出生方式与婴幼儿期特应性皮炎的发生有关。

Birth mode is associated with development of atopic dermatitis in infancy and early childhood.

作者信息

Hoel Sveinung T, Wiik Johanna, Carlsen Karin C L, Endre Kim M A, Gudmundsdóttir Hrefna Katrín, Haugen Guttorm, Hoyer Angela, Jonassen Christine Monceyron, LeBlanc Marissa, Nordlund Björn, Rudi Knut, Skjerven Håvard O, Staff Anne Cathrine, Hedlin Gunilla, Söderhäll Cilla, Vettukattil Riyas, Aaneland Hilde, Rehbinder Eva M

机构信息

Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.

Department of Gynecology and Obstetrics, Østfold Hospital Trust, Kalnes, Norway.

出版信息

J Allergy Clin Immunol Glob. 2023 Mar 29;2(3):100104. doi: 10.1016/j.jacig.2023.100104. eCollection 2023 Aug.

DOI:10.1016/j.jacig.2023.100104

PMID:37779526

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10509990/

Abstract

BACKGROUND

Birth by caesarean section (CS) is associated with development of allergic diseases, but its role in the development of atopic dermatitis (AD) is less convincing.

OBJECTIVE

Our primary aim was to determine if birth mode was associated with AD in 3-year-olds and secondarily to determine if birth mode was associated with early onset and/or persistent AD in the first 3 years of life.

METHODS

We included 2129 mother-child pairs from the Scandinavian population-based prospective PreventADALL cohort with information on birth mode including vaginal birth, either traditional (81.3%) or in water (4.0%), and CS before (6.3%) and after (8.5%) onset of labor. We defined early onset AD as eczema at 3 months and AD diagnosis by 3 years of age. Persistent AD was defined as eczema both in the first year and at 3 years of age, together with an AD diagnosis by 3 years of age.

RESULTS

AD was diagnosed at 3, 6, 12, 24, and/or 36 months in 531 children (25%). Compared to vaginal delivery, CS was overall associated with increased odds of AD by 3 years of age, with adjusted odds ratio (95% confidence interval) of 1.33 (1.02-1.74), and higher odds of early onset AD (1.63, 1.06-2.48). The highest odds for early onset AD were observed in infants born by CS after onset of labor (1.83, 1.09-3.07). Birth mode was not associated with persistent AD.

CONCLUSION

CS was associated with increased odds of AD by 3 years of age, particularly in infants presenting with eczema at 3 months of age.

摘要

背景

剖宫产与过敏性疾病的发生有关，但其在特应性皮炎（AD）发生中的作用尚不明确。

目的

我们的主要目的是确定分娩方式是否与3岁儿童的AD有关，其次是确定分娩方式是否与生命最初3年的早发型和/或持续性AD有关。

方法

我们纳入了来自斯堪的纳维亚基于人群的前瞻性PreventADALL队列的2129对母婴，这些母婴有关于分娩方式的信息，包括传统阴道分娩（81.3%）、水中分娩（4.0%）以及分娩发动前（6.3%）和发动后（8.5%）的剖宫产。我们将早发型AD定义为3个月时出现湿疹且3岁前诊断为AD。持续性AD定义为1岁和3岁时均有湿疹，且3岁前诊断为AD。

结果

531名儿童（25%）在3、6、12、24和/或36个月时被诊断为AD。与阴道分娩相比，剖宫产总体上与3岁时AD的发生几率增加有关，调整后的优势比（95%置信区间）为1.33（1.02 - 1.74），早发型AD的几率更高（1.63，1.06 - 2.48）。分娩发动后剖宫产出生的婴儿中早发型AD的几率最高（1.83，1.09 - 3.07）。分娩方式与持续性AD无关。