产前和产后的压力和儿童哮喘：时间和性别的关系
2016/11/09
摘要
背景：围产期压力的时间和性别对儿童哮喘的影响还没有被研究。
目的：在一项前瞻性队列研究中，我们研究了产前和/或产后压力和儿童哮喘（N = 765）之间的关系，并且利用性别对影响进行修正。
方法：确定母体在产前和产后的负面生活事件。对负面生活事件进行评分，分为0，1至2，3至4，或5或更大，以评估暴露-反应的关系。我们研究了产前和产后压力对6岁儿童哮喘的影响，建模成每个独立的预测因子，相互调整产前和产后压力，并最终考虑产前和产后压力之间的相互作用。在分层分析和拟合相互作用方面通过性别对影响进行了修正。
结果:当独立考虑在每一阶段的压力时，男孩中在产前和产后顺序尺度每一水平的增加的剂量-反应关系是显而易见的（产前：比值比[OR]，1.38；95% CI，1.06-1.79；趋势P值为.03；产后：OR，1.53；95% CI，1.16-2.01；趋势P值= .001。）；女生中，只有产后的趋势显著（OR，1.60；95% CI，1.14-2.22；趋势P值= .005，）。产前和产后期间较高的压力与女孩被诊断为哮喘的几率增加有关（OR，1.37；95% CI，0.98-1.91；P interaction = .07），而与男孩没有关系（OR，1.08；95% CI，0.82-1.42；P interaction = .61）。
结论：虽然男孩更容易在产前期间受到压力，但是女孩受产后压力和两个阶段与哮喘相关的累积压力的影响更大。了解与早期生命压力相关的性别和时间上的差异，可能为哮喘的成因和自然史提供独特的视角。
关键词：负面生活事件；儿童哮喘；围产期压力；性别和时间的影响
（杨冬 审校）
J Allergy Clin Immunol.2016Sep;138(3):740-747.e3. doi: 10.1016/j.jaci.2016.01.014. Epub 2016 Mar 4.
Prenatal and postnatal stress and asthma in children: Temporal- and sex-specific associations.
Lee A1, Mathilda Chiu YH2, Rosa MJ3, Jara C3, Wright RO4, Coull BA5, Wright RJ6.
Author information
Abstract
BACKGROUND:Temporal- and sex-specific effects of perinatal stress have not been examined for childhood asthma.
OBJECTIVES:We examined associations between prenatal and/or postnatal stress and children's asthma (n = 765) and effect modification by sex in a prospective cohort study.
METHODS:Maternal negative life events were ascertained prenatally and postpartum. Negative life event scores were categorized as 0, 1 to 2, 3 to 4, or 5 or greater to assess exposure-response relationships. We examined effects of prenatal and postnatal stress on children's asthma by age 6 years, modeling each as independent predictors, mutually adjusting for prenatal and postnatal stress, and finally considering interactions between prenatal and postnatal stress. Effect modification by sex was examined in stratified analyses and by fitting interaction terms.
RESULTS:When considering stress in each period independently, among boys, a dose-response relationship was evident for each level increase on the ordinal scale prenatally (odds ratio [OR], 1.38; 95% CI, 1.06-1.79; P value for trend = .03) and postnatally (OR, 1.53; 95% CI, 1.16-2.01; P value for trend = .001); among girls, only the postnatal trend was significant (OR, 1.60; 95% CI, 1.14-2.22; P value for trend = .005). Higher stress in both the prenatal and postnatal periods was associated with increased odds of receiving a diagnosis of asthma in girls (OR, 1.37; 95% CI, 0.98-1.91; Pinteraction = .07) but not boys (OR, 1.08; 95% CI, 0.82-1.42; Pinteraction = .61).
CONCLUSIONS:Although boys were more vulnerable to stress during the prenatal period, girls were more affected by postnatal stress and cumulative stress across both periods in relation to asthma. Understanding sex and temporal differences in response to early-life stress might provide unique insight into the cause and natural history of asthma.
Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
KEYWORDS:Negative life events; childhood asthma; perinatal stress; sex- and temporal-specific effects
JAllergyClinImmunol. 2016 Sep;138(3):740-747.e3.doi:10.1016/j.jaci.2016.01.014.Epub 2016 Mar 4.
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中国儿童未控制哮喘及其危险因素：一项横断面观察研究
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豚鼠模型哮喘进展过程中肺音的变化
