Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Child Health Advocacy Institute, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China.
World J Pediatr. 2021 Aug;17(4):419-428. doi: 10.1007/s12519-021-00436-x. Epub 2021 Jun 10.
Asthma has been a global problem, especially in children. We aim to evaluate the contemporary prevalence and influencing factors of asthma among children aged 3-7 years in Shanghai, China.
A random sample of preschool children was included in this study. The International Study of Asthma and Allergies in Childhood questionnaire was adopted to assess the childhood asthma. Multivariable logistic regression models were used to evaluate the associations between independent variables and childhood asthma.
Of 6389 preschool children who were invited to take part in this study, 6163 (response rate: 96.5%) completed the questionnaire and were included in the analysis. The overall prevalence of asthma was 14.6% which increased more than six folds from 2.1% in 1990. Being male, younger age, preterm delivery, being born in spring or autumn, being delivered by elective cesarean section without indication, miscarriage, high socioeconomic status, having allergy history, and exposure to passive smoking, latex paint, and dust were potential risk factors for childhood asthma. Spending more time outdoors (> 30 min/day), having indoor plants, and cleaning rooms more frequently were potential protective factors.
The prevalence of childhood asthma in Shanghai has increased dramatically during the past three decades. The findings about risk and protective factors of childhood asthma could be used to develop appropriate strategies to prevent and control childhood asthma in Shanghai and in other similar metropolitan cities.
哮喘是一个全球性问题，尤其在儿童中更为常见。本研究旨在评估中国上海地区 3-7 岁儿童哮喘的现患率及其影响因素。
本研究采用随机抽样的方法选取了学龄前儿童作为研究对象。采用国际儿童哮喘和过敏研究（ISAAC）问卷调查了儿童哮喘的患病情况。采用多因素 logistic 回归模型分析了各因素与儿童哮喘之间的相关性。
在 6389 名受邀参加本研究的学龄前儿童中，有 6163 名（应答率：96.5%）完成了问卷调查并纳入了分析。哮喘现患率为 14.6%，较 1990 年的 2.1%增加了 6 倍以上。男性、年龄较小、早产、春季或秋季出生、无医学指征行择期剖宫产、流产、高社会经济地位、有过敏史、接触被动吸烟、乳胶漆和灰尘是儿童哮喘的潜在危险因素。经常在户外活动（>30min/d）、室内有植物和经常打扫房间是儿童哮喘的潜在保护因素。
在过去的 30 年中，上海地区儿童哮喘的现患率显著增加。本研究关于儿童哮喘的危险因素和保护因素的发现，可为上海乃至其他类似大都市地区制定预防和控制儿童哮喘的策略提供依据。
