Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Hunan, 410013, China.
Changsha Woman and Children Health Care Hospital Affilated to Hunan Normal University, NO. 416 Chengnan East Road, Changsha, 410007, Hunan, China.
BMC Pediatr. 2023 Mar 1;23(1):96. doi: 10.1186/s12887-023-03870-0.
The purpose of this study was to provide evidence for early life care by meta-analyzing the relationship between infection during pregnancy and up to 2 years of age and the risk of subsequent allergic rhinitis (AR).
Published studies up to April 2022 were systematically searched in PubMed, Embase, Web of Science, Cochrane Library, SinoMed, CNKI, Wanfang Database, and VIP. Literature screening, including quality assessment, was performed, and the effect values (OR, HR, RR) and 95% confidence intervals (95% CI) of infection during pregnancy and up to 2 years of age and allergic rhinitis were extracted from each qualified study.
In total, 5 studies with a sample size of 82,256 reported the relationship between infection during pregnancy and offspring AR. Meta-analysis showed that maternal infection during pregnancy was associated with an increased risk of childhood AR in offspring (OR = 1.34, 95% CI: 1.08-1.67). Altogether, 13 studies with a sample size of 78,426 reported evidence of an association between infection within 2 years of age and subsequent AR in children. A pooled meta-analysis of all studies showed that early infection within 2 years of age was closely associated with childhood AR (OR = 1.25, 95% CI: 1.12-1.40), especially upper respiratory tract infection (OR = 1.32, 95% CI: 1.06-1.65) and gastrointestinal infections (OR = 1.37, 95% CI: 1.01-1.86), but ear infection showed similar results in the cohort study (OR = 1.13, 95% CI: 1.04-1.22).
Current evidence suggests that infection during pregnancy, early upper respiratory infection, gastrointestinal infections and ear infection within 2 years of age would increase the risk of AR in children. Therefore, the prevention of infection during pregnancy and in infancy and young children needs to be emphasized.
本研究旨在通过荟萃分析妊娠期感染与 2 岁以下儿童过敏性鼻炎（AR）风险的关系，为早期生命护理提供证据。
系统检索 PubMed、Embase、Web of Science、Cochrane 图书馆、SinoMed、CNKI、万方数据库和 VIP 截至 2022 年 4 月的已发表研究。进行文献筛选，包括质量评估，并从每个合格研究中提取妊娠期和 2 岁以下感染与过敏性鼻炎的效应值（OR、HR、RR）和 95%置信区间（95%CI）。
共有 5 项研究纳入 82256 例样本量，报告了妊娠期感染与后代 AR 之间的关系。Meta 分析显示，母亲妊娠期感染与后代儿童期 AR 风险增加相关（OR=1.34，95%CI：1.08-1.67）。共有 13 项研究纳入 78426 例样本量，报告了 2 岁以内感染与儿童后续 AR 之间的关联证据。所有研究的汇总 Meta 分析表明，2 岁以内的早期感染与儿童期 AR 密切相关（OR=1.25，95%CI：1.12-1.40），尤其是上呼吸道感染（OR=1.32，95%CI：1.06-1.65）和胃肠道感染（OR=1.37，95%CI：1.01-1.86），但中耳炎在队列研究中显示出相似的结果（OR=1.13，95%CI：1.04-1.22）。
现有证据表明，妊娠期感染、2 岁以内的早期上呼吸道感染、胃肠道感染和耳部感染会增加儿童患 AR 的风险。因此，需要强调预防妊娠期和婴幼儿期感染。
