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母亲哮喘与新生儿暂时性呼吸急促

Maternal asthma and transient tachypnea of the newborn.

作者信息

Demissie K, Marcella S W, Breckenridge M B, Rhoads G G

机构信息

Department of Family Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey 08903-0019, USA.

出版信息

Pediatrics. 1998 Jul;102(1 Pt 1):84-90. doi: 10.1542/peds.102.1.84.

Abstract

OBJECTIVE

To examine the relationship between transient tachypnea of the newborn and asthma complicating pregnancy.

DESIGN

Historical cohort analysis. Setting. Singleton live deliveries in New Jersey hospitals during 1989 to 1992 (n = 447 963).

PATIENTS

Mother-infant dyads were identified from linked birth certificate and maternal and infant hospital claims data. Women with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis code (493) for asthma (n = 2289) were compared with a four-fold larger randomly selected control sample (n = 9156) from the remaining pool of women.

MAIN OUTCOME MEASURE

Transient tachypnea of the newborn.

RESULTS

In the overall sample, after controlling for the confounding effects of important variables, infants of asthmatic mothers were more likely [odds ratio (OR), 1. 79; 95% confidence interval (CI), 1.35-2.37] than infants of control mothers to exhibit transient tachypnea of the newborn. A stratified analysis by gestational age and sex revealed larger and statistically significant associations in term infants (OR, 2.02; 95% CI, 1.42-2.87) as opposed to preterm infants (OR, 1.51; 95% CI, 0.94-2.43) and in male infants (OR, 1.91; 95% CI, 1.35-2.71) as opposed to female infants (OR, 1.51; 95% CI, 0.92-2.47). On the other hand, after adjusting for important confounding variables, respiratory distress syndrome and maternal asthma were not found to be associated (OR, 1.14; 95% CI, 0.79-1.64).

CONCLUSION

The results of this study provide evidence that maternal asthma is a risk factor for transient tachypnea of the newborn and differences in gestational age and sex were apparent in this association. The mechanism for this association remains to be determined.

摘要

目的

研究新生儿短暂性呼吸急促与妊娠合并哮喘之间的关系。

设计

历史队列分析。研究地点:1989年至1992年新泽西州医院的单胎活产情况(n = 447963)。

研究对象

通过关联出生证明以及母婴医院索赔数据来确定母婴二元组。将患有国际疾病分类第九版临床修订本(ICD - 9 - CM)哮喘诊断代码(493)的女性(n = 2289)与从其余女性群体中随机选取的四倍大的对照样本(n = 9156)进行比较。

主要观察指标

新生儿短暂性呼吸急促。

结果

在总体样本中,在控制了重要变量的混杂效应后,哮喘母亲的婴儿出现新生儿短暂性呼吸急促的可能性[优势比(OR)为1.79;95%置信区间(CI)为1.35 - 2.37]高于对照母亲的婴儿。按胎龄和性别进行分层分析显示,足月儿(OR为2.02;95%CI为1.42 - 2.87)与早产儿(OR为1.51;95%CI为0.94 - 2.43)相比,以及男婴(OR为1.91;95%CI为1.35 - 2.71)与女婴(OR为1.51;95%CI为0.92 - 2.47)相比,存在更大且具有统计学意义的关联。另一方面,在调整了重要的混杂变量后,未发现呼吸窘迫综合征与母亲哮喘有关联(OR为1.14;95%CI为0.79 - 1.64)。

结论

本研究结果提供了证据,表明母亲哮喘是新生儿短暂性呼吸急促的一个危险因素,并且在这种关联中胎龄和性别的差异很明显。这种关联的机制仍有待确定。

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