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母亲哮喘对围产期转归的影响:2阶段取样队列研究

2012/02/29

   有关妊娠期母亲哮喘对围产期转归的影响存在争议。本试验旨在研究妊娠期母亲哮喘与小胎龄(SGA)、低出生体重(LBW)和早产的关系。对40788名孕妇进行以人群为基础的队列研究,这些哮喘和非哮喘女性来自1990~2002年加拿大魁北克的3个管理数据库。采用2阶段取样,通过邮寄问卷调查收集额外信息。采用广义估计方程模型,比较哮喘和非哮喘女性间SGA、LBW和早产的校正后优势比。队列研究入选13007名哮喘女性和27781名非哮喘女性。
   结果显示,哮喘女性SGA(OR=1.27, 95%CI: 1.14, 1.41)、LBW(1.41: 1.22, 1.63)和早产(1.64: 1.46, 1.83)优势比显著高于非哮喘女性。与非哮喘妊娠女性相比,妊娠期哮喘母亲更易出现SGA、LBW和早产婴儿。由于本队列研究入选的对象来自于高社会经济状态人群,因此该结果能扩展至低社会经济状态女性人群中。
 
(刘国梁 审校)
Eur J Epidemiol. 2012 Jan 28. [Epub ahead of print]
 
 

Source
Faculty of Pharmacy, Université de Montréal, succursale Centre-ville, C.P. 6128, Montréal, QC, H3C 3J7, Canada.

Abstract
There are conflicting results concerning the impact of maternal asthma during pregnancy on perinatal outcomes. The present study investigated the associations between maternal asthma during pregnancy and the risk of a small-for-gestational-age (SGA) infant, a low-birth-weight (LBW) infant, and preterm birth. A population-based cohort of 40,788 pregnancies from asthmatic and non-asthmatic women was reconstructed through the linking of three Quebec (Canada) administrative databases between 1990 and 2002. A two-stage sampling cohort design was used to collect additional information by way of a mailed questionnaire. The generalized estimation equation models were used to obtain adjusted odds ratios of SGA, LBW and preterm birth comparing asthmatic and non-asthmatic women. The cohort included 13,007 pregnancies from asthmatic and 27,781 pregnancies from non-asthmatic women. Final estimates showed that the odds of SGA (odds ratio: 1.27, 95% confidence interval: 1.14, 1.41), LBW (1.41: 1.22, 1.63) and preterm delivery (1.64: 1.46, 1.83) were significantly higher among asthmatic than non-asthmatic women. Mothers with asthma during pregnancy are more likely to have SGA, LBW, or preterm birth infants than non-asthmatic women. These results can be more easily generalized to women with lower socio-economic status since the cohort under represents women with high socio-economic status.

Eur J Epidemiol. 2012 Jan 28. [Epub ahead of print]


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