Department of Women and Children's Health (Paediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, UK.
Faculty of Medicine, Universidad Autónoma de Madrid (UAM), Madrid, Spain.
Int J Gynaecol Obstet. 2023 May;161(2):509-516. doi: 10.1002/ijgo.14562. Epub 2022 Nov 21.
To evaluate the influence of respiratory allergy on obstetrics and perinatal outcomes.
A nested case-control retrospective study on 41 035 pregnant women. Obstetrics and perinatal outcomes of women with or without respiratory allergy were compared. Rates of preterm delivery (<37 weeks of gestation), low birth weight (<2500 g), neonatal acidosis (pH < 7.20), low 5-min APGAR score (<7), cesarean section rate and indications, and perinatal morbidity and mortality were analyzed. Results are expressed as number and percentages. χ and Fisher exact tests were used for comparisons. Logistic regression was used. Statistical significance was set at 95% level (P < 0.05).
A total of 724 (1.8%) patients had respiratory allergy, and their rates of preterm delivery and low birth weight were significantly higher than those of control women (both P < 0.001). Nevertheless, analyzing the causes, multiple gestation rate was significantly higher in this group, and adjusting by this, no statistical difference was found in any of the perinatal outcomes studied. In addition, in vitro fertilization and sterility were also significantly higher in the respiratory allergy group (both P < 0.001).
Women with respiratory allergy are at higher risks of prematurity and low birth weight but these results are mediated by sterility, in vitro fertilization, and multiple gestation rate. Nonetheless, participation of inflammatory mechanisms should be further studied.
评估呼吸性过敏对产科及围产结局的影响。
对 41035 名孕妇进行巢式病例对照回顾性研究。比较有或无呼吸性过敏孕妇的产科及围产结局。早产(<37 周)、低出生体重(<2500g)、新生儿酸中毒(pH<7.20)、5 分钟 APGAR 评分低(<7)、剖宫产率及指征、围产儿发病率及死亡率的发生率进行分析。结果以例数和百分比表示。采用 χ2 和 Fisher 确切检验进行比较。采用 logistic 回归分析。以 95%置信水平(P<0.05)为差异有统计学意义。
共有 724 名(1.8%)患者患有呼吸性过敏,其早产和低出生体重的发生率明显高于对照组(均 P<0.001)。然而,分析原因后发现,该组多胎妊娠率明显较高,在调整这一因素后,所研究的围产结局中无统计学差异。此外,该组体外受精和不孕的发生率也明显更高(均 P<0.001)。
患有呼吸性过敏的女性早产和低出生体重的风险较高,但这些结果是由不孕、体外受精和多胎妊娠率介导的。然而,应进一步研究炎症机制的参与。