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Am. J Epidemiol.:剖腹产的儿童3岁时患哮喘风险增加

2012/01/13 来源:生物谷
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导读
来自挪威母亲和儿童队列研究(MoBa)的结果表明,经剖腹产的孩子在3岁时有一个增加的患哮喘风险。尤其是在无哮喘和过敏症遗传倾向的家庭的儿童中。

一项新的研究支持了以前的研究结果,经剖腹产的儿童罹患哮喘的风险增加。

来自挪威母亲和儿童队列研究(MoBa)的结果表明,经剖腹产的孩子在3岁时有一个增加的患哮喘风险。尤其是在无哮喘和过敏症遗传倾向的家庭的儿童中。

来自于超过37000参与者的MoBa研究数据被用于研究生产方式和出生三岁时的下呼吸道感染、喘息、哮喘形成之间的关系。计划或紧急的剖腹产的儿童与正常的阴道生产的儿童进行比较。

结果表明,剖腹产出生的儿童在3岁时有一个略高的患哮喘风险,但无增加的下呼吸道感染或气喘的风险。剖腹产的儿童比无过敏母亲的儿童有更高的患哮喘的风险。

"剖腹产本身不太可能会引起哮喘风险的增加,而是这种生产方式的孩子可能有一个潜在的脆弱性,"Maria Magnus说。

剖腹产的儿童可能有一个增加的患哮喘风险由于肠道内被改变的菌落,能影响他们免疫系统的发育,或者因为这种方式生产的儿童在生命的头几周往往有一个增加的严重呼吸问题的风险。

 

Delivery by Cesarean Section and Early Childhood Respiratory Symptoms and Disorders: The Norwegian Mother and Child Cohort Study

M. C. Magnus, S. E. Haberg, H. Stigum, P. Nafstad, S. J. London, S. Vangen, W. Nystad.

Studies have indicated that children delivered by cesarean section are at an increased risk of developing wheezing and asthma. This could be the result of an altered immune system development due to delayed gut colonization or of increased neonatal respiratory morbidity. The authors examined the associations between delivery by cesarean section and the development of wheezing, asthma, and recurrent lower respiratory tract infections in children up to 36 months of age among 37,171 children in the Norwegian Mother and Child Cohort Study. Generalized linear models were used in the multivariable analysis. Children delivered by cesarean section had an increased likelihood of current asthma at 36 months of age (relative risk = 1.17, 95% confidence interval: 1.03, 1.32), and the association was stronger among children of nonatopic mothers (relative risk = 1.33, 95% confidence interval: 1.12, 1.58). No increased risk of wheezing or recurrent lower respiratory tract infections was seen among children delivered by cesarean section. Findings were similar among children delivered by acute and elective cesarean section. In conclusion, children delivered by cesarean section may have an increased risk of current asthma at 36 months, but residual confounding cannot be excluded. In future prospective studies, investigators should reexamine this association in different age groups.

文献链接:http://aje.oxfordjournals.org/content/174/11/1275

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