Study on the risk factors of allergic diseases in infants aged 0-36 months in Longhua District, Shenzhen
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摘要:
目的 分析0~36月龄婴幼儿过敏性疾病的相关危险因素, 为后期开展婴幼儿过敏性疾病的干预提供理论依据。 方法 对在深圳市龙华区社区健康服务机构体检的0~36月龄婴幼儿家长进行过敏性疾病问卷调查, 收集婴幼儿过敏性疾病相关的危险因素, 运用χ2或t检验及二项logistic回归分析模型进行统计分析, 探讨婴幼儿过敏性疾病的危险因素和保护因素。 结果 共收集调查对象399例, 男209例, 女190例, 其中过敏组80例, 占比20.05%;正常组319例, 占比79.95%。单因素和多因素分析结果显示, 父亲过敏史(OR=4.009, 95% CI: 1.618~9.930)、家庭装修(OR=5.702, 95% CI: 1.247~26.075)、妊娠期疾病史(OR=2.022, 95% CI: 1.022~4.000)、婴幼儿服用益生菌(OR=2.214, 95% CI: 1.201~4.081)、孕期压力大(OR=5.296, 95% CI: 1.298~21.616)可能是婴幼儿过敏性疾病的危险因素(均P < 0.05), 而孕期补充益生菌(OR=0.427, 95% CI: 0.210~0.867)可能是婴幼儿过敏性疾病的保护因素(P < 0.05)。 结论 父亲过敏史、家庭装修、妊娠期疾病史、婴幼儿服用益生菌、孕期压力大可能导致婴幼儿过敏性疾病的发生, 而孕期补充益生菌有助于预防婴幼儿过敏性疾病的发生。 Abstract:Objective The study aims to analyze the various risk factors associated with allergic diseases in infants aged 0-36 months, thereby providing a theoretical framework for preventive measures against such conditions. Methods Parents of children aged 0-36 months who attended the community health service institutions for routine physical examinations in L District, Shenzhen, were selected for this study.Data on allergic diseases were collected through a structured questionnaire survey.Subsequent analysis was performed using Chi-square, t-test, and binomial logistic regression to assess both risk and protective factors of allergic diseases. Results A total of 399 children were collected, including 209 boys and 190 girls.The allergic group comprised 80 children (20.05%) who had allergic diseases, while the normal group consisted of 319 children (79.95%) without any allergic conditions.The univariate and multivariate analyses revealed the father's allergic history (OR=4.009, 95% CI: 1.618-9.930), house decoration (OR=5.702, 95% CI: 1.247-26.075), gestational disease history (OR=2.022, 95% CI: 1.022-4.000), probiotics use in infants (OR=2.214, 95% CI: 1.201-4.081), and high stress during pregnancy (OR=5.296, 95% CI: 1.298-21.616) were the risk factors of allergic diseases in infants (all P < 0.05).Conversely, probiotics supplementation during pregnancy (OR=0.427, 95% CI: 0.210-0.867) served as a protective factor against these conditions in infants (P < 0.05). Conclusions The results indicate that factors such as the father's allergic history, indoor housing renovations, a history of gestational diseases, the usage of probiotics in infants, and high levels of stress during pregnancy may increase the susceptibility of infants to allergic diseases.However, the administration of probiotics during pregnancy may serve as a protective factor against the onset of these allergic conditions in infants. -
Key words:
- Allergic diseases /
- Risk factors /
- Protective factors
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表 1 2020年7―12月深圳市龙华区0~36月儿童基本情况及过敏性疾病危险因素的单因素分析
Table 1. Univariate analysis of basic information and risk factors for allergic diseases of children aged 0-36 months in Longhua District, Shenzhen City, From July to December 2020
