母亲孕期哮喘的控制和严重程度与其后代过敏性皮炎和过敏性鼻炎发生率的关系
2009/09/16
目的：研究母亲孕期哮喘控制的控制水平及其严重程度与儿童过敏性皮炎（AD）和过敏性鼻炎（AR）发病率之间的关系。
研究设计：在3 个魁北克省的数据库中选取哮喘或非哮喘母亲的26265名独生子女（1999-2002）作为该队列研究的研究对象。哮喘母亲至少经过一次或一次以上的诊断，孕前2年或孕期有过一次以上的药物治疗史。基于经过验证的有效指标对孕期的哮喘控制及其严重程度进行评价。采用ICD-9对691名AD儿童患者和477名AR儿童患者进行编码。
结果：孕期母亲哮喘与儿童AD风险增加相关（校正HR为1.11；95％ CI：1.02-1.21），而与AR无关（校正HR为1.04；95％ CI：0.91-1.20）。哮喘控制和严重程度与儿童中两种疾病的预后均无关。母亲孕期AR与鼻内糖皮质激素治疗使儿童AR的风险分别增加70％和45％。
结论：应该对怀孕期间有哮喘或AR的母亲的子女进行严密监测，尽早对AD和AR进行诊断和治疗。
（林江涛 审校）
Martel MJ, Beauchesne MF, Malo JL, et al.
J Pediatr. 2009 Jul 18. [Epub ahead of print
Maternal Asthma, its Control and Severity in Pregnancy, and the Incidence of Atopic Dermatitis and Allergic Rhinitis in the Offspring
Martel MJ, Beauchesne MF, Malo JL, Rey E, Perreault S, Forget A, Blais L.
Faculty of Pharmacy, Université de Montréal (M.M., M.B., S.P., L.B.), the Pharmacy Department (M.B.) and the Research Center (J.L., A.F.), Hôpital du Sacré-Coeur de Montréal, the Obstetric and Gynecology Department, CHU Ste-Justine (E.R.), Montréal, Québec, Canada.
OBJECTIVE: To evaluate the relationship between maternal asthma, its level of control and severity during pregnancy, and atopic dermatitis (AD) and allergic rhinitis (AR) incidence in children.
STUDY DESIGN: A cohort of 26 265 singletons born to mothers with and without asthma (1990-2002) was constituted by use of 3 Quebec databases. Mothers with asthma had to have received >/=1 diagnosis and >/=1 prescription for asthma 2 years before or during pregnancy. Asthma control and severity during pregnancy was based on validated indexes. ICD-9 codes 691 and 477 allowed us to identify cases of AD and AR.
RESULTS: Maternal asthma during pregnancy was associated with an increased AD risk (adjusted hazard ratio: 1.11, 95% confidence interval: 1.02-1.21), but not of AR (adjusted hazard ratio: 1.04, 95% confidence interval: 0.91-1.20) in children. Asthma control and severity were not associated with either outcome. Maternal AR and intranasal corticosteroid use during pregnancy increased the risk of childhood AR by 70% and 45%.
CONCLUSIONS: Children of mothers with asthma or AR during pregnancy should be closely monitored to diagnose and treat AD and AR as early as possible.
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体重超重妇女与哮喘的控制
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儿童哮喘严重性与接触室内常见的灰尘过敏原之间的关系
