Chen T, Li A L, Yin Z Y, Gan H, Zheng X H, Huang Z F, Sun B Q
Department of Clinical Laboratory, The Key Laboratory of Advanced Interdisciplinary Studies Center, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease,Guangzhou510120, China Kingmed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou510182, China.
Department of Clinical Laboratory, The Key Laboratory of Advanced Interdisciplinary Studies Center, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease,Guangzhou510120, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2024 Dec 6;58(12):1912-1920. doi: 10.3760/cma.j.cn112150-20231212-00436.
This study aims to analyze the differentiating factors between only allergic rhinitis and allergic rhinitis combined with other allergic diseases in pre-school children and to explore the impact of relevant family and maternal factors during pregnancy on pediatric allergic diseases.The study employed an epidemiological cross-sectional survey design, conducted from January to June 2022 at the Helong Street Health Service Center in Baiyun District, Guangzhou City, China. This cross-sectional investigation focused on 15 preschool education centers within the jurisdiction. It encompassed a total of 4 661 pre-school children aged 3-6 years within the district, resulting in the collection of 3 437 valid questionnaires. The study utilized an online survey, covering aspects such as children's birth conditions, early living environment, maternal lifestyle and emotional state during pregnancy, and paternal information. The questionnaire was designed by an expert team and incorporated advanced logic functions to ensure data accuracy. Diagnosis of allergic diseases included evaluation of symptoms such as rhinitis, asthma, eczema and along with collecting family member's allergy information. Factors like maternal emotional stress during pregnancy, premature birth, and breastfeeding were also considered. The analysis of frequency differences between groups was conducted using the Chi-square test. The distribution differences between two groups were examined using the -test or Mann-Whitney test. Additionally, binary logistic regression analysis was employed to identify risk factors for the occurrence of allergic diseases. To illustrate the distribution and co-occurrence of different allergic diseases in children, upset plots were created. Furthermore, forest plots were utilized to analyze the risk factors. The study included 455 children with only allergic rhinitis and 759 children with rhinitis combined with other allergic diseases. The results showed no significant demographic differences between the two groups. Logistic model results indicated that children with allergic rhinitis who had suffered from severe eczema within the first 12 months had a (95%):19.818 times (2.670-147.095) higher probability of developing combined allergic diseases than those without eczema, while the probability increased 2.345 times (1.825-3.013) for those with mild to moderate eczema. A higher level of maternal education was also identified as a risk factor, increasing the risk by about 1.5 times. Additionally, the risk of developing combined allergic diseases in children with one allergic parent was (95%):1.662 times (1.273-2.170) higher than in those with non-allergic parents, and 2.181 times (1.504-3.163) higher if both parents had allergies. Moreover, negative maternal emotional stress during pregnancy was more significant in children with combined allergic diseases. In conclusion, severe eczema in the first 12 months, mild to moderate eczema; allergies in one or both parents; parents' educational level, household disposable income level; firstborn status; and negative maternal emotions during pregnancy are risk factors for children with allergic rhinitis combined with other allergic diseases.
本研究旨在分析学龄前儿童单纯性过敏性鼻炎与合并其他过敏性疾病的过敏性鼻炎之间的鉴别因素，并探讨孕期相关家庭因素和母亲因素对儿童过敏性疾病的影响。该研究采用流行病学横断面调查设计，于2022年1月至6月在中国广州市白云区鹤龙街社区卫生服务中心开展。这项横断面调查聚焦于辖区内的15所学前教育中心。研究涵盖了该地区共4661名3至6岁的学龄前儿童，共收集到3437份有效问卷。该研究采用在线调查方式，内容涵盖儿童的出生情况、早期生活环境、母亲孕期的生活方式和情绪状态以及父亲的信息。问卷由一个专家团队设计，并纳入了先进的逻辑功能以确保数据准确性。过敏性疾病的诊断包括对鼻炎、哮喘、湿疹等症状的评估以及收集家庭成员的过敏信息。还考虑了母亲孕期的情绪压力、早产和母乳喂养等因素。采用卡方检验进行组间频率差异分析。使用t检验或曼-惠特尼检验检查两组之间的分布差异。此外，采用二元逻辑回归分析来确定过敏性疾病发生的风险因素。为了说明儿童中不同过敏性疾病的分布和共现情况，绘制了 upset 图。此外，利用森林图分析风险因素。该研究纳入了455名单纯性过敏性鼻炎儿童和759名合并其他过敏性疾病的鼻炎儿童。结果显示两组在人口统计学方面无显著差异。逻辑模型结果表明，在出生后12个月内患有重度湿疹的过敏性鼻炎儿童患合并过敏性疾病的概率（95%）比未患湿疹的儿童高19.818倍（2.670 - 147.095），而患有轻度至中度湿疹的儿童概率增加2.345倍（1.825 - 3.013）。母亲受教育程度较高也被确定为一个风险因素，风险增加约1.5倍。此外，父母一方患有过敏症的儿童患合并过敏性疾病的风险（95%）比父母无过敏症的儿童高1.662倍（1.273 - 2.170），如果父母双方都有过敏症则高2.181倍（1.504 - 3.163）。此外，母亲孕期的负面情绪压力在合并过敏性疾病的儿童中更为显著。总之，出生后12个月内的重度湿疹、轻度至中度湿疹；父母一方或双方过敏；父母的教育水平、家庭可支配收入水平；头胎情况；以及母亲孕期的负面情绪是患有过敏性鼻炎合并其他过敏性疾病儿童的风险因素。
