母乳喂养、亲代过敏史与儿童哮喘之间的关系—--一项对PIAMA受试者随访8年的研究
2010/01/07
迄今为止，对于有关母乳喂养与儿童随年龄增长相应递增的哮喘症状严重程度之间的关系，以及随着时间的流逝这种关系是否受亲代变态反应性疾病史影响，以及如何受其影响，尚不清楚。
就此，S Scholtens等人选取均参加了PIAMA(哮喘与变态反应性疾病的发生率与防控)项目组的1996～1997年出生的荷兰籍儿童做为研究对象，通过每年的问卷调查得出有关其母乳喂养情况以及儿童哮喘相关情况（包括喘息，呼吸困难症状以及吸入糖皮质激素治疗的剂量等），8年来监测其与空气变应原相关的特异性IgE水平和支气管激发试验。最后对上述数据进行统计分析(logistic回归和GEEs)，同时根据亲代变态反应状态将其分别统计。统计后发现，调查儿童中有35% (1081人)母乳喂养超过16周。到8岁的患儿有12.6% (392人)患有哮喘。比较未喝母乳与喝母乳超过16周的儿童发现，无论是父母双亲有无变态反应病史，母乳喂养史与3～8岁期间的儿童哮喘发生率低这一事实明显相关。而对于8岁儿童，母乳喂养史与儿童是否对空气变应原致敏无明显相关。母乳喂养与支气管气道高反应之间无相关性。观察中未发现母乳喂养与性别、父亲或母亲患变态反应疾病史之间存在相关性。
该研究指出，母乳喂养与8岁以下儿童哮喘发病率低有关，但未发现与家族过敏史有关。
（于娜 中国医科大学附属第一医院呼吸内科 110001 摘译）
（Thorax 2009;64:604-609）
Breast feeding, parental allergy and asthma in children followed for 8 years. The PIAMA birth cohort study
S Scholtens1, A H Wijga2, B Brunekreef1, M Kerkhof3, M O Hoekstra4, J Gerritsen5, R Aalberse6, J C de Jongste7 and H A Smit2
1 Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
2 Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
3 Department of Epidemiology and Bioinformatics, University of Groningen, Groningen, The Netherlands
4 Centre for Paediatric Allergology, Wilhelmina Children’s Hospital, Utrecht, The Netherlands
5 Beatrix Children’s Hospital, University Medical Centre Groningen, University of Groningen, The Netherlands
6 Sanquin Research, Amsterdam, The Netherlands
7 Department of Pediatrics, Division of Respiratory Medicine, Erasmus MC-Sophia, Rotterdam, The Netherlands
Correspondence to:
Dr S Scholtens, National Institute for Public Health and the Environment (RIVM), Centre for Prevention and Health Services Research (pb 101), PO Box 1, 3720 BA Bilthoven, The Netherlands; salome.scholtens@rivm.nl
Background: It is unclear how the association between breast feeding and asthma develops with age of the child and how this association over time is influenced by maternal or paternal allergy. These factors—the age of the child and maternal or paternal allergy—might partly explain the conflicting results observed in cross-sectional studies.
Methods: The study population consisted of 3115 Dutch children born in 1996/1997 who participated in the PIAMA (Prevention and Incidence of Asthma and Mite Allergy) birth cohort study. Data on breast feeding and asthma (based on wheeze, dyspnoea and prescription of inhaled steroids) were collected by yearly questionnaires. At 8 years, specific immunoglobulin E (IgE) to airborne allergens and bronchial responsiveness were measured. Data were analysed by logistic regression and generalised estimating equations (GEEs), and stratified by maternal and paternal allergic status.
Results: 35% (n = 1081) of the children were breast fed for >16 weeks. At 8 years of age, 12.6% (n = 392) had asthma. Breast feeding (>16 weeks vs no breast feeding) was significantly associated with a lower asthma prevalence from 3 to 8 years of age, in children of both non-allergic and allergic mothers. The inverse association between breast feeding and sensitisation to airborne allergens at 8 years was non-significant. Breast feeding was not associated with bronchial hyper-responsiveness. No interaction between breast feeding and gender, maternal allergy or paternal allergy was observed in any of the associations.
Conclusions: Breast feeding is associated with a lower asthma risk in children until 8 years of age without evidence of attenuation and regardless of the family history of allergy.
