妊娠期体重增加对儿童哮喘表型的影响:一项前瞻性队列研究
2024/07/30
摘要
背景：产前人体测量指标对特定儿童哮喘表型发展的贡献尚不清楚。
目的：探讨孕前体重指数(BMI)和孕期增重(GWG)与儿童过敏性和非过敏性哮喘表型的关系。
方法：研究对象为美国田纳西州中部地区足月健康婴儿。孕前BMI和孕期增重分别根据世界卫生组织(WHO)和美国医学研究所(IOM)推荐标准进行分类。过敏性哮喘定义为持续5年的哮喘且吸入变应原皮肤试验或特异性IgE阳性。哮喘采用多变量logistic回归模型，非哮喘、过敏性哮喘和非过敏性哮喘采用多项logistic回归模型。
结果：共纳入1 266例儿童。5年随访时，194例(15.3%)患者发生哮喘；其中102例(52.6%)合并过敏性哮喘。与孕期增重适宜者相比，孕期增重不足或过多均与哮喘发病风险增加相关(孕期增重不足:aOR 1.76 [95% CI: 1.03～2.98]；过度:aOR 1.70 [95% CI: 1.12-2.57])，与非哮喘相比，过敏性哮喘的风险增加(不充分:aOR 3.49 [95% CI: 1.66-7.32];过度:aOR 2.55 [95% CI: 1.34-4.85])。孕前BMI与哮喘或哮喘表型无关。
结论：孕期增重不足和过多均与过敏性哮喘风险相关。这些结果支持孕期最佳增重对儿童健康结局的益处。
Contribution of gestational weight gain to childhood asthma phenotypes: a prospective cohort study
Akihiro Shiroshita, Tebeb Gebretsadik, Larry J Anderson, William D Dupont, Sarah Osmundson, Brittney Snyder, Christian Rosas-Salazar, Tina V Hartert
Abstract
Background: The contribution of prenatal anthropometric measures to the development of specific childhood asthma phenotypes is not known.
Objective: We aimed to evaluate associations between prepregnancy body mass index (BMI) and gestational weight gain (GWG) with allergic and non-allergic asthma phenotypes in childhood.
Methods: Our study population included term, healthy infants in the middle Tennessee region of the United States. Prepregnancy BMI and GWG were ascertained from questionnaires administered during early infancy and categorized based on World Health Organization (WHO) and Institute of Medicine (IOM) recommendations, respectively. Allergic asthma was defined as 5-year current asthma and a positive skin test or specific IgE to aeroallergen(s). We used multivariable logistic regression models for asthma and multinomial logistic regression models for non-asthma, allergic asthma, and non-allergic asthma.
Results: A total of 1,266 children were included. At the 5-year follow-up, 194 (15.3%) had asthma; among them, 102 (52.6%) had allergic asthma. Both inadequate and excessive GWG, compared to adequate GWG, were associated with increased odds of asthma (inadequate: aOR 1.76 [95% CI: 1.03-2.98]; excessive: aOR 1.70 [95% CI: 1.12-2.57]) and increased odds of allergic asthma compared to no asthma (inadequate: aOR 3.49 [95% CI: 1.66-7.32]; excessive: aOR 2.55 [95% CI: 1.34-4.85]). Prepregnancy BMI was not associated with asthma nor with asthma phenotypes.
Conclusion: Both inadequate and excessive GWG were associated with allergic asthma risk. These results support the benefits of optimal GWG during pregnancy on child health outcomes.
背景：产前人体测量指标对特定儿童哮喘表型发展的贡献尚不清楚。
目的：探讨孕前体重指数(BMI)和孕期增重(GWG)与儿童过敏性和非过敏性哮喘表型的关系。
方法：研究对象为美国田纳西州中部地区足月健康婴儿。孕前BMI和孕期增重分别根据世界卫生组织(WHO)和美国医学研究所(IOM)推荐标准进行分类。过敏性哮喘定义为持续5年的哮喘且吸入变应原皮肤试验或特异性IgE阳性。哮喘采用多变量logistic回归模型，非哮喘、过敏性哮喘和非过敏性哮喘采用多项logistic回归模型。
结果：共纳入1 266例儿童。5年随访时，194例(15.3%)患者发生哮喘；其中102例(52.6%)合并过敏性哮喘。与孕期增重适宜者相比，孕期增重不足或过多均与哮喘发病风险增加相关(孕期增重不足:aOR 1.76 [95% CI: 1.03～2.98]；过度:aOR 1.70 [95% CI: 1.12-2.57])，与非哮喘相比，过敏性哮喘的风险增加(不充分:aOR 3.49 [95% CI: 1.66-7.32];过度:aOR 2.55 [95% CI: 1.34-4.85])。孕前BMI与哮喘或哮喘表型无关。
结论：孕期增重不足和过多均与过敏性哮喘风险相关。这些结果支持孕期最佳增重对儿童健康结局的益处。
(中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校)
(J Allergy Clin Immunol Pract. 2024 Jul 17:S2213-2198(24)00738-4. doi: 10.1016/j.jaip.2024.07.008.)
(J Allergy Clin Immunol Pract. 2024 Jul 17:S2213-2198(24)00738-4. doi: 10.1016/j.jaip.2024.07.008.)
Contribution of gestational weight gain to childhood asthma phenotypes: a prospective cohort study
Akihiro Shiroshita, Tebeb Gebretsadik, Larry J Anderson, William D Dupont, Sarah Osmundson, Brittney Snyder, Christian Rosas-Salazar, Tina V Hartert
Abstract
Background: The contribution of prenatal anthropometric measures to the development of specific childhood asthma phenotypes is not known.
Objective: We aimed to evaluate associations between prepregnancy body mass index (BMI) and gestational weight gain (GWG) with allergic and non-allergic asthma phenotypes in childhood.
Methods: Our study population included term, healthy infants in the middle Tennessee region of the United States. Prepregnancy BMI and GWG were ascertained from questionnaires administered during early infancy and categorized based on World Health Organization (WHO) and Institute of Medicine (IOM) recommendations, respectively. Allergic asthma was defined as 5-year current asthma and a positive skin test or specific IgE to aeroallergen(s). We used multivariable logistic regression models for asthma and multinomial logistic regression models for non-asthma, allergic asthma, and non-allergic asthma.
Results: A total of 1,266 children were included. At the 5-year follow-up, 194 (15.3%) had asthma; among them, 102 (52.6%) had allergic asthma. Both inadequate and excessive GWG, compared to adequate GWG, were associated with increased odds of asthma (inadequate: aOR 1.76 [95% CI: 1.03-2.98]; excessive: aOR 1.70 [95% CI: 1.12-2.57]) and increased odds of allergic asthma compared to no asthma (inadequate: aOR 3.49 [95% CI: 1.66-7.32]; excessive: aOR 2.55 [95% CI: 1.34-4.85]). Prepregnancy BMI was not associated with asthma nor with asthma phenotypes.
Conclusion: Both inadequate and excessive GWG were associated with allergic asthma risk. These results support the benefits of optimal GWG during pregnancy on child health outcomes.
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成人儿童期重度哮喘的特点——60年随访研究
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重度哮喘伴低血嗜酸粒细胞的临床和经济负担
