Lewis S, Butland B, Strachan D, Bynner J, Richards D, Butler N, Britton J
Division of Respiratory Medicine, University of Nottingham, UK.
Thorax. 1996 Jul;51(7):670-6. doi: 10.1136/thx.51.7.670.
Data from two national British birth cohorts were used to measure the increase in prevalence of wheezing illness at age 16 between 1974 and 1986, and to investigate the role of several potential risk factors in the increase.
The occurrence of self-reported asthma or wheezy bronchitis within the past year, and the frequency of attacks of wheezing illness at age 16, were compared in 11,262 and 9266 children born in one week of 1958 and 1970, respectively. The effects of several putative risk factors for asthma--including birth weight, maternal age, birth order, breast feeding, maternal smoking in pregnancy, child's personal smoking, and father's social class--on the change in occurrence of wheezing illness at age 16 were assessed by multiple logistic regression.
The annual period prevalence of asthma or wheezy bronchitis at age 16 increased from 3.8% in 1974 to 6.5% in 1986 (prevalence ratio (PR) = 1.71, 95% CI 1.52 to 1.93). The proportion of children experiencing attacks more than once a week increased from 0.2% to 0.7% (PR = 3.77, 95% CI 2.28 to 6.23). The prevalence of self-reported eczema and hayfever within the past year doubled between 1974 and 1986, suggesting that the increase in asthma was part of a general increase in the prevalence of atopic disease. However, in the complete dataset, after adjustment for the effects of the risk factors studied, the prevalence odds ratio for asthma or wheezy bronchitis in 1986 compared with 1974 was virtually unchanged from the unadjusted value at 1.77 (95% CI 1.46 to 2.15).
The prevalence of wheezing illness in British teenagers increased by approximately 70% between 1974 and 1986. This increase appears to have occurred in the context of a general increase in atopic disease and was largely unexplained by changes in the distribution of maternal age, birth order, birth weight, infant feeding, maternal smoking, active smoking by the child, or father's social class.
利用来自英国两个全国性出生队列的数据，来衡量1974年至1986年间16岁时喘息性疾病患病率的增加情况，并调查几种潜在风险因素在这一增加过程中的作用。
分别比较了1958年和1970年某一周出生的11262名和9266名儿童在过去一年中自我报告的哮喘或喘息性支气管炎的发生情况，以及16岁时喘息性疾病的发作频率。通过多因素逻辑回归评估了几种假定的哮喘风险因素——包括出生体重、母亲年龄、出生顺序、母乳喂养、母亲孕期吸烟、儿童个人吸烟以及父亲的社会阶层——对16岁时喘息性疾病发生变化的影响。
16岁时哮喘或喘息性支气管炎的年期间患病率从1974年的3.8%增至1986年的6.5%（患病率比（PR）=1.71，95%置信区间1.52至1.93）。每周发作不止一次的儿童比例从0.2%增至0.7%（PR = 3.77，95%置信区间2.28至6.23）。1974年至1986年间，过去一年中自我报告的湿疹和花粉热患病率翻了一番，这表明哮喘患病率的增加是特应性疾病总体患病率上升的一部分。然而，在完整的数据集中，在对所研究的风险因素的影响进行调整后，1986年与1974年相比，哮喘或喘息性支气管炎的患病率比值比与未调整值相比几乎没有变化，为1.77（95%置信区间1.46至2.15）。
1974年至1986年间，英国青少年喘息性疾病的患病率增加了约70%。这种增加似乎是在特应性疾病总体增加的背景下发生的，并且在很大程度上无法用母亲年龄、出生顺序、出生体重、婴儿喂养、母亲吸烟、儿童主动吸烟或父亲社会阶层的分布变化来解释。
