Strachan D P, Seagroatt V, Cook D G
Department of Public Health Sciences, St George's Hospital Medical School, London, UK.
Int J Epidemiol. 1994 Oct;23(5):1060-8. doi: 10.1093/ije/23.5.1060.
Cohorts born at different times of year differ in their risk of exposure to seasonal respiratory infections in early life, but are likely to have similar socioeconomic status and lifestyle thereafter.
We investigated the long-term consequences of acute chest illness in infancy for later development of chronic respiratory disease by analysing variations by month of birth in hospital admissions for respiratory illness (total n = 49,866), chronic respiratory symptoms and ventilatory function among British school children (n = 11,482) and middle-aged adults (total n = 55,829).
Admission for bronchiolitis in the first year of life was three times more common for infants born September to November (autumn) than those born March to May, yet people born in the autumn experienced fewer respiratory symptoms and had better ventilatory function. In two surveys of middle-aged men, forced expiratory volume in one second/forced ventilatory capacity (FEV1/FVC) was significantly (P = 0.025) higher among autumn births. Hospital admissions for chronic bronchitis/emphysema and pneumonia varied little with season of birth. Admissions for asthma were significantly (P < 0.05) more common among children and young adults born in the autumn.
These findings do not support the hypothesis of a causal link between chest illness in infancy and the later development of chronic bronchitis and emphysema. The variation in asthma admissions with month of birth deserves further investigation.
不同季节出生的队列在生命早期暴露于季节性呼吸道感染的风险不同,但此后可能具有相似的社会经济地位和生活方式。
我们通过分析英国学龄儿童(n = 11,482)和中年成年人(总计n = 55,829)呼吸道疾病住院情况(总计n = 49,866)、慢性呼吸道症状和通气功能按出生月份的变化,研究婴儿期急性胸部疾病对慢性呼吸道疾病后期发展的长期影响。
9月至11月(秋季)出生的婴儿在出生后第一年患细支气管炎的住院率是3月至5月出生婴儿的三倍,但秋季出生的人呼吸道症状较少,通气功能较好。在两项中年男性调查中,秋季出生者的一秒用力呼气量/用力肺活量(FEV1/FVC)显著更高(P = 0.025)。慢性支气管炎/肺气肿和肺炎的住院率随出生季节变化不大。秋季出生的儿童和年轻人中哮喘住院率显著更高(P < 0.05)。
这些发现不支持婴儿期胸部疾病与慢性支气管炎和肺气肿后期发展之间存在因果联系的假设。哮喘住院率随出生月份的变化值得进一步研究。