摘要
目的:研究足月新生儿呼吸道疾病发病率与后来儿童期哮喘发病风险增大间的相关性,并明确这种相关性是否能够解释剖宫产与儿童期哮喘存在相关性这一既往报道。设计:根据苏格兰产科医院患病记录(SMR),分析产妇数据(SMR02)、新生儿数据(SMR11)和急性医源性分娩意外数据,进行回顾性群体研究。机构:苏格兰产科医院。试验对象:收集1992-1995年间,苏格兰23所产科医院出生的所有单胎足月新生儿病例。
Objective: To determine whether neonatal respiratory morbidity at term is associated with an increased risk of later asthma and whether this may explain previously described associations between caesarean delivery and asthma. Design: Retrospective cohort study using Scottish Morbidity Record (SMR) data of maternity (SMR02), neonatal (SMR11), and acute hospital (SMR01) discharges. Setting: Scotland. Participants: All singleton births at term between 1992 - 1995 in 23 Scottish maternity hospitals. Main outcome measures: Hospital admission with a diagnosis of asthma in the principal position between 1992 and 2000. Results: Children who had a diagnosis of transient tachypnoea of the newborn or respiratory distress syndrome were at increased risk of being admitted to hospital with a diagnosis of asthma (hazard ratio (HR) 1.7, 95% confidence interval (95% CI) 1. 4 to 2. 2, p < 0. 001) . This association was observed both among children delivered vaginally (HR 1. 5, 95% CI 1. 1 to 2. 0, p = 0. 007) and among those delivered by caesarean section (HR 2. 2, 95% CI 1.6 to 3.0, p < 0.001) . In the absence of neonatal respiratory morbidity, delivery by caesarean section was weakly associated with the risk of asthma in childhood (HR 1. 1, 95% CI 1. 0 to 1. 2, p = 0. 004). The strengths of the associations were similar whether the caesarean delivery was planned or emergency and were not significantly altered by adjustment for maternal, obstetric, and other neonatal characteristics. Conclusions: Neonatal respiratory morbidity at term is associated with an increased risk of asthma in childhood which may explain previously described associations between caesarean delivery and later asthma.