Thorax 2009;64:604-609; doi:10.1136/thx.2007.094938
就此，S Scholtens等人选取均参加了PIAMA(哮喘与变态反应性疾病的发生率与防控)项目组的1996～1997年出生的荷兰籍儿童做为研究对象，通过每年的问卷调查得出有关其母乳喂养情况以及儿童哮喘相关情况（包括喘息，呼吸困难症状以及吸入糖皮质激素治疗的剂量等），8年来监测其与空气变应原相关的特异性IgE水平和支气管激发试验。最后对上述数据进行统计分析(logistic回归和GEEs)，同时根据亲代变态反应状态将其分别统计。统计后发现，调查儿童中有35% (1081人)母乳喂养超过16周。到8岁的患儿有12.6% (392人)患有哮喘。比较未喝母乳与喝母乳超过16周的儿童发现，无论是父母双亲有无变态反应病史，母乳喂养史与3～8岁期间的儿童哮喘发生率低这一事实明显相关。而对于8岁儿童，母乳喂养史与儿童是否对空气变应原致敏无明显相关。母乳喂养与支气管气道高反应之间无相关性。观察中未发现母乳喂养与性别、父亲或母亲患变态反应疾病史之间存在相关性。
该研究指出，母乳喂养与8岁以下儿童哮喘发病率低有关，但未发现与家族过敏史有关。
（于娜 中国医科大学附属第一医院呼吸内科 110001 摘译）
（Thorax 2009;64:604-609）
Breast feeding, parental allergy and asthma in children followed for 8 years. The PIAMA birth cohort study
S Scholtens1, A H Wijga2, B Brunekreef1, M Kerkhof3, M O Hoekstra4, J Gerritsen5, R Aalberse6, J C de Jongste7 and H A Smit2
1 Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
2 Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
3 Department of Epidemiology and Bioinformatics, University of Groningen, Groningen, The Netherlands
4 Centre for Paediatric Allergology, Wilhelmina Children’s Hospital, Utrecht, The Netherlands
5 Beatrix Children’s Hospital, University Medical Centre Groningen, University of Groningen, The Netherlands
6 Sanquin Research, Amsterdam, The Netherlands
7 Department of Pediatrics, Division of Respiratory Medicine, Erasmus MC-Sophia, Rotterdam, The Netherlands
Correspondence to:
Dr S Scholtens, National Institute for Public Health and the Environment (RIVM), Centre for Prevention and Health Services Research (pb 101), PO Box 1, 3720 BA Bilthoven, The Netherlands; salome.scholtens@rivm.nl
Background: It is unclear how the association between breast feeding and asthma develops with age of the child and how this association over time is influenced by maternal or paternal allergy. These factors—the age of the child and maternal or paternal allergy—might partly explain the conflicting results observed in cross-sectional studies.
Methods: The study population consisted of 3115 Dutch children born in 1996/1997 who participated in the PIAMA (Prevention and Incidence of Asthma and Mite Allergy) birth cohort study. Data on breast feeding and asthma (based on wheeze, dyspnoea and prescription of inhaled steroids) were collected by yearly questionnaires. At 8 years, specific immunoglobulin E (IgE) to airborne allergens and bronchial responsiveness were measured. Data were analysed by logistic regression and generalised estimating equations (GEEs), and stratified by maternal and paternal allergic status.
Results: 35% (n = 1081) of the children were breast fed for >16 weeks. At 8 years of age, 12.6% (n = 392) had asthma. Breast feeding (>16 weeks vs no breast feeding) was significantly associated with a lower asthma prevalence from 3 to 8 years of age, in children of both non-allergic and allergic mothers. The inverse association between breast feeding and sensitisation to airborne allergens at 8 years was non-significant. Breast feeding was not associated with bronchial hyper-responsiveness. No interaction between breast feeding and gender, maternal allergy or paternal allergy was observed in any of the associations.
Conclusions: Breast feeding is associated with a lower asthma risk in children until 8 years of age without evidence of attenuation and regardless of the family history of allergy.
Thorax 2009;64:604-609; doi:10.1136/thx.2007.094938
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体力活动与哮喘发作的相关性：一项针对老年女性哮喘患者的前瞻性研究
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ISAAC（儿童哮喘和变态反应性疾病全球研究）的第三阶段总结：有关哮喘患病率和严重程度全球性调查