变量 Variable 合计(n=399)
Sum(n=399)过敏组(n=80) ①
Allergy group(n=80) ①正常组(n=319) ①
Normal group(n=319) ①χ2/t值
χ2/t valueP值
P value性别 Sex 0.050 0.823 女 Female 190 37(46.25) 153(47.96) 男 Male 209 43(53.75) 166(52.04) 月龄组/月 Age of month/months 3.625 0.163 0~ < 7 90 13(16.25) 77(24.14) 7~ < 13 120 30(37.50) 90(28.21) 13~36 189 37(46.25) 152(47.65) 出生身长/cm, x±s Birth length/cm, x±s 50.25±2.59 49.88±1.93 50.35±2.72 1.463 0.144 出生体重/kg, x±s Birth weight/kg, x±s 3.21±0.52 3.21±0.47 3.22±0.53 0.053 0.957 胎次 Parity 0.767 0.385 第1胎 Firstborn 197 43(53.75) 154(48.28) 多胎 Multiple Birth 202 37(46.25) 165(51.72) 分娩方式 Delivery mode 0.244 0.692 自然生产 Eutocia 265 55(68.75) 210(65.83) 剖宫产 Cesarean section 134 25(31.25) 109(34.17) 祖籍 Ancestral home 0.005 1.000 广东省 Guangdong Province 136 27(33.75) 109(34.17) 其他省份 Other provinces 263 53(66.25) 210(65.83) 父亲年龄组/岁 Age of father group/years 0.253 0.686 ＜35 275 57(71.25) 218(68.34) ≥35 124 23(28.75) 101(31.66) 母亲年龄组/岁 Age of mother group/years 0.108 0.870 ＜35 330 67(83.75) 262(82.13) ≥35 70 13(16.25) 57(17.87) 父亲文化程度 Paternal education 0.856 0.652 初中及以下 Junior high school and below 101 22(27.50) 79(24.76) 高中中专 High school and technical secondary school 105 23(28.75) 82(25.71) 大专大学及以上College or above 193 35(43.75) 158(49.53) 母亲文化程度 Maternal education 1.472 0.479 初中及以下 Junior high school and below 107 25(31.25) 82(25.71) 高中中专 High school and technical secondary school 113 19(23.75) 94(29.46) 大专大学及以上 College or above 179 36(45.00) 143(44.83) 家庭吸烟环境 Home smoking environment 0.105 0.803 否 No 186 36(45.00) 150(47.02) 是 Yes 213 44(55.00) 169(52.98) 母亲过敏史 Maternal allergy history 11.822 0.002 无 No 373 68(85.00) 305(95.61) 有 Yes 26 12(15.00) 14(4.39) 父亲过敏史 Paternal allergy history 9.544 0.007 无 No 374 69(86.25) 305(95.61) 有 Yes 25 11(13.75) 14(4.39) 家庭装修 Home decoration 15.965 0.001 否 No 389 73(91.25) 316(99.06) 是 Yes 10 7(8.75) 3(0.94) 孕期药物接触 Drug exposure during pregnancy 1.692 0.240 无 No 368 71(88.75) 297(93.10) 有 Yes 31 9(11.25) 22(6.90) 妊娠期疾病史 History of diseases during pregnancy 5.613 0.021 无 No 330 59(73.75) 271(84.95) 有 Yes 69 21(26.25) 48(15.05) 孕期补充益生菌 Take probiotics during pregnancy 0.459 0.779 无 No 300 70(87.50) 239(74.92) 有 Yes 90 10(12.50) 80(25.08) 孕期补充叶酸 Folic acid supplementation during pregnancy 0.459 0.779 无 No 21 3(3.75) 18(5.64) 有 Yes 378 77(96.25) 301(94.36) 孕期补充钙剂 Calcium supplements during pregnancy 1.017 0.441 无 No 48 7(8.75) 41(12.85) 有 Yes 351 73(91.25) 278(87.15) 孕期压力 Pregnancy stress 7.467 0.024 轻松 Relaxed 124 21(26.25) 103(32.29) 一般 General 263 53(66.25) 210(65.83) 压力大 High 12 6(7.50) 6(1.88) 孕期鱼虾贝类食用 Eat fish, shrimp and shellfish during pregnancy 1.550 0.461 很少或无 Little or none 122 29(36.25) 93(29.15) 偶尔 Occasionally 209 39(48.75) 170(53.29) 经常 Frequently 68 12(15.00) 56(17.55) 婴幼儿服用益生菌 Probiotics for infants 5.647 0.018 否 No 140 19(23.75) 121(37.93) 是 Yes 259 61(76.25) 198(62.07) 婴幼儿1月内使用普通奶粉 Use regular milk powder within 1 month for infants 2.069 0.167 否 No 223 39(48.75) 184(57.68) 是 Yes 176 41(51.25) 135(42.32) 注：①以[人数(占比/%)]表示。
Note: ① [Number of people (proportion/%)].
