哮喘联盟

   摘要
   目的：旨在研究胎龄是否影响呼吸道感染导致出生后第一年入院治疗和5岁后哮喘风险的关系。
   背景：在瑞典住院患者和一般人群中进行对照研究，跟踪主要和次要治疗的后续诊断。
   受试者：国家登记处于1981～1995年纳入42334例住院的呼吸道感染患者和211594例未住院治疗的感染患者（均为出生后第一年的婴儿）。
   主要结果：5岁后通过登记处记录哮喘诊断和治疗。
   结果：在调整性别、胎龄、慢性肺疾病、母亲哮喘和母亲吸烟后，多因素回归分析被用于确定1岁前呼吸道感染和5岁后哮喘关系的HR值为1.51（1.47 -1.51）（95% CI）。当通过胎龄分类时（额外增加出生体重的调整），疗效变化有显著的统计学差异，且胎龄＜28周的早产儿哮喘风险级别最高，HR调整值为2.22（1.59-3.09）。这种更高的哮喘风险持续至10岁以后，但不同胎龄的风险差异在16岁后减小。
   结论：极早产儿在早期呼吸道感染后最可能发生慢性呼吸道后遗症。
 

（苏楠 审校）
BMJ Open. 2013 Oct 29;3(10):e004034. doi: 10.1136/bmjopen-2013-004034.

 

Respiratory infections in preterm infants and subsequent asthma: a cohort study.
 

Montgomery S, Bahmanyar S, Brus O, Hussein O, Kosma P, Palme-Kilander C.
 

Abstract
OBJECTIVES: To investigate whether gestational age modifies the association of airway infections that result in hospital admission during the first year after birth, with subsequent asthma risk after age 5 years.
SETTING: Hospital inpatients and a general population comparison group in Sweden followed for subsequent diagnoses in primary and secondary care.
PARTICIPANTS: National registers identified 42 334 children admitted to hospital for respiratory infection in their first year after birth during 1981-1995, individually matched with 211 594 children not admitted to hospital for infection during their first year.
PRIMARY OUTCOME: Asthma diagnoses and prescribed asthma treatments after the age of 5 years identified through registers.
RESULTS: Cox regression was used to identify a HR (and 95% CI) of 1.51 (1.47 to 1.51) for the association of respiratory infection before 1 year of age with asthma after age 5 years, after adjustment for sex, gestational age, chronic lung disease, maternal asthma and maternal smoking. When stratified by gestational age (and with additional adjustment for birth weight), there is statistically significant effect modification by gestational age, with the highest magnitude asthma risk among those born with a gestational age of less than 28 weeks, producing an adjusted HR of 2.22 (1.59 to 3.09). This higher magnitude asthma risk persisted until after age 10 years, but differences in risk by gestational age were less pronounced for asthma after age 16 years.
CONCLUSIONS: Extremely preterm infants are most likely to have chronic respiratory sequelae following respiratory infections in early life.
 

BMJ Open. 2013 Oct 29;3(10):e004034. doi: 10.1136/bmjopen-2013-004034.