低出生体质量儿婴儿期食物过敏发生的危险因素

Risk factors of developing infantile food allergy in low birth weight infants

目的探讨低出生体质量儿食物过敏发生的危险因素。方法选择2007年1月1日至2011年12月31日在北京大学第三医院NICU住院治疗，出院后在食物过敏门诊就诊且符合食物过敏诊断标准的低出生体质量儿作为食物过敏组（49例），采用分层抽样的方法抽取同期在NICU住院治疗，出院后在儿童保健门诊建档随访但无食物过敏表现的低出生体质量儿作为对照组（49例）。采用调查问卷的方法调查2组患儿性别、胎龄、产出方式、出院后喂养方式、父母饮酒、吸烟史、父母变应性疾病史及母孕期每日进食鸡蛋情况和婴儿期鸡蛋添加时间。同时查阅患儿住院期间的病历资料，分析患儿所患疾病、胃肠外营养、PS和呼吸机的应用情况。计数资料比较采用，检验，计量资料比较采用t检验，多因素分析采用非条件Logistic回归分析。结果2组患儿出生体质量、性别、产出方式、出院后喂养方式、父母烟酒暴露、母孕期每日进食鸡蛋情况、婴儿期鸡蛋添加时间及其住院期间所患的各系统疾病、胃肠外营养、PS和呼吸机应用情况比较差异均无统计学意义，而胎龄、父母变应性疾病史比较差异有统计学意义。食物过敏组中胎龄33～35周、36～37周患儿的比例高于对照组，胎龄29～32周患儿的比例低于对照组（X2=10．312，P：0．016；X2=20．753，P=0．000）。非条件Logistic回归分析显示，低出生体质量儿食物过敏的发生仅与父母一方或双方的变应性疾病史有相关性（OR=5．574，P=0．004；OR：14．487，P=0．000）。结论父母双方变应性疾病史与低出生体质量儿食物过敏的发病有关。

Objective To investigate the risk factors of low birth weight infants with food allergy. Methods Forty-nine food allergy children who had been admitted to the neonatal intensive care unit（NICU） of Peking University Third Hospital from Jan. 1,2007 to Dec. 31,2011 and followed up in the Pediatrics Allergy Clinic after discharged from hospital were involved as food allergy group. Forty-nine children who had been admitted to the NICU of Peking University Third Hospital at the same time and followed up in the Child Health Care Clinic after discharged from hospital but had no manifestations of food allergy were selected by stratified sampling as control group. A questionnaire was designed to record the children＇s gender, gestation age, mode of delivery, feeding patterns after discharging from hospital, tobacco and alcohol consumption of their parents, allergy history of their parents, the intake of egg of the mother during lactation and the children＇s introduction of egg. At the same time, their hospital notes were investigated. The diseases they had and the application of parental nutrition, pulmonary surfactant and ventilator were all analyzed. Quantitative data were analyzed with Chi-square, qualitative data were analyzed with t-test. The risk factors of food allergy of the low birth weight infants were examined by unconditional Logistic regression. Results The birth weight, gender, mode of delivery, feeding patterns after discharging from hospital, parents, exposure to tobacco smoke and alcohol, the intake of egg of the mother during lactation and the children＇s introduction of egg between the 2 groups were no significantly different. The diseases they got and the application of parental nutrition, pulmonary surfactant and ventilator when they in hospital were no significantly different, too. The gestation age, parental history of allergy between the 2 groups were significantly different. The proportion of children of 33 - 35 weeks and. 36 - 37 weeks gestation age in food allergy group were significantly higher than those in control group,while the 29 -32 weeks gestation age were significantly lower than those in control group （X2 = 10.312, P =0. O16 ;X2 = 20. 753, P = 0.000）. But by unconditional Logistic regression analysis, only the one or both parents, history of allergy was the risk factor for the development of food allergy of the low birth weight infants （ OR = 5. 574, P = 0.004 ; OR = 14.487, P = 0. 000）. Conclusion Parents history of allergy is related to the development of food allergy of the low birth weight infants.