杭州浙大迪迅生物基因工程有限公司

　　原標題：剖腹產、早產和食物過敏風險：瑞典全國100多萬兒童群組研究
　　背景：我們對兒童生命早期食物過敏的危險因素知之甚少。
　　方法：這項瑞典全國性群組研究，使用了來自衛(wèi)生保健登記簿中2001-2012年在瑞典出生的1086378名兒童的前瞻性記錄數(shù)據(jù)。我們采用Cox回歸分析，估計95%置信區(qū)間的危險比（HRs）于衛(wèi)生保健登記簿中的圍產期特征（如剖腹產和早產）和確診的食物過敏之間的關系，并對嬰兒性別和母親因素進行了校正（分娩年齡、出生地、產次、吸煙、體重指數(shù)、哮喘/肺病）。
　　結果：在13年的隨訪中，26732名兒童（2.5%）被診斷為食物過敏。食物過敏與剖腹產（HR，1.21；95% CI，1.18-1.25）、胎齡大（HR，1.15；95% CI，1.10-1.19）和新生兒5分鐘Apgar評分低（HR，1.22；95% CI，1.10-1.36）呈正相關，但與極早產（妊娠<32周：HR，0.74；95% CI，0.56-0.98）呈負相關。未發(fā)現(xiàn)食物過敏與中度早產、低出生體重或小于胎齡之間存在關聯(lián)。當結果僅限于2個診斷食物過敏記錄時，風險估計是相似的。1000名接受剖腹產的兒童與對照組相比，額外5名兒童出現(xiàn)食物過敏，這表明通過剖宮產出生的兒童中17%的食物過敏可以通過這種方式（歸因分數(shù)）來解釋。
　　結論：剖腹產與食物過敏風險增加相關，而極早產降低了風險。


延伸閱讀
JACI：
[IF:13.258]
Cesarean delivery, preterm birth, and risk of food allergy: Nationwide Swedish cohort study of more than 1 million children
DOI: org/10.1016/j.jaci.2018.06.044
Abstract:
Background:
Little is known about early-life risk factors for food allergy in children .
Methods:
This nationwide Swedish cohort study of 1,086,378 children born in Sweden in 2001-2012 used prospectively recorded data from health care registers. Using Cox regression,we estimated hazard ratios (HRs) with 95% CIs for the association between perinatal characteristics (eg, cesarean delivery and preterm birth) and food allergy as defined by diagnoses in the National Patient Register, adjusting for infant sex and maternal factors (age at delivery, country of birth, parity, smoking, body mass index, and asthma/pulmonary disease).
Results:
During the 13-year follow-up, 26,732 (2.5%) children were given a diagnosis of food allergy. Food allergy was positively associated with cesarean delivery (HR, 1.21; 95% CI, 1.18-1.25), large for gestational age (HR, 1.15; 95% CI,1.10-1.19), and low 5-minute Apgar score (HR, 1.22; 95% CI, 1.10-1.36) but negatively associated with very preterm birth (<32 weeks of gestation: HR, 0.74; 95% CI, 0.56-0.98). No association was found between food allergy and moderately preterm birth, low birth weight, or small for gestational age.Risk estimates were similar when the outcome was restricted to 2 records of diagnosed food allergy. In 1,000 children undergoing cesarean delivery, an extra 5 developed food allergy compared with the reference group, suggesting that 17% of food allergy in children born by means of cesarean delivery can be explained by this exposure (attributable fraction).
Conclusions:
Cesarean delivery was associated with increasedrisk of food allergy, whereas very preterm birth decreased risk.
First Author:
Niki Mitselou
Correspondence:
Department of Pediatrics, Orebro University € Hospital, S€ odra Grev Rosengatan, Orebro 701 85, Sweden
All Authors:
Niki Mitselou, Jenny Hallberg,  Olof Stephansson, Catarina Almqvist, Erik Melen, and Jonas F. Ludvigsson
　　創(chuàng)建過敏性疾病的科研、科普知識交流平臺，為過敏患者提供專業(yè)診斷、治療、預防的共享平臺。