Article record

识别可改变的风险因素以预防哮喘母亲所生婴儿的特应性喘息：一项队列研究

Identification of modifiable risk factors to prevent atopic wheeze in infants born to mothers with asthma: a cohort study.

临床研究鼻科IF 3.6Q2

文献信息

PMID	42744207
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Jihong Liu 查看其他 9 位作者 Bronwyn K Brew；Xingpei Zhao；Adam Collison；Megan E Jensen；Joerg Mattes；Paul D Robinson；Peter D Sly；Peter G Gibson；Vanessa E Murphy
作者单位	Arnold School of Public Health, University of South