哮喘联盟

   摘要
   背景：哮喘是一种异质性疾病，存在多种表型，且发病年龄参与分类。我们对于不同发病年龄产前应激与哮喘表型间可能的相关性知之甚少。我们旨在探讨产前应激与哮喘是否存在相关性，如果存在，这种相关性是否由于哮喘发病年龄不同而有差异。
   方法：我们对丹麦几个国家级注册的数据库进行一项队列研究，包括1996-2007年间所有在丹麦出生的单身人士(N = 750 058)。失去亲人组我们选取了母亲怀孕前一年或期间失去至亲（一个孩子，伴侣/配偶，父母或兄弟姐妹）的儿童。采用Cox比例风险回归模型，我们比较了非失去至亲母亲所生儿童与失去至亲母亲所生儿童的哮喘风险比（HRs）。
   结果：产妇丧亲之痛带来的产前应激与0-3岁儿童哮喘发生风险微增加相关[HR = 1.04, 95%可信区间(CI): 1.00-1.07]，然而意外的丧亲之痛与之高度相关[HR = 1.13, 95% 可信区间 (CI):1.02-1.24]。产前丧亲与4-15岁儿童的哮喘无相关性(HR = 1.02, 95% CI: 0.96-1.09)。
   结论：产前应激可能与0-3岁儿童的哮喘事件相关，但是与4-15岁儿童的哮喘不相关（不论哮喘发作年龄）。

 

（苏欣 审校）
Eur J Public Health. 2015 Dec;25(6):1042-6. doi: 10.1093/eurpub/ckv129. Epub 2015 Jun 25.
 

Prenatal stress and childhood asthma in the offspring: role of age at onset.
 

Liu X1, Olsen J2, Agerbo E3, Yuan W4, Sigsgaard T5, Li J6.
 

Abstract
BACKGROUND:Asthma is a heterogeneous disorder with different phenotypes, and age at onset may define part of them. Little is known about possible association between prenatal stress and asthma phenotypes according to age at onset. We aim to investigate whether there is an association between prenatal stress and asthma, and if so, whether such an association differs according to age at asthma onset.
METHODS:We carried out a cohort study based on several national registers in Denmark, including all live singletons born during 1996-2007 in Denmark (N = 750 058). We identified children born to mothers who lost a close relative (a child, partner/spouse, a parent or a sibling) 1 year prior to or during pregnancy as the bereaved group. Using Cox proportional hazards regression model, we evaluated the hazard ratios (HRs) for asthma in children of bereaved mothers, compared with children of non-bereaved mothers.
RESULTS:Prenatal stress following maternal bereavement was associated with a marginally increased risk of asthma events in children aged 0-3 years [HR = 1.04, 95% confidence interval (CI): 1.00-1.07], while unexpected bereavement was associated with a higher risk (HR = 1.13, 95% CI: 1.02-1.24). There was no association between prenatal bereavement and asthma in children aged 4-15 years (HR = 1.02, 95% CI: 0.96-1.09).
CONCLUSIONS:Prenatal stress is possibly associated with asthma events in children aged 0-3 years, but not with asthma in children aged 4-15 years irrespective of age at asthma onset.
 

Eur J Public Health. 2015 Dec;25(6):1042-6. doi: 10.1093/eurpub/ckv129. Epub 2015 Jun 25.