妊娠期使用抗生素和学龄前儿童哮喘：混杂因素的影响
2016/11/09
摘要
背景：最近的研究表明，生命早期肠道菌群可能在儿童哮喘的发展中发挥了重要作用，表明在生命早期或晚期妊娠服用抗生素可能与儿童哮喘有关。
目的：本研究的目的是利用IADB. nl.处方数据库里的数据评估产前使用抗生素与学龄前儿童哮喘之间的关联。为了评估潜在的混杂因素的影响，我们开展了两个案例：有同胞的案例和病例对照研究，并对研究结果进行比较。
方法：我们进行了一项有同胞案例的研究，使用IADB nl处方数据库里的数据，对1228例哮喘患儿与1228个没有哮喘的同胞进行比较。此外，进行了病例对照研究。学龄前儿童哮喘定义为5周岁前有≥3抗哮喘药物的处方治疗。条件LOGISTIC回归模型被用来估计原始的和调整后的比值比(aORs)。
结果：在有同胞的病例和对照病例的分析中，在第三孕期使用抗生素与学龄前儿童哮喘风险增加相关（aOR 1.37；95% CI 1.02-1.83和aOR 1.40；95% CI 1.15-1.47）。时间趋势分析表明，结果在抗生素暴露方面并没有受时间趋势的影响。在孕期任何时段使用抗生素与学龄前儿童哮喘的发展之间的显著相关只在病例对照组中观察到了(aOR 1.46; 95% CI 1.34-1.59)。
结论：在孕期第三阶段使用抗生素与学龄前儿童哮喘的风险的小幅增加有关。这个相关性不受时间的影响，进一步支持在儿童哮喘早期肠道菌群的重要作用。
关键词：抗生素；哮喘；同胞案例研究；儿童；父母对比；妊娠
（杨冬 审校）
ClinExpAllergy.2016Sep;46(9):1214-26.doi:10.1111/cea.12756. Epub 2016 Jun 13.
Antibiotic use during pregnancy and asthma in preschool children: the influence of confounding.
Mulder B1, Pouwels KB1, Schuiling-Veninga CC1, Bos HJ1, de Vries TW2, Jick SS3,4, Hak E1,5.
Author information
Abstract
BACKGROUND:A recent study suggested that early-life intestinal microbiota may play an important role in the development of childhood asthma, indicating that antibiotics taken during early life or in late pregnancy may be associated with childhood asthma.
OBJECTIVE:This study aims to assess the association between prenatal antibiotic use and asthma in preschool children using data from the prescription database IADB.nl. To assess the influence of potential confounding, we conducted both a case-sibling and a case-control study and compared the results.
METHODS:We conducted a case-sibling study in which 1228 children with asthma were compared to 1228 siblings without asthma, using data from the prescription database IADB.nl. In addition, a case-control study was conducted. Asthma in preschool children was defined as ≥ 3 prescriptions for anti-asthma medication within a year before the fifth birthday. Conditional logistic regression was used to estimate crude and adjusted odds ratios (aORs).
RESULTS:In both the case-sibling and case-control analysis, the use of antibiotics in the third trimester of pregnancy was associated with an increased risk of asthma in preschool children (aOR 1.37; 95% CI 1.02-1.83 and aOR 1.40; 95% CI 1.15-1.47). Time-trend analyses showed that results were not influenced by a time trend in antibiotic exposure. A significant association between exposure to antibiotics in any trimester of pregnancy and the development of asthma in preschool children was observed in the case-control analysis only (aOR 1.46; 95% CI 1.34-1.59).
CONCLUSION:Antibiotic use in the third trimester of pregnancy was associated with a small increased risk of asthma in preschool children. This association was robust to time-invariant confounding or exposure time trends, further supporting the important role for early-life intestinal microbiota in the development of childhood asthma.
© 2016 John Wiley & Sons Ltd.
KEYWORDS:antibiotics; asthma; case-sibling study; childhood; maternal-paternal comparison; pregnancy
ClinExpAllergy.2016Sep;46(9):1214-26.doi:10.1111/cea.12756. Epub 2016 Jun 13.
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高中生吸烟、哮喘与相关的信念：一项以人群为基础的研究
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大量饮酒导致高IgE水平但过敏性疾病的风险不高
