Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University.
Department of Obstetrics and Gynecology, Asahikawa Medical University.
J Epidemiol. 2022 Jun 5;32(6):270-276. doi: 10.2188/jea.JE20200438. Epub 2021 Jul 10.
Lower respiratory tract infections (LRTIs) are a cause of inpatient and outpatient care among children. Although orofacial clefts seem to be associated with LRTIs, epidemiological studies are scarce on this topic. This study aimed to examine whether infants with orofacial clefts were associated with LRTIs.
This prospective cohort study used data from the Japan Environment and Children's Study, for which baseline recruitment was conducted during 2011-2014. This study included 81,535 participants. The number of infants with cleft lip and palate (CLP), cleft lip (CL), and cleft palate only (CP) was 67, 49, and 36, respectively. We defined history of LRTIs until 12 months' age reported by their mothers as the dependent variable. Accumulated breastfeeding duration was used as a potential mediator.
The incidence proportion of LRTIs among the control group was 6.0%. The incidence proportion among infants with CLP, CL, and CP were 11.9%, 14.3%, and 5.6%, respectively. After adjusting for covariates, compared with the control group, infants with CLP and CL were associated with risk of LRTIs (incidence risk ratio [IRR] of CLP, 2.38; 95% confidence interval [CI], 1.30-4.36 and IRR of CL, 2.73; 95% CI, 1.40-5.33), but not ones with CP (IRR 1.08; 95% CI, 0.28-4.15). Accumulated breastfeeding duration decreased the IRR of CLP only (IRR of CLP, 2.16; 95% CI, 1.19-3.93).
Infants with orofacial clefts aged 1 year have a potentially high incidence proportion of LRTIs. Accumulated breastfeeding duration might mediate the associations of CLP.
下呼吸道感染（LRTIs）是儿童住院和门诊治疗的原因。尽管口腔裂似乎与 LRTIs 有关，但关于这个主题的流行病学研究很少。本研究旨在研究口腔裂婴儿是否与 LRTIs 有关。
这项前瞻性队列研究使用了日本环境与儿童研究的数据，该研究在 2011-2014 年期间进行了基线招募。该研究包括 81535 名参与者。唇裂和腭裂（CLP）、唇裂（CL）和单纯腭裂（CP）的婴儿数量分别为 67、49 和 36。我们将母亲报告的 12 个月龄前的 LRTI 病史定义为因变量。累积母乳喂养时间被用作潜在的中介。
对照组的 LRTI 发生率比例为 6.0%。CLP、CL 和 CP 组的发生率比例分别为 11.9%、14.3%和 5.6%。调整了协变量后，与对照组相比，CLP 和 CL 组的婴儿与 LRTIs 的风险相关（CLP 的发病率风险比[IRR]为 2.38；95%置信区间[CI]为 1.30-4.36，CL 的 IRR 为 2.73；95%CI 为 1.40-5.33），但 CP 组无关联（IRR 为 1.08；95%CI 为 0.28-4.15）。累积母乳喂养时间仅降低了 CLP 的 IRR（CLP 的 IRR 为 2.16；95%CI 为 1.19-3.93）。
1 岁的口腔裂婴儿 LRTIs 的发生率比例可能较高。累积母乳喂养时间可能介导 CLP 的相关性。
