母亲过敏特征史与日本环境与儿童研究中早产妊娠结局的关联。

Association of Maternal History of Allergic Features with Preterm Pregnancy Outcomes in the Japan Environment and Children's Study.

机构信息

Medical Support Center for the Japan Environment and Children's Study, National Center for Child Health and Development, Tokyo, Japan,

Department of Health and Psychosocial Medicine, Aichi Medical University School of Medicine, Nagakute, Japan,

出版信息

Int Arch Allergy Immunol. 2021;182(7):650-662. doi: 10.1159/000513749. Epub 2021 Feb 18.

Abstract

INTRODUCTION

Previous studies have reported that maternal asthma increases the risk of preterm birth. We hypothesized that inflammatory reactions caused by allergic diseases might affect the uterine environment and, subsequently, perinatal outcomes. The objective of this study was to examine the associations between allergic features among mothers and preterm pregnancy outcomes in a nationwide birth cohort.

METHODS

We analyzed data from pregnant women obtained from the Japanese Environment and Children's Study (JECS), a nationwide general birth cohort study. We used binomial and multinomial logistic regression models to examine the associations between maternal allergic features and preterm birth, threatened preterm labor (TPL), and preterm premature rupture of the membrane (PPROM).

RESULTS

A total of 97,683 pregnant women were included. Prevalence of preterm birth, TPL, and PPROM was 4.7, 19.6, and 1.2%, respectively. Maternal history of allergic diseases (asthma, allergic rhinitis, allergic conjunctivitis, food allergy, drug allergy, and contact dermatitis) increased the risk of TPL(adjusted odds ratio [aOR] = 1.11 [95% CI: 1.06-1.17], aOR = 1.12 [1.08-1.16], aOR = 1.10 [1.04-1.16], aOR = 1.17 [1.09-1.26], aOR = 1.35 [1.23-1.48], and aOR = 1.34 [1.20-1.49], respectively). Although some maternal allergic features showed a negative association with preterm birth, the variables affecting preterm birth differed according to the gestational age of the fetus (22-33 weeks vs. 34-36 weeks). There were no significant associations between maternal allergic features and PPROM.

CONCLUSION

Maternal allergic disease, except atopic dermatitis, may increase the risk of TPL. Comorbidity of maternal allergic disorders and perinatal adverse outcomes require further investigation.

摘要

介绍

先前的研究报告称,母亲哮喘会增加早产的风险。我们假设过敏疾病引起的炎症反应可能会影响子宫环境,并进而影响围产期结局。本研究的目的是在一个全国性的出生队列中检查母亲过敏特征与早产妊娠结局之间的关联。

方法

我们分析了来自日本环境与儿童研究(JECS)的孕妇数据,这是一项全国性的一般出生队列研究。我们使用二项和多项逻辑回归模型来检查母亲过敏特征与早产、早产威胁(TPL)和早产胎膜早破(PPROM)之间的关联。

结果

共有 97683 名孕妇纳入研究。早产、TPL 和 PPROM 的发生率分别为 4.7%、19.6%和 1.2%。母亲过敏疾病史(哮喘、过敏性鼻炎、过敏性结膜炎、食物过敏、药物过敏和接触性皮炎)增加了 TPL 的风险(调整后的优势比[aOR] = 1.11[95%CI:1.06-1.17],aOR = 1.12[1.08-1.16],aOR = 1.10[1.04-1.16],aOR = 1.17[1.09-1.26],aOR = 1.35[1.23-1.48],aOR = 1.34[1.20-1.49])。尽管一些母亲的过敏特征与早产呈负相关,但影响早产的变量因胎儿的胎龄(22-33 周与 34-36 周)而异。母亲过敏特征与 PPROM 之间没有显著关联。

结论

除特应性皮炎外,母亲的过敏疾病可能会增加 TPL 的风险。母体过敏疾病的合并症与围产期不良结局需要进一步研究。

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