目的 描述儿童早期不同时期过敏发生情况,阐述产前及儿童早期不同时期过敏性疾病与儿童神经发育相关性。方法 于2015年2月—2016年8月期间在马鞍山市妇幼保健院围产门诊招募初次建册孕妇2 212名,随访至儿童36月龄,通过问卷填写收集产前和儿童早期过敏性疾病发生信息,使用《年龄与进程问卷》(ASQ)评价36月龄儿童沟通、精细动作、粗大动作、解决问题和个人社会能力发育水平,将结果“接近界值”和“低于界值”定义为发育异常。结果 共有1 742名儿童完成36月龄问卷调查,其中男童占52.0%,女童48.0%。不同时期过敏性疾病的发生率分别为:母亲孕前过敏发生率为22.6%(480/2 120),孕期过敏发生率为13.5%(254/1 882),婴幼儿3月龄湿疹发生率为36.0%(713/1 981),12月龄过敏发生率26.0%(472/1 816),24月过敏发生为22.3%(352/1 581)。单因素分析中,仅孕前过敏与ASQ结果分布存在统计学差异。孕前母亲过敏与36月龄“精细动作”异常呈显著正相关,调整儿童性别、是否独生子女、家庭收入、母亲年龄因素后,两者相关性仍有统计学意义(aOR=1.89,95%CI:1.04~3.42)。结论 产前和儿童早期过敏性疾病均较为常见,应重视母亲产前过敏对儿童神经发育潜在危害效应,进一步开展两者关联的机制研究。
Abstract
Objective To describe the incidence of allergies in different periods of early childhood, and to analyze the correlation between anaphylactic diseases and children′s neurodevelopment in prenatal and childhood. Methods During February 2015 to August 2016, 2 212 pregnant women who had their first antenatal examination at Ma′anshan Maternity and Child Health Hospital were recruited in this cohort, and were followed up until children were 36 months old. Information of allergy in prenatal and early childhood was collected by filling out questionnaires. The Ages and Stages questionnaire (ASQ) was used to evaluate 36-month-old children′s neurodevelopment including communication (CM), fine motion (FM), gross motion (GM), problem-solving (CG) and personal-social (PS) development. Both "near the threshold" and "below the threshold" were defined as abnormal development. Results Finally 1 742 children completed survey at 36 months old, of whom 52.0% were boys and 48.0% were girls. The incidences of allergic diseases in mothers before and during pregnancy were 22.6% (480/2 120) and 13.5% (254/1 882), respectively. The incidences of allergic and in infants at the age of 3, 12 and 24 months were 36.0% (713/1 981), 26.0% (472/1 816) and 22.3% (352/1 581), respectively. Univariate analysis showed that there was only significant difference in ASQ results in children whose mother had pre-pregnancy allergy or not. There was a significantly positive correlation between maternal pre-pregnancy allergy and abnormal development of fine motor at 36 months old. After adjusting gender, only child or not, family incomes and maternal age, the correlation was still statistically significant (aOR=1.89, 95%CI: 1.04 - 3.42). Conclusions Allergy is common in both prenatal period and early childhood. Attention should be paid to the potential harmful effects of maternal allergy on children′s neurodevelopment, and further researches on the mechanism are warranted.
关键词
过敏 /
免疫 /
儿童神经心理发育 /
前瞻性研究
Key words
allergy /
immunology /
child neuropsychological development /
prospective study
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基金
安徽省妇幼协会项目(2020FY03);马鞍山市科技局项目(2020)
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