儿童哮喘中的社会不平等现象：来自英国千禧年的队列研究结果
2016/05/26
摘要
儿童喘息受社会因素影响而有不同的社会模式，但现在还不清楚是什么因素导致了社会差异。对英国千禧年的基于11,141名年龄在9个月、3、5和7岁的独生子女的队列研究进行回归分析。根据社会经济状况，用多项式回归分析对早期和持续性/复发性喘鸣进行相对风险率（RRR）的评估。将孕产妇、产前和早期生活特点作为潜在的因子进行评估。母亲没有学历的孩子相比于母亲有学历的孩子更可能同时有两种喘息类型（早期喘息RRR 为1.53，95% CI 1.26-1.86；持续性/复发性喘鸣RRR为1.32，95% CI 1.04-1.67）。控制产妇年龄、孕期和哺乳期间吸烟，消除了喘息的高风险。男性、产妇年龄、体质指数、过敏体质、孕期吸烟、早产、母乳喂养、接触其他儿童和有毛宠物与喘息有独立相关，但关联模式对不同的喘息类型来说有不同。在这个具有英国代表性的队列中，产妇孕期和哺乳期间吸烟的调整可以消除常见的喘息表型上的社会经济的不平等性。减少这些危险因素中的社会差异的政策可能会减少喘息和哮喘的不一致。
（苏欣 审校）
Eur Respir J. 2016 Mar;47(3):818-28. doi: 10.1183/13993003.01117-2015. Epub 2015 Dec 17.
Social inequalities in wheezing in children: findings from the UK Millennium Cohort Study.
Taylor-Robinson DC1, Pearce A2, Whitehead M3, Smyth R2, Law C2.
Author information
Abstract
Wheezing in childhood is socially patterned, but it is unclear what factors explain the social differences.Regression analysis of the UK Millennium Cohort Study, based on 11 141 singleton children who participated at ages 9 months and 3, 5 and 7 years. Relative risk ratios (RRR) for early and persistent/relapsing wheeze were estimated using multinomial regression, according to measures of socioeconomic circumstances. Maternal, antenatal and early-life characteristics were assessed as potential mediators.Children of mothers with no educational qualifications were more likely to have both wheeze types, compared to children of mothers with degree-level qualifications (RRR 1.53, 95% CI 1.26-1.86 for early wheeze; 1.32 95% CI 1.04-1.67 for persistent/relapsing wheeze). Controlling for maternal age, smoking during pregnancy and breastfeeding removed the elevated risk of wheezing. Male sex, maternal age, body mass index, atopy, smoking during pregnancy, preterm birth, breastfeeding, exposure to other children and furry pets were independently associated with wheezing, but the pattern of association varied between wheezing types.In this representative UK cohort, adjustment for maternal smoking during pregnancy and breastfeeding removed the socioeconomic inequalities in common wheezing phenotypes. Policies to reduce the social gradient in these risk factors may reduce inequalities in wheezing and asthma.
Copyright ©ERS 2016.
Eur Respir J. 2016 Mar;47(3):818-28. doi: 10.1183/13993003.01117-2015. Epub 2015 Dec 17.
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中国哮喘危险因素中的环境与遗传易感性现状
