摘要 目的分析母亲孕期及儿童1岁内抗生素暴露和6~11月龄、18~23月龄儿童过敏性疾病的相关性。方法采用前瞻性出生队列研究,2015年6月至2016年6月在马鞍山市妇幼保健院纳入2122名孕妇,从孕期开始一直随访至儿童24月龄。排除失访及抗生素用药史、儿童过敏性疾病信息不完整的母子564对,共有1558对母子纳入本次研究分析。收集父母及儿童一般人口学信息、生命早期抗生素暴露情况等资料,参考“国际间儿童哮喘及其他过敏性疾病的对比研究(ISAAC)”调查6~11月龄和18~23月龄儿童过敏性疾病信息。采用单因素和多因素二分类非条件logistic回归模型分析生命早期抗生素暴露对6~11月龄和18~23月龄儿童过敏性疾病的影响。结果孕妇孕期抗生素使用率为3.4%(53名),儿童在0~2月龄、3~5月龄、6~11月龄的抗生素使用率分别为15.2%(237名)、15.5%(242名)、17.3%(269名)。6~11月龄儿童过敏性疾病总患病率为24.1%(375名),18~23月龄儿童过敏性疾病总患病率为22.0%(342名)。在调整父(母)亲文化程度、家庭人均月收入、父(母)亲过敏史、妊娠时父(母)亲年龄、母亲孕前体重指数(BMI)、孕期是否接触二手烟、分娩方式、儿童性别、出生体重、是否早产后,儿童3~5月龄使用抗生素(RR=1.61,95%CI:1.19~2.17)和6~11月龄使用抗生素(RR=1.43,95%CI:1.06~1.93)是6~11月龄儿童过敏性疾病发生的危险因素;儿童0~2月龄使用抗生素(RR=1.41,95%CI:1.03~1.95)、3~5月龄使用抗生素(RR=1.54,95%CI:1.12~2.11)和6~11月龄使用抗生素(RR=1.58,95%CI:1.17~2.14)是18~23月龄儿童过敏性疾病发生的危险因素。结论儿童1岁内抗生素暴露是其在6~11月龄和18~23月龄发生过敏性疾病的危险因素,儿童在婴儿期应尽量避免不必要的抗生素使用。 Objective To analyze the associations between prenatal and 1-year-old exposure to antibiotics and allergic symptoms in children aged 6-11 months and 18-23 months.Methods In this study,a prospective birth cohort study was adopted.A total of 2122 pregnant women were enrolled in Maternal and Child Health Care Center of Ma′anshan from June 2015 to June 2016,and they were followed up from the beginning of pregnancy to children′s 24 months of age.Excluding 564 pairs of mothers and children who were lost to follow-up or with incomplete information on the use of antibiotics and children′s allergic symptoms,a total of 1558 pairs of mothers and children were included in the analysis of this study.The parents and children′s general demographic information,early-life antibiotic exposure and other data were collected,the information about allergic symptoms in children aged 6-11 months and 18-23 months were investigated by reference to the"International Study of Asthma and Allergies in Childhood(ISAAC)".The univariate and multivariate binary unconditional logistic regression model was used to was used to estimate associations between the effects of early-life antibiotic exposure on allergic symptoms in 2-year-old children.Results The antibiotic usage rate of pregnant women during pregnancy was 3.4%(53),and the antibiotic usage rates of children between 0 to 2 months,3 to 5 months,and 6 to 11 months were separately 15.2%(237),15.5%(242)and 17.3%(269).The total prevalence of allergic diseases in children aged 6 to 11 months was 24.1%(375 children),and the total prevalence of allergic diseases in children aged 18 to 23 months was 22.0%(342 children).After adjust parental(maternal)education level,family monthly income per capita,parental(maternal)allergy history,parental(maternal)age at pregnancy,mother′s Body Mass Index(BMI)before pregnancy,exposure to second-hand smoke during pregnancy,delivery method,child gender,birth weight,preterm birth,the use of antibiotics when children were 3-5 months old(RR=1.61,95%CI:1.19-2.1
出处 《中华预防医学杂志》 CAS CSCD 北大核心 2021年第5期598-605,共8页 Chinese Journal of Preventive Medicine
基金 马鞍山市卫生计生委第十一批科教专项资金资助课题 2015年马鞍山市科技计划项目(YL-2015-06) 2015年度合生元母婴营养与健康研究项目(2015FYH006) 2018年合生元母婴营养与健康研究项目(2018FYH009)。
分类号 R72 [医药卫生—儿科]
