哮喘联盟

   摘要
   背景：哮喘风险，特别是在晚期早产儿中的风险尚未明确。协变量不均衡以及缺乏对照造成前人研究结果不一致。
   目的：本研究旨在运用倾向评分方法评估晚期早产儿的哮喘风险。
   方法：本研究为以人口为基础的出生队列研究。所有研究对象为1976年至1982年间出生于明尼苏达州罗彻斯特市的儿童。7岁前的哮喘患病情况采用既定标准评估。建立对比晚期早产和足月分娩儿的logistic回归模型，运用15个协变量计算倾向得分。我们采用倾向性评分方法来匹配晚期早产儿（妊娠34周0-7天至36周6-7天）和足月分娩儿（妊娠37周0-7天至40周6-7天），卡钳值为倾向得分经过logit变换后标准差的20%。
   结果：在7040符合条件的婴儿中，5915例儿童数据完整。在倾向得分匹配前，相对于足月儿（272/5653,4.8%），晚期早产儿（20/262,7.6%）的哮喘风险较高（P=.039）。两组间协变量不均衡显著。采用倾向得分匹配后，我们发现晚期早产儿与足月儿哮喘风险相似（分别为6.6%和7.7%，P=.61），该结果与为控制显著协变量的协变量校正的Cox回归模型相一致（P = .57）。
   结论：晚期早产史并不与儿童哮喘独立相关，报导的晚期早产儿哮喘风险可能由协变量不均衡所导致。
 

（苏欣 审校）
J Allergy Clin Immunol Pract. 2015 May 2. pii: S2213-2198(15)00138-5. doi: 10.1016/j.jaip.2015.03.018. [Epub ahead of print]

 

Risk of Asthma in Late Preterm Infants: A Propensity Score Approach.
 

Voge GA1, Katusic SK2, Qin R2, Juhn YJ3.
Author information
 

Abstract
BACKGROUND:The risk of asthma, specifically in former late preterm infants, has not been well defined. Covariate imbalance and lack of controlling for this has led to inconsistent results in prior studies.
OBJECTIVE:The objective of this study was to determine the risk of asthma in former late preterm infants using a propensity score approach.
METHODS:The study was a population-based birth cohort study. Study subjects were all children born in Rochester, Minn, between 1976 and 1982. Asthma status during the first 7 years of life was assessed by applying predetermined criteria. The propensity score was formulated using 15 covariates by fitting a logistic regression model for late preterm birth versus term birth. We applied the propensity score method to match late preterm infants (34 0/7 to 36 6/7 weeks of gestation) to term infants (37 0/7 to 40 6/7 weeks of gestation) within a caliper of 0.2 standard deviation of logit of propensity score.
RESULTS:Of the eligible 7040 infants, 5915 children had complete data. Before propensity score matching, late preterm infants had a higher risk of asthma (20 of 262, 7.6%) compared with full-term infants (272 of 5653, 4.8%) (P = .039). There was significant covariate imbalance between comparison groups. After matching with propensity scores, we found that former late preterm infants had a similar risk of asthma to the matched full-term infants (6.6% vs 7.7%, respectively, P = .61), and the result was consistent with covariate-adjustment Cox regression models controlling for significant covariates (P = .57).
CONCLUSION:A late preterm birth history is not independently associated with childhood asthma, as the reported risk of asthma among former late preterm infants appears to be due to covariate imbalance.
 

J Allergy Clin Immunol Pract. 2015 May 2. pii: S2213-2198(15)00138-5. doi: 10.1016/j.jaip.2015.03.018. [Epub ahead of print]