孕产期母亲用药、环境接触及分娩方式与婴幼儿过敏性疾病的关联性研究

Role of maternal drug use and environmental exposure during pregnancy and delivery pattern in allergic infants and toddlers

目的探讨孕产期母亲用药、环境接触及分娩方式对婴幼儿过敏性疾病的影响。方法基于横断面调查的病例对照研究。按我国的地理和人口分布，在全国范围内选择33个城市，采用整群抽样方法在各城市的城区随机选择一个社区作为样本区，调查对象为0～24月龄婴幼儿母亲，进行面对面问卷调查。调查对象分为两组，曾出现过敏性疾病症状且被诊断为过敏性疾病的婴幼儿为过敏组（2113例）和从未发生过敏性疾病症状的婴幼儿为对照组（6303例）。结果父母双方有过敏史和父母单方有过敏史均为婴幼儿发生过敏的危险因素，父母双方均有过敏史（OR=3．950）的危险关联强度高于父母单方有过敏史者（OR=2．277）；孕期使用抗生素（DR=1．396）、孕期接触消毒剂及清洁剂（OR=1．386）、孕期吸烟或接触吸烟环境（OR=1．301）、剖宫产（OR=1．255）是婴幼儿发生过敏性疾病的危险因素，各因素组间差异均有统计学意义（P〈0．05）。结论婴幼儿过敏预防重点在孕产期的一级预防，应避免无临床指征情况下剖宫产、孕期滥用抗生素和消毒剂以及接触烟草。

Objective To understand correlation between maternal drug use and environmental exposure during pregnancy and delivery pattern and allergy in infants and toddlers, and provide theoretical bases for the early prevention and intervention of infantile allergies. Methods Case control study based on cross-sectional investigation was conducted. Thirty-three cities were selected in China. Randomly cluster sampling method was used to select a community in each city as the study sample, the women with infants aged 0-24 months were interviewed in the form of face-to-face questionnaire survey. Infants and toddlers were divided into two groups： case group, including 2 113 children who had allergic symptoms and were diagnosed with allergic disease, and control group, including 6 303 children who never had symptoms of allergic disease. Results Children whose parents had allergic disease histories were more likely to have allergic disease （OR= 3.950） compared with the children whose mother or father had allergic disease histories （OR=2.277）. Maternal use of antibiotics （OR=1.396）, disinfector exposure （OR=1.386）, smoking exposure （OR=1.301） during pregnancy and cesarean delivery （OR=1.255） were risk factors for allergic disease in infants and toddlers, the differences were significant （P〈0.05）. Conclusion It is essential to conduct primary prevention of infant allergy during pregnancy, and it is necessary to avoid unnecessary cesarean delivery and irrational antibiotic use, disinfector and smoking exposures during pregnancy.