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表 2 婴幼儿过敏性疾病危险因素的多因素logistic回归分析
Table 2. Multivariate logistic regression analysis on risk factors for allergic disease in infants
序号
Serial
number影响因素
Influencing
factor赋值情况
Assignment condition参照因素
Reference factor比较因素
Comparative factorβ sx Wald值
Wald valueυ OR值(95% CI) OR value (95% CI) P值
P value1 母亲过敏史
Maternal allergy history无=0，有=1
No=0, Yes=1否
No是
Yes0.890 0.498 3.189 1 2.434(0.917~6.462) 0.074 2 父亲过敏史
Paternal allergy history无=0，有=1
No=0, Yes=1否
No是
Yes1.388 0.463 9.000 1 4.009(1.618~9.930) 0.003 3 家庭装修
Home decoration无=0，有=1
No=0, Yes=1否
No是
Yes1.741 0.776 5.037 1 5.702(1.247~26.075) 0.025 4 妊娠期疾病史
History of diseases during pregnancy无=0，有=1
No=0, Yes=1否
No是
Yes0.704 0.348 4.094 1 2.022(1.022~4.000) 0.043 5 孕期补充益生菌
Take probiotics during pregnancy无=0，有=1
No=0, Yes=1否
No是
Yes-0.851 0.362 5.536 1 0.427(0.210~0.867) 0.019 6 孕期压力(1)
Pregnancy stress(1)轻松=0，一般=1，压力大=2
Relaxed=0, General=1, High=2轻松
Relaxed一般
General0.073 0.322 0.052 1 1.076(0.572~2.022) 0.820 7 孕期压力(2)
Pregnancy stress(2)轻松=0，一般=1，压力大=2
Relaxed=0, General=1, High=2轻松
Relaxed压力大
High1.667 0.718 5.397 1 5.296(1.298~21.616) 0.020 8 婴幼儿服用益生菌
Probiotics for infants无=0，有=1
No=0, Yes=1否
No是
Yes0.795 0.312 6.481 1 2.214(1.201~4.081) 0.011 9 分娩方式
Delivery mode自然生产=0，剖宫产=1
Eutocia=0, Cesarean section=1自然分娩
Eutocia剖宫产
Cesarean
section-0.177 0.295 0.361 1 0.837(0.469~1.494) 0.548 10 孕期药物接触史
Drug exposure during pregnancy无=0，有=1
No=0, Yes=1否
No是
Yes-0.079 0.508 0.024 1 0.924(0.341~2.504) 0.877 11 孕期鱼虾贝类食用(1)
Eat fish, shrimp and shellfish during pregnancy(1)很少或无=0，偶尔(一周1次左右)=1，经常(一周2次及以上)=2
Little or none=0, Occasionally=1, Frequently(2 or more/week)=2很少或无
Little or none偶尔
Occasionally-0.385 0.304 1.605 1 0.681(0.375~1.234) 0.205 12 孕期鱼虾贝类食用(2)
Eat fish, shrimp and shellfish during pregnancy(2)很少或无=0，偶尔(一周1次左右)=1，经常(一周2次及以上)=2
Little or none=0, Occasionally=1, Frequently(2 or more/week)=2很少或无
Little or none经常
Frequently-0.099 0.427 0.054 1 0.905(0.392~2.090) 0.816
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[1] 刘宏彦, 冷俊宏, 刘恩庆, 等. 天津市婴儿过敏性疾病影响因素病例对照研究[J]. 中国皮肤性病学杂志, 2020, 34(9): 1067-1072. DOI: 10.13735/j.cjdv.1001-7089.201909045.Liu HY, Leng JH, Liu EQ, et al. A case-control study on affect factors of infant allergic disease in Tianjin[J]. Chin J Dermatovenereol, 2020, 34(9): 1067-1072. DOI: 10.13735/j.cjdv.1001-7089.201909045. [2] 马卓颖, 胡燕. 儿童过敏性疾病危险因素及高危儿早期筛查[J]. 临床儿科杂志, 2020, 38(12): 957-960. DOI: 10.3969/j.issn.1000-3606.2020.12.018.Ma ZY, Hu Y. Risk factors of allergic diseases and early screening of high risk children[J]. J Clin Pediatr, 2020, 38(12): 957-960. DOI: 10.3969/j.issn.1000-3606.2020.12.018. [3] 徐刚, 蒋倩倩, 殷勇, 等. 上海市0~14岁儿童哮喘的影响因素及防制对策[J]. 中华疾病控制杂志, 2015, 19(10): 1010-1014. DOI: 10.16462/j.cnki.zhjbkz.2015.10.011.Xu G, Jiang QQ, Yin Y, et al. Influencing factors and prevention and control strategies for asthma of child patients aged between 0 and 14 years[J]. Chin J Dis Control Prev, 2015, 19(10): 1010-1014. DOI: 10.16462/j.cnki.zhjbkz.2015.10.011. [4] 陶鋆, 蔡莉. 生命早期多不饱和脂肪酸摄入对儿童过敏性疾病的影响研究进展[J]. 