目的 分析母亲围孕期阴道炎、牙周病和婴儿1岁内过敏性疾病症状的关联。方法 2015年6月—2016年6月,于马鞍山市妇幼保健院建立母婴健康队列。收集父母及幼儿一般人口学信息、围孕期阴道炎、牙周病情况等资料,采用二分类logistic回归分析围孕期牙周病、阴道炎对婴儿1岁内过敏性疾病症状的影响。结果 共纳入1 760对母婴。孕妇孕前3个月、孕早期和孕中期阴道炎发生率分别为8.6%、2.6%和3.2%,孕妇前3个月、孕早期和孕中期牙周病发生率44.2%、39.3%和46.9%。婴儿1岁内过敏性疾病发病率为25.6%。调整混杂因素后,发现孕前3个月患阴道炎(OR=1.69,95%CI:1.18～2.43)及孕中期患牙周病(OR=1.36,95%CI:1.09～1.70)是婴儿过敏性疾病症状发生的危险因素。结论 母亲围孕期牙周病、阴道炎是婴儿发生过敏性疾病症状的危险因素,建议孕龄女性在备孕期间尽量先治疗好牙周病和阴道炎。
Abstract
Objective To analyze the association between maternal perinatal vaginitis, periodontal disease, and the occurrence of allergic disease symptoms in infants within the first year of life. Methods A maternal-infant health cohort was established at Ma'anshan Maternal and Child Health Care Hospital from June 2015 to June 2016. General demographic information of parents and infants, as well as data on perinatal vaginitis and periodontal disease, were collected. Binary logistic regression analysis was used to evaluate the impact of perinatal periodontal disease and vaginitis on the occurrence of allergic disease symptoms in infants within the first year of life. Results A total of 1 760 mother-infant pairs were included in this study. The prevalence rates of vaginitis during the three months before pregnancy, first trimester, and second trimester were 8.6%, 2.6%, and 3.2%, respectively. The prevalence rates of periodontal disease during the three months before pregnancy, first trimester, and second trimester were 44.2%, 39.3%, and 46.9%, respectively. The incidence of allergic disease symptoms in infants within the first year of life was 25.6%. After adjusting for confounding factors, vaginitis during the three months before pregnancy (OR= 1.69, 95%CI: 1.18 - 2.43) and periodontal disease during the second trimester (OR= 1.36, 95% CI: 1.09 - 1.70) were identified as risk factors for the occurrence of allergic disease symptoms in infants. Conclusions Maternal prenatal vaginitis and periodontal disease are risk factors for the development of allergic disease symptoms in infants. It is recommended that women of childbearing age receive treatment for periodontal disease and vaginitis before conception.
关键词
围孕期 /
牙周病 /
阴道炎 /
过敏性疾病 /
队列研究
Key words
perinatal pregnancy /
periodontal disease /
vaginitis /
allergic diseases /
cohort study
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Dribin TE, Motosue MS, Campbelrl, et al. Overview of allergy and anaphylaxis[J]. Emerg Med Clin North Am, 2022,40(1):1-17.
[2] Keet CA, Savage JH, Seopaul S, et al. Temporal trends and racial/ethnic disparity in self-reported pediatric food allergy in the United States[J]. Ann Allergy Asthma Immunol, 2014,112(3):222-229.e3.
[3] Asher I, Pearce N. Global burden of asthma among children[J]. Int J Tuberc Lung Dis, 2014, 18(11):12691278.
[4] Bahadori K, DoyleWaters MM, Marra C, et al. Economic burden of asthma: A systematic review[J]. BMC Pulm Med, 2009, 9: 24.
[5] Xie Y, Xiong X, Elkind-Hirsch KE, et al.Change of periodontal disease status during and after pregnancy[J]. Periodontol, 2013, 84, 725-731.
[6] Raju K,Berens L, Periodontology and pregnancy: An overview of biomedical and epidemiological evidence[J].Periodontol 2000, 2021, 87, 132-142.
[7] Asa'ad FA, Rahman G, Al Mahmoud N, et al. Periodontal disease awareness among pregnant women in the central and eastern regions of Saudi Arabia[J].Investig Clin Dent, 2015, 6: 8-15.
[8] Tarannum F, Prasad RK,Shobha R,et al.Awareness of the association between periodontal disease and adverse pregnancy outcome among the general female population[J]. Indian J Dent Res,2015, 26, 21-25.
[9] Saraf VS, Sheikh SA, Ahmad A, et al. Vaginal microbiome:Normalcy vs dysbiosis[J]. Arch Microbiol, 2021,203(7):3793-3802.
[10] 胡明淼,周雪勤. 阴道微生态与女性生殖道疾病的相关性研究进展[J]. 局解手术学杂志,2023,32(6):544-547.
