支气管哮喘患儿并神经精神共患病母亲孕期环境和饮食危险因素

Maternal dietary and environmental risk factors in children with asthma comorbid neuropsychiatric disorders

目的探讨6~16岁支气管哮喘(哮喘)患儿并神经精神共患病孕期环境和饮食危险因素。方法2016年3月至2017年3月期间,收集贵州省人民医院儿科哮喘专科门诊确诊的6~16岁哮喘患儿临床资料,在充分知情同意下,所有哮喘患儿父母均接受简明儿童少年国际神经精神访谈(MINI Kid)量表访谈。其母亲同时填写《孕期饮食问卷》《孕期环境问卷》。根据有无合并神经精神疾病将纳入研究患儿分为共患病组和单纯哮喘组。通过单因素筛选和多因素非条件Logistics回归分析哮喘合并神经精神共患病孕期饮食和环境危险因素。结果共有261例哮喘患儿纳入本次研究,其中男163例,女98例;年龄(11.25±3.12)岁;哮喘合并神经精神共患病检出率26.4%(69/261)例。母亲孕期环境和饮食单因素分析显示:母亲孕期烟草暴露、冬天煤料燃烧、食品添加剂摄入在共患病组与单纯哮喘组差异均有统计学意义(χ^2=7.385、3.993、4.529,均P<0.05),其余因素在2组中差异均无统计学意义(均P>0.05);多因素非条件Logistic回归分析显示:母亲孕期烟草暴露是哮喘神经精神共患病孕期独立危险因素(OR=5.098,95%CI:1.089~23.871,P=0.039)。结论母亲孕期烟草暴露是哮喘患儿神经精神共患病孕期独立危险因素,需加强孕期父母相关危险因素宣教,以期降低哮喘患儿神经精神疾病共患率。

Objective To explore the prenatal dietary and environmental risk factors in children aged 6-16 years with asthma (CWA) comorbid neuropsychiatric disorders. Methods This cross-sectional study was conducted from March 2016 to March 2017.CWA aged 6 to 16 years were recruited as the study participants at the Outpatient Asthma Unit of Guizhou Provincial People′s Hospital, China.Informed consent was obtained from their parents, and their parents were invited to participate in the Mini International Neuropsychiatric Interview of children and adolescents (MINI Kid) to assess the current neuropsychiatric disorders.Meanwhile, the questionnaires information about prenatal diet and environment were collected from their mothers as well.Patients were divided into 2 groups, one group with asthma comorbid neuropsychiatric disorders and the other with asthma only.Single factor analysis and multivariate non-conditional Logistic regression analysis were used to determine the risk factors associated with neuropsychiatric comorbidity. Results The study consisted of 261 patients (male: 163 cases, female: 98 cases) with asthma, with the age of (11.25±3.12) years, the rate of asthma comorbid neuropsychiatric disorders was 26.4%(69/261 cases). Single factor analysis showed that prenatal tobacco smoke exposure, winter coal combustion, food additives had statistically significant differences between the 2 group (χ^2=7.385, 3.993, 4.529, all P<0.05), the other factors were not significantly different between two groups (all P>0.05);multivariate analysis indicated that prenatal tobacco smoke exposure was the independent risk factor for neuropsychiatric comorbidity in CWA (OR=5.098, 95%CI: 1.089-23.871, P=0.039). Conclusions The result revealed that the prenatal tobacco smoke exposure is the independent risk factor for neuropsychiatric comorbidity in CWA, need to enhance the propaganda and education of negative effects for parents should be enhanced during pregnancy to diminish the prevalence.