Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
School of Statistics, East China Normal University, Shanghai, China.
BMJ Open. 2021 Nov 25;11(11):e045728. doi: 10.1136/bmjopen-2020-045728.
Asthma is a common chronic disease that imposes a substantial burden on individuals and society. However, the natural history of childhood asthma in a large population remained to be studied. This study aimed to describe the natural course of childhood asthma and examine the association between early life factors and childhood asthma.
A population-based cohort study.
This study was based on the national registry data in Denmark.
All liveborn singletons in Denmark during 1995-1997 were identified and followed them till the end of 2009. Finally, 193 673 children were eligible for our study.
The following characteristics were examined as potential early life factors associated with childhood asthma, including parity, maternal asthma history, maternal smoking during pregnancy, maternal social status, delivery method and gender.
Asthma cases were identified on the basis of hospitalisation for asthma and prescriptions for antiasthmatic medications. Asthma remission was defined as no hospitalisation or prescription recorded for 2 years. Cox proportional hazards' regression and logistic regression were used to evaluate the association between early life factors and the occurrence and remission of childhood asthma.
The cumulative occurrence rate of asthma in children aged 3-14 years was 13.3% and the remission rate was 44.1%. The occurrence rate decreased with age. Being female had a lower risk of asthma (HR: 0.72, 95% CI 0.70 to 0.74) and higher remission rate of asthma (HR: 1.18, 1.13 to 1.22), while maternal asthma was associated with a higher risk of asthma (HR: 2.15, 2.04 to 2.26) and decreased remission rate of asthma (HR: 0.79, 0.73 to 0.85). These patterns remained the same for early onset asthma.
Female gender had a lower risk of asthma and a better chance of remission, while maternal asthma history had an opposite effect. The early life factors may influence the natural course of childhood asthma.
哮喘是一种常见的慢性疾病，给个人和社会带来了沉重负担。然而，大量人群的儿童哮喘自然史仍有待研究。本研究旨在描述儿童哮喘的自然病程，并探讨生命早期因素与儿童哮喘之间的关系。
基于人群的队列研究。
本研究基于丹麦全国登记处的数据。
确定 1995-1997 年期间丹麦所有活产单胎，并随访至 2009 年底。最终，有 193673 名儿童符合我们的研究条件。
研究考察了以下特征作为与儿童哮喘相关的潜在生命早期因素，包括产次、母亲哮喘史、母亲孕期吸烟、母亲社会地位、分娩方式和性别。
根据哮喘住院和抗哮喘药物处方确定哮喘病例。哮喘缓解定义为连续 2 年无住院或处方记录。采用 Cox 比例风险回归和逻辑回归评估生命早期因素与儿童哮喘发生和缓解之间的关系。
3-14 岁儿童哮喘的累积发生率为 13.3%，缓解率为 44.1%。发生率随年龄增长而降低。女性哮喘的发病风险较低（HR：0.72，95%CI 0.70 至 0.74），缓解率较高（HR：1.18，1.13 至 1.22），而母亲哮喘与哮喘发病风险增加（HR：2.15，2.04 至 2.26）和哮喘缓解率降低（HR：0.79，0.73 至 0.85）相关。这些模式对于早发型哮喘仍然适用。
女性性别哮喘发病风险较低，缓解机会较大，而母亲哮喘史则有相反的影响。生命早期因素可能影响儿童哮喘的自然病程。
