哮喘联盟

   摘要
   背景:一直以来都有严谨的调查研究在分析围产期因素与哮喘发病的联系。然而，哮喘、体外受孕(IVF)和剖腹分娩间的相关性证据仍不明确。
   目的:在控制一些潜在的混杂因素后，本研究评估了哮喘发病率与IVF和剖腹产之间的关系。
   方法:由年龄为9～13岁的2016例希腊儿童(健康成长研究人群)的父母填写调查问卷，内容包括过去12个月里父母报告的喘息（现在）、既往喘息、医生诊断的哮喘、受孕方式以及分娩方式。某些围产期的数据来自儿童医疗记录，其他信息由父母报告；所有儿童均接受人体测量。
   结果:体外受孕与医生诊断哮喘相关(OR = 2.25; 95% CI = 1.11-4.56)，但在校正了潜在的混杂因素后，与现在/既往喘息无关。同样，校正后，剖腹产与哮喘相关(OR = 1.39; 95% CI = 1.04-1.87)，与现在/既往喘息无关。采用相同的多因素logistic回归模型分析后，IVF (OR = 2.04; 95% CI = 1-4.15)和剖腹产(OR = 1.34; 95% CI = 1-1.81)与哮喘的相关性减弱至临界值。
   结论和临床相关性:体外受孕和剖腹产出生的儿童将来可能发生哮喘。任何一个变量都可能影响其他的混杂因素与哮喘相关性；这可能是本研究结果与其他相关研究结果不一致的部分原因所在。
 

（林江涛 审校）
Clin Exp Allergy. 2013 Sep;43(9):1058-66. doi: 10.1111/cea.12152.
 

Conception via in vitro fertilization and delivery by Caesarean section are associated with paediatric asthma incidence.
 

Guibas GV, Moschonis G, Xepapadaki P, Roumpedaki E, Androutsos O, Manios Y, Papadopoulos NG.
 

Abstract
BACKGROUND:The association between perinatal factors and asthma inception is under rigorous investigation. Nevertheless, evidence of a correlation between asthma, conception via in vitro fertilization (IVF) and delivery through Caesarean section (C-section) is inconclusive.
OBJECTIVE:We aimed to assess the relation of asthma incidence with IVF and C-section, after controlling for several potential confounding factors.
METHODS:Parent-reported wheeze in the last 12 months (current), wheeze ever, physician-diagnosed asthma, method of conception, and type of delivery were recorded from questionnaires filled in by the parents of 2016 Greek children aged 9-13, (the Healthy Growth Study population). Some perinatal data were recorded from children's medical records and others were reported by parents; anthropometric measurements were also conducted in children.
RESULTS:IVF was correlated with physician-diagnosed asthma (OR = 2.25; 95% CI = 1.11-4.56), but not with current/ever wheeze after adjustment for potential confounding factors. After adjustment, C-section was also associated with asthma (OR = 1.39; 95% CI = 1.04-1.87), but not with current/ever wheeze. When the association of both IVF and C-section with asthma was examined in the same multivariate logistic regression model, it was weakened to borderline significance (OR = 2.04; 95% CI = 1-4.15 and OR = 1.34; 95% CI = 1-1.81 respectively).
CONCLUSIONS AND CLINICAL RELEVANCE:Conception via IVF and delivery by C-section may predispose children to future asthma development. Either variable could also exert a confounding effect on the link of the other to asthma; this may partially be accountable for inconsistencies in the findings of pertinent studies.
 

Clin Exp Allergy. 2013 Sep;43(9):1058-66. doi: 10.1111/cea.12152.