中华疾病控制杂志, 2017, 21(1): 94-98. DOI: 10.16462/j.cnki.zhjbkz.2017.01.022.Tao J, Cai L. Research advance on the influence of exposure to polyunsaturated fatty acid in early life on childhood allergic diseases[J]. Chin J Dis Control Prev, 2017, 21(1): 94-98. DOI: 10.16462/j.cnki.zhjbkz.2017.01.022. [5] Dharmage SC, Lowe AJ, Matheson MC, et al. Atopic dermatitis and the atopic March revisited[J]. Allergy, 2014, 69(1): 17-27. DOI: 10.1111/all.12268. [6] 周静, 吴瑕, 杨虹, 等. 深圳地区3104例过敏性疾病患者食物过敏原结果分析[J]. 中国中西医结合皮肤性病学杂志, 2016, 15(5): 263-266. DOI: 10.3969/j.issn.1672-0709.2016.05.002.Zhou J, Wu X, Yang H, et al. Analysis of food allergens in 3 104 patients with allergic diseases in Shenzhen Area[J]. Chin J Dermato Venerol Integ Trad W Med, 2016, 15(5): 263-266. DOI: 10.3969/j.issn.1672-0709.2016.05.002. [7] 王硕, 蒋竞雄, 王燕, 等. 城市0-24月龄婴幼儿过敏性疾病症状流行病学调查[J]. 中国儿童保健杂志, 2016, 24(2): 119-122. DOI: 10.11852/zgetbjzz2016-24-02-03.Wang S, Jiang JX, Wang Y, et al. Survey on prevalence of allergic symptoms among 0 to 24 months old children in Chinese cities[J]. Chin J Child Health Care, 2016, 24(2): 119-122. DOI: 10.11852/zgetbjzz2016-24-02-03. [8] 王守桂, 张祥生, 赵艳芳, 等. 安徽省芜湖市城区0~24月龄婴幼儿过敏性疾病的危险因素分析[J]. 中国当代儿科杂志, 2017, 19(3): 303-307. DOI: 10.7499/j.issn.1008-8830.2017.03.010.Wang SG, Zhang XS, Zhao YF, et al. Risk factors for allergic diseases in children aged 0-24 months in the Wuhu urban area, Anhui Province, China[J]. Chin J Contemp Pediatr, 2017, 19(3): 303-307. DOI: 10.7499/j.issn.1008-8830.2017.03.010. [9] Koplin JJ, Allen KJ, Gurrin LC, et al. The impact of family history of allergy on risk of food allergy: a population-based study of infants[J]. Int J Environ Res Public Health, 2013, 10(11): 5364-5377. DOI: 10.3390/ijerph10115364. [10] 曹向可, 王维, 钱庆增, 等. 3岁以下婴幼儿喘息的危险因素分析[J]. 广东医学, 2017, 38(10): 1548-1551. DOI: 10.13820/j.cnki.gdyx.2017.10.013.Cao XK, Wang W, Qian QZ, et al. Risk factors of wheezing in infants under 3 years old[J]. Guangdong Medical Journal, 2017, 38(10): 1548-1551. DOI: 10.13820/j.cnki.gdyx.2017.10.013. [11] Venter C, Pereira B, Grundy J, et al. Prevalence of sensitization reported and objectively assessed food hypersensitivity amongst six-year-old children: a population based study[J]. Pediatr Allergy Immunol, 2006, 17(5): 356-363. DOI: 10.1111/j.1399-3038.2006.00428.x. [12] Andersson NW, Hansen MV, Larsen AD, et al. Prenatal maternal stress and atopic diseases in the child: a systematic review of observational human studies[J]. Allergy, 2016, 71(1): 15-26. DOI: 10.1111/all.12762. [13] Pape K, Liu X, Sejbæk CS, et al. Maternal life and work stressors during pregnancy and asthma in offspring[J]. Int J Epidemiol, 2021, 49(6): 1847-1855. DOI: 10.1093/ije/dyaa133. [14] Bush NR, Savitz J, Coccia M, et al. Maternal stress during pregnancy predicts infant infectious and noninfectious illness[J]. J Pediatr, 2021, 228: 117-125, e2. DOI: 10.1016/j.jpeds.2020.08.041. [15] 殷道根, 何珍, 段学燕, 等. 孕期及婴幼儿期补充益生菌预防儿童特应性皮炎效果的Meta分析[J]. 中国当代儿科杂志, 2019, 21(1): 82-88. DOI: 10.7499/j.issn.1008-8830.2019.01.015.Yin DG, He Z, Duan XY, et al. Effect of probiotic supplementation during pregnancy and infancy in preventing atopic dermatitis in children: a Meta analysis[J]. Chin J Contemp Pediatr, 2019, 21(1): 82-88. DOI: 10.7499/j.issn.1008-8830.2019.01.015. -
