暴露和婴幼儿期呼吸道感染是儿童期哮喘的主要决定因素。我们研究了影响儿童过敏敏化（AS）、哮喘和肺功能的因素，以及不同生命阶段个体和环境特征之间的平衡。 1714 名年龄在 7-16 岁、居住在意大利南部的儿童通过父母问卷、皮肤点刺试验和肺功能检查进行了调查。我们发现 41.0%的 AS 患病率：在没有父母哮喘病史的儿童中，男性、母亲怀孕期间吸烟（MatSmoke）和婴幼儿期前两年的急性呼吸道疾病（ARD2Y）是 AS 的显著危险因素。MatSmoke 与 ARD2Y 相关（OR = 1.79），这种关联受性别影响。ARD2Y 反过来又是儿童期当前哮喘的显著危险因素（OR = 8.53），与 AS（OR 高达 3.03）和鼻结膜炎（OR = 3.59）有关。中呼气流量（FEF）受到 ARD2Y 的负面影响，存在性别相关效应。因此，暴露于 MatSmoke 的男性的 FEF 明显低于未暴露的男性。尽管很难区分过敏性呼吸道疾病发展背后的复杂相互作用，但 ARD2Y 似乎强烈影响儿童期的哮喘和肺功能。反过来，ARD2Y 受到产前吸烟暴露的影响，具有性别依赖性效应。
