孕期母血干扰素诱导蛋白10浓度与婴儿期湿疹的关系及分娩方式对其作用的影响

Effect of IP10 concentration during pregnancy on eczema in infancy and the effect of mode of delivery on its relationship

目的探讨孕期母血干扰素诱导蛋白10(IP10)对婴儿湿疹发生风险的影响及其与分娩方式在婴儿湿疹中的作用。方法采用前瞻性队列研究,纳入2015年1月—2016年12月加入广州出生队列研究的890对母子对,孕14~27周时采集母体外周血并检测血液中IP10浓度,通过父母填写调查问卷采集儿童1岁内的湿疹信息。采用限制性立方样条图、Log-binomial回归模型分析孕期母血IP10水平与婴儿湿疹的关系及分娩方式与孕期母血IP10的交互作用,并校正潜在混杂因素(妊娠期糖尿病、妊娠期高血压、孕妇过敏史、孕期烟草暴露、孕前BMI)。结果孕期母血IP10浓度[M(P_(25),P_(75))]为[104.53(62.94,184.06)pg/mL],20.0%子代婴儿期发生湿疹。将IP10以线性变量纳入回归分析发现,IP10与子代婴儿期湿疹发生风险增加相关(校正RR:1.51,95%CI:1.02~2.24)。与IP10低水平相比,IP10高水平孕妇的子代婴儿湿疹发生风险增加(校正RR:1.58,95%CI:1.09~2.29),并未发现分娩方式与孕期母血IP10在婴儿期湿疹中的交互作用(P=0.06)。结论孕期炎性因子IP10影响婴儿期湿疹的发生风险,暂未观察到分娩方式与IP10在婴儿期湿疹发生中的交互作用,关于分娩方式与孕期其他炎性因子在婴儿湿疹关联中的作用尚需将来做进一步研究。

Objective To explore the effect of maternal blood interferon-inducible protein 10(IFN-yinducible protein 10,IP10)on the risk of infant eczema and the role of delivery mode in infant eczema.MethodsA prospective cohort study design was used.There were 890 mother-child pairs who joined the Born in Guangzhou Cohort Study(BIGCS)from January 2015 to December 2016.We collected maternal peripheral blood at 14-27 weeks of pregnancy and detected the concentration of IP10 in the blood.The eczema information of children within 1 year of age was collected by questionnaires filled out by their parents.Restricted cubic spline plots and log-binomial regression models were used to analyze the relationship between the levels of IP10 in maternal peripheral blood during pregnancy and the occurrence of infants′eczema as well as the interaction between delivery mode and maternal blood IP10 during pregnancy after adjusting for potential confounding factors(gestational diabetes,hypertension during pregnancy,maternal allergy history,tobacco exposure during pregnancy,pre-pregnancy BMI).ResultsThe median IQR of IP10 in maternal peripheral blood during pregnancy was 104.53(62.94,184.06)pg/mL.The proportion of infants′eczema was 20.0%.The regression model analysis of IP10 as a linear variable showed that the level of IP10 was associated with an increased risk of infants′eczema in the offspring(adjusted RR:1.51,95%CI:1.02-2.24).Compared with lowest IP10 levels,pregnant women with highest IP10 levels have an increased risk of infant eczema in their offspring(adjusted RR:1.58,95%CI:1.09-2.29).We did not find any interaction between delivery mode and maternal blood IP10 during pregnancy on infantile eczema(P=0.06).Conclusion Inflammatory factor IP10 during pregnancy affects the risk of eczema in infants.The interaction between delivery mode and IP10 in infantile eczema has not been observed yet.The role of delivery mode and other inflammatory factors during pregnancy in the association of infant eczema still needs further research.