Hu MM, Zhou XQ. Research progress on the relationship between vaginal microecology and female reproductive tract diseases[J]. J Reg Anat Oper Surg,2023,32(6):544-547.(in Chinese)
[11] Brown RG, Marchesi JR, Lee YS, et al. Vaginal dysbiosis increases risk of preterm fetal membrane rupture,neonatal sepsis and is exacerbated by erythromycin[J]. BMC Med,2018,16(1):9.
[12] 顾华妍,张海燕,王薇,等. 自然流产前患者阴道微生态评价与诱病危险因素分析[J]. 中国妇产科临床杂志,2020,21(3):248-250.
Gu HY, Zhang HY, Wang W, et al. Vaginal microecology evaluation and analysis of predisposing risk factors of patients with spontaneous abortion[J]. Chin J Clin Obstet Gynecol, 2020,21(3):248-250.(in Chinese)
[13] Al Memar M, Bobdiwala S, Fourie H, et al. The association between vaginal bacterial composition and miscarriage:A nested case-control study[J]. BJOG,2020,127(2):264-274.46.
[14] 张玥. 妊娠晚期阴道微生态改变与不良妊娠结局的相关性研究[D]. 呼和浩特:内蒙古医科大学,2020.
Zhang Y. Correlation between vaginal microecological changesin late preagnancy and adverse pregnancy outcomes[D].Hohhot:Inner Mongolia Medical University,2020.(in Chinese)
[15] Subramaniam A, Ptacek T, Lobashevsky E, et al. Midtrimester cervicovaginal microbiota: Identification of microbial variations associated with puerperal infection at term[J]. Am J Perinatol,2016,33(12):1165-1175.
[16] 李艳霞. 妊娠晚期阴道菌群紊乱与妊娠结局的相关性研究[J]. 实用医技杂志,2021,28(5):646-648.
Li YX. Correlation between vaginal flora disturbance and pregnancy outcome in the third trimester[J]. Journal of Practical Medical Techniques,2021,28(5):646-648. (in Chinese)
[17] 刘妍,史明强,袁碧波. 孕妇阴道微生态失衡与妊娠结局相关性的双向性队列研究[J]. 中国实用乡村医生杂志,2023,30(5):36-40.
Liu Y, Shi MQ, Yuan BB. A bidirectional cohort study ofon the relationship between vaginal microecological imbalance and pregnancy outcome[J]. Chinese Practical Journal of Rural Doctor,2023,30(5):36-40.(in Chinese)
[18] Starzyńska A, Wychowański P, Nowak M, et al. Association between maternal periodontitis and development of systematic diseases in offspring[J].Int J Mol Sci, 2022, 23(5):2473.
[19] Mi NN, Lin XP, Jin Y. Periodontal disease in pregnancy and adverse pregnancy outcomes: Progress in related mechanisms and management strategies[J]. Front med, 2022,9:963956.
[20] Hsieh VC, Liu CC, Hsiao YC, et al. Risk of allergic rhinitis, allergic conjunctivitis, and eczema in children born to mothers with gum inflammation during pregnancy[J]. PLoS One, 2016, 11(5):e0156185.
[21] Haake SK, Nisengard RJ, Newman MG, et al. Microbial interactions with the host in periodontal diseases[M]// Newman MG, Takei HH, Carranza FA. Carranza's Clinical Periodontology. Philadelphia: W.B. Saunders Co, 2002: 132-152.
[22] Iheozor-Ejiofor Z, Middleton P, Esposito M,et al. Treating periodontal disease for preventing adverse birth outcomes in pregnant women[J]. Cochrane Database Syst Rev, 2017, 6(6):CD005297.
[23] Han YW, Fardini Y, Chen C, et al.Term stillbirth caused by oral Fusobacterium nucleatum[J]. Obstet Gynecol, 2010,115: 442-425.
[24] Scirica CV, Gold DR, Ryan L, et al. Predictors of cord blood IgE levels in children at risk for asthma and atopy[J]. Allergy Clin Immunol, 2007,119:81-88.
[25] Hajishengallis G. Periodontitis: From microbial immune subversion to systemic inflammation[J]. Nat rev immunol, 2015,15(1):30-44.
[26] Rigato PO, Fusaro AE, Victor JR, et al. Maternal immunization to modulate the development of allergic response and pathogen infections[J]. Immunotherapy. 2009,1: 141-156.
[27] Apostol AC, Jensen KDC, Beaudin AE. Training the fetal immune system through maternal inflammation-A layered hygiene hypothesis[J]. Front Immunol, 2020, 11:123.
[28] Dahlgren J, Samuelsson AM, Jansson T, et al. Interleukin-6 in the maternal circulation reaches the rat fetus in mid-gestation[J]. Pediatr Res,2006,60(2):147-151.
基金
2016年度马鞍山市科技计划项目(YL-2016-12)
PDF(544 KB)
