剖宫产与儿童过敏性鼻炎 哮喘关系研究

Caesarean section and risk of allergic rhinitis and asthma in children

目的探讨剖宫产与儿童过敏性鼻炎和哮喘间的关系，并了解家族过敏史对其关系的影响。方法在2010年苏州平江地区0～14岁儿童哮喘流行病学调查的基础上，从540例典型哮喘患儿中抽取年龄5～14岁者427例，其中男性290例、女性137例，平均年龄（8．46±2．3）岁。同时按1：1配对原则从5～14岁非哮喘儿童中抽取性别相同、年龄相近的儿童427例，共854例作为研究对象。儿童的出生史（分娩方式、出生体重、胎龄），个人过敏史，周围环境情况及家族过敏史等内容通过全国哮喘防治协作组制定的统一问卷获得。调查数据采用卡方检验、Logistie回归进行统计分析。结果854例儿童中，剖宫产388例（过敏性鼻炎158例，哮喘191例），阴道分娩466例（过敏性鼻炎146例，哮喘236例）。在调整混杂因素后，剖宫产与儿童过敏性鼻炎风险增加有关（OR=1．66，95％cI1．21，2．29），尤其是在有家族过敏史的儿童危险升高近2．6倍（OR=2．58，95％CI1．46，4．56），而无家族过敏史的儿童中没有发现剖宫产与过敏性鼻炎的关系（OR=I．42，95％C10．95，2．13）。剖宫产出生的儿童较阴道分娩者哮喘患病风险没有增加（OR=0．91，95％C10．68，1．22）。结论剖宫产与儿童过敏性鼻炎发病风险增加有关系，尤其在有家族过敏史的儿童中明显，而剖宫产与儿童哮喘发病无关联。

Objective To investigate if there is an association between caesarean section and allergic rhinitis as well as asthma in Suzhou children and whether the association is affected by family history of allergies. Methods This study was based on the epidemiological investigation of asthma among children aged 0-14 years from Pingjiang area of Suzhou city in 2010. From 540 asthmatic children we selected 427 children aged 5 to 14 years, 290 males and 137 females , the average age being （8.46-＋2.3）years. Another 427 non-asthmatic children were chosen by 1：1 matching by the same sex and age with the asthma children , A total of 854 cases were chosen as the study population. Then analyze the survey data by using Chi-square test and Logistic regression analysis. Results Of the 854 children, 388 were delivered by cesarean section （allergic rhinitis 158 cases, asthma 191 cases） and 466 by vaginal （allergic rhinitis 146 cases, asthma 236 cases）. After adjusting for potential confounders, caesarean section was associated with an increased risk of allergic rhinitis （OR= 1.66,95% CI 1.21,2.29）. Specifically, while approximately 2.6-fold higher odds of allergic rhinitis was observed in children with a family history of allergies （OR=2.58,95%CI 1.46,4.56）, no association was observed in children without a family history of allergies （OR= 1.42,95%CI 0.95,2.13 ）. Children born by cesarean section had no higher risk of asthma than those delivered vaginally （OR-0.91,95%CI 0.68, 1.2：2）. Conclusion The association of caesarean section and allergic rhinitis appears more remarkable in children with family history of allergies. However, caesarean section is not associated with asthma in childhood.