孕前口服避孕药与儿童患喘息、哮喘和过敏性鼻炎的风险
2016/05/31
摘要
背景：孕妇口服避孕药（OCP）的使用及儿童哮喘的患病率在西方国家是很高的。本研究的目的是探讨在日本OCP的使用与儿童喘息和过敏性疾病的关系。
方法：相关的数据是从东京儿童健康、疾病和发展研究（T-CHILD）中一个基于医院出生队列研究项目中提取的，这个项目采取妊娠期间问卷调查包括怀孕历史和OCP使用的持续时间。采用儿童哮喘和过敏症国际研究（ISAAC）项目的问卷调查来识别儿童喘息和过敏性疾病。对母亲过敏史、母亲文化程度、母亲妊娠年龄、母亲BMI、孕期吸烟、分娩方式、分娩孕周、日托考勤，以前的活产数、胎儿的性别等这些因素，利用逻辑回归模型评估它们之间的关系，并做出调整。
结果：OCP的使用与以往的喘息（调整后的比值比[aOR]，1.62；95%可信区间[CI]，1.10-2.40），现在的哮鸣音（aOR，1.59；95% CI，1.01-2.50），有哮喘（aOR，1.65；95% CI，1.02-2.65），和有鼻炎（aOR，1.90；95% CI，1.30-2.80）。统计显示，与之前没有使用口服避孕药相比，使用口服避孕药三个多月有既往的哮鸣音（P = 0.012），现在的哮鸣音（P = 0.035），和有鼻炎（P = 0.002）的可能性均增加。
结论：我们的研究结果表明，孕妇使用口服避孕药对儿童喘息、哮喘和鼻炎的发展都有作用。长期使用口服避孕药可能增加喘息和过敏性鼻炎的风险。
（杨冬 审校）
Allergol Int. 2016 Mar 30. pii: S1323-8930(16)30006-5. doi: 10.1016/j.alit.2016.02.012. [Epub ahead of print]
Preconceptional exposure to oral contraceptive pills and the risk of wheeze, asthma and rhinitis in children.
Yamamoto-Hanada K1, Futamura M2, Yang L3, Shoda T3, Narita M3, Kobayashi F4, Saito H5, Ohya Y6.
Author information
Abstract
BACKGROUND:The prevalence of maternal oral contraceptive pills (OCP) use and that of childhood asthma are high in western countries. The aim of this study is to examine the association of OCP use with childhood wheeze and allergic diseases in Japan.
METHODS:Relevant data were extracted from a hospital based birth cohort study named as Tokyo-Children's Health, Illness and Development Study (T-CHILD) of which questionnaire conducted during pregnancy included maternal history and duration of OCP use. To identify wheeze and allergic diseases in the children, the questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC) was used. Logistic regression models were applied to estimate those association and adjustments were made for maternal history of allergy, maternal education level, maternal age at pregnancy, maternal BMI, maternal smoking during pregnancy, mode of delivery, gestational age at delivery, daycare attendance, number of previous live births, and gender of child.
RESULTS:OCP use was associated with ever wheeze (adjusted odds ratio [aOR], 1.62; 95% confidence interval [CI], 1.10-2.40), current wheeze (aOR, 1.59; 95% CI, 1.01-2.50), ever asthma (aOR, 1.65; 95% CI, 1.02-2.65), and ever rhinitis (aOR, 1.90; 95% CI, 1.30-2.80). Compared with no prior OCP use, using OCP for more than three months statistically increased the odds of ever wheeze (P = 0.012), current wheeze (P = 0.035), and ever rhinitis (P = 0.002).
CONCLUSIONS:Our findings suggest that maternal OCP use has a role in the development of wheeze, asthma and rhinitis in children. Extended use of OCP is likely to increase the risk of wheeze and rhinitis.
Copyright © 2016 Japanese Society of Allergology.Production and hosting by Elsevier B.V. All rights reserved.
KEYWORDS:Asthma; Birth cohort; Oral contraceptives; Rhinitis; Wheeze
Allergol Int. 2016 Mar 30. pii: S1323-8930(16)30006-5. doi: 10.1016/j.alit.2016.02.012. [Epub ahead of print]
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