哮喘联盟

   摘要
   目的：本研究旨在通过0-18个月的婴幼儿和早产儿的队列研究评估体重指数(BMI)和身高增长与8岁时哮喘发病情况的关系。该研究假设BMI快速增长可导致哮喘发病风险升高，而身高快速增加则可起到保护作用。
   设计：对来源于婴儿健康与发展计划的数据进行观察性的二次分析
   地点：美国8个研究中心
   纳入人群：863例早产（胎龄≤37周）且低出生体重（≤2500 g）的儿童
   主要研究变量：0-4个月、4-12个月、12-18个月四个阶段BMI和身高增长的Z值
   主要评价结局：依据父母的汇报评估8岁儿童哮喘的发病情况，而父母的汇报基于过往医生的诊断。
   结果：8岁时，149例(17%)儿童被确诊患有哮喘。通过校正母婴因素，Logistic回归分析的结果显示，0-4个月的婴幼儿，BMI每增加一个Z值，则8岁时哮喘发病风险随之增加(OR 1.3, 95% CI 1.1-1.5)；4-12个月的婴幼儿结果类似。0-4个月的婴幼儿，身长增长较快，与哮喘发病风险降低无关(OR 1.1, 95% CI 0.9-1.3)，4-12个月和12-18个月的婴幼儿结果类似。
   结论：早产儿第一年BMI增长越快与哮喘发病风险越高有关。但是，身长增长并没有显示出保护作用。该结果进一步证实，早产儿出生后体重过快增长可能是有害无益的。
 

（杨冬 审校）
Arch Dis Child Fetal Neonatal Ed. 2015 Sep 9. pii: fetalneonatal-2015-308340. doi: 10.1136/archdischild-2015-308340. [Epub ahead of print]

 

Preterm infant growth and asthma at age 8 years.
 

Belfort MB1, Cohen RT2, Rhein LM3, McCormick MC4.
 

Abstract
OBJECTIVES:To examine associations of gain in body mass index (BMI) and linear growth from term to 18 months with asthma at age 8 years in a cohort of preterm infants. We hypothesised that rapid BMI gain would increase asthma risk, whereas rapid linear growth would be protective.
DESIGN:Observational secondary analysis of data from the Infant Health and Development Program.
SETTING:8 centres in the USA.
PATIENTS:863 preterm (≤37 weeks), low birthweight (≤2500 g) children.
MAIN EXPOSURE VARIABLES:Gain in BMI and linear growth from term to 4 months, 4-12 months and 12-18 months, in z-scores.
MAIN OUTCOME MEASURE:Asthma at age 8 years, assessed by parent report of the child ever receiving the diagnosis from a doctor.
RESULTS:At age 8 years, 149 (17%) had ever been diagnosed with asthma. Adjusting for maternal and child factors in logistic regression, for each additional z-score gain in BMI from term to 4 months, odds of asthma at age 8 years were higher (OR 1.3, 95% CI 1.1 to 1.5); findings were similar for BMI gain from 4-12 months. More rapid linear growth from term to 4 months was not associated with lower odds of asthma (OR 1.1, 95% CI 0.9 to 1.3), with similar findings for 4-12 months and 12-18 months.
CONCLUSIONS:More rapid BMI gain in the 1st year of life was associated with higher odds of asthma, whereas linear growth did not appear protective. Our results add to mounting evidence that excess weight gain after term may be harmful to preterm infants.
 

Arch Dis Child Fetal Neonatal Ed. 2015 Sep 9. pii: fetalneonatal-2015-308340. doi: 10.1136/archdischild-2015-308340. [Epub ahead of print]