关于母亲体重指数、孕期体重增加和后代哮喘的纵向研究
2016/04/11
摘要
背景:目前研究产前暴露和童年晚期哮喘发病之间关系的数据较少。在青少年与他们母亲的纵向研究中，我们研究了产妇孕前体重指数(BMI)和孕期增重(GWG)与后代(子女)患过敏性和非过敏性哮喘发病率之间的关联。
方法：我们对在“今日成长研究” （Growing Up Today Study）登记的12，963名9-14岁的孩子的数据进行了分析，他们的母亲是护士健康研究II（Nurses' Health Study II）的参与者。通过定期向参与者及其母亲发送问卷来评估医生诊断的哮喘和过敏发生的情况。我们使用Logistic回归分析评估母亲BMI和 GWG与后代总的及不同亚型哮喘发生的关联。
结果：2，694名孩子（21%）在童年或青春时期被报告医生诊断哮喘。母亲产前超重(OR: 1.19， 95% CI: 1.03-1.38)和肥胖(1.34， 1.08-1.68)跟后代哮喘有关联。在哮喘亚型分析中，关联仅见于那些在12岁之前开始发病的哮喘。而且，母亲肥胖和非过敏性哮喘的关联见于男孩(2.39， 1.40-4.09)而不是女孩(0.96， 0.50-1.85; Pinteraction =0.03)；而过敏性哮喘则正好相反。至于GWG，体重增加<15磅和后代患哮喘的高风险有关联(1.28， 0.98-1.66)，与过敏或性别没有明确的关系。
结论：多个产前因素和儿童哮喘风险的关联支持哮喘的早期起源假说。过敏和性别特定模式提示多种病因学的途径。
（南方医科大学南方医院 彭显如 赵海金）
2016 Mar 10. doi: 10.1111/all.12876. [Epub ahead of print]
Longitudinal study of maternal body mass index, gestational weight gain, and offspring asthma.Allergy.
Dumas O, Varraso R, Gillman MW, Field AE, Camargo CA Jr
Abstract
BACKGROUND:Sparse data are available on the relationship between prenatal exposures and asthma during later childhood. In a longitudinal study of adolescents and their mothers, we examined the association of (1) maternal pre-pregnancy body mass index (BMI) and (2) gestational weight gain (GWG), with incidence of allergic and non-allergic asthma in offspring.
METHODS:Analyses were conducted using data from 12,963 children aged 9-14 years at enrollment in the Growing Up Today Study, and their mothers, who are participants in the Nurses' Health Study II. Physician-diagnosed asthma and allergies were assessed by questionnaires sent regularly to participants and their mothers. Logistic regression was used to evaluate associations of maternal BMI and GWG with offspring asthma, overall and by subtype.
RESULTS:Physician-diagnosed asthma during childhood or adolescence was reported by 2,694 children (21%). Maternal pre-pregnancy overweight (OR: 1.19, 95% CI: 1.03-1.38) and obesity (1.34, 1.08-1.68) were associated with offspring asthma. In asthma subtype analyses, the association was seen only for asthma onset before age 12 years. Moreover, the association of maternal obesity with non-allergic asthma was observed in boys (2.39, 1.40-4.09) and not in girls (0.96, 0.50-1.85; Pinteraction =0.03); the opposite pattern was suggested for allergic asthma. With regard to GWG, an association was suggested between gains of <15 lb and higher risk of offspring asthma (1.28, 0.98-1.66), without clear allergy- or sex-related patterns.
CONCLUSION:The relation of several prenatal factors to risk of childhood asthma supports the early origins hypothesis for asthma. The observed allergy- and sex-specific patterns suggest multiple etiologic pathways. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
KEYWORDS:Allergy; Childhood Asthma; DOHaD; gestational weight gain; maternal obesity
2016 Mar 10. doi: 10.1111/all.12876. [Epub ahead of print]
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客观的咳嗽频率，气道炎症和哮喘的疾病控制
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胆碱补充能否成为老年哮喘的治疗措施？
