剖宫产婴儿的喘息与食物过敏：上州儿童研究。

婴儿过敏反应，如皮疹、喘息，应立即停用可疑食物 #生活常识# #育儿常识# #婴幼儿急救知识#

Abstract

We examined whether cesarean delivery (CD) increased the risk of wheeze or food allergy in early childhood compared with vaginal delivery and whether these associations were mediated by breastfeeding. The study population was the Upstate KIDS cohort (2008-2010) of mothers and infants from the State of New York (excluding New York City). Infant's wheeze was reported by questionnaire every 4-6 months until 3 years of age, as were food allergies beginning at 8 months. Modified Poisson regression was used to compare risks of the outcomes according to mode of delivery (MOD). Potential confounders were identified a priori using directed acyclic graphs. Emergency CD (n = 1,356) was associated with elevated risk of wheeze, adjusting for pregnancy complications, maternal atopy, gestational age, birth weight, and smoking during pregnancy (risk ratio = 2.47, 95% confidence interval: 1.31, 4.66), and an increased risk of food allergy, adjusting for maternal atopy, prepregnancy body mass index, smoking during pregnancy, and parity (risk ratio = 3.02, 95% confidence interval: 1.26, 7.25). Neither outcome was significantly associated with planned CD (n = 1,565 infants). Breastfeeding mediated the association between MOD and wheeze but not food allergy. Other factors not associated with early-life microbial transfer, but relating to the development of the outcomes, might contribute to the association between MOD and wheeze/food allergy.

摘要

我们研究了与阴道分娩相比，剖宫产是否会增加幼儿期喘息或食物过敏的风险，以及这些关联是否通过母乳喂养来介导。研究人群是来自纽约州（不包括纽约市）的母亲和婴儿的上州 KIDS 队列（2008-2010 年）。婴儿的喘息通过问卷每 4-6 个月报告一次，直到 3 岁，食物过敏从 8 个月开始报告。使用修正泊松回归比较了根据分娩方式（MOD）的结局风险。使用有向无环图预先确定了潜在的混杂因素。在调整了妊娠并发症、母体特应性、胎龄、出生体重和孕期吸烟等因素后，急诊剖宫产（n=1356）与喘息风险增加相关（风险比=2.47，95%置信区间：1.31，4.66），且与食物过敏风险增加相关，调整了母体特应性、孕前体重指数、孕期吸烟和产次等因素后（风险比=3.02，95%置信区间：1.26，7.25）。计划性剖宫产（n=1565 名婴儿）与这两种结局均无显著关联。母乳喂养介导了 MOD 与喘息之间的关联，但与食物过敏无关。其他与早期微生物转移无关但与结局发展有关的因素可能会导致 MOD 与喘息/食物过敏之间的关联。

网址：剖宫产婴儿的喘息与食物过敏：上州儿童研究。 https://www.yuejiaxmz.com/news/view/1334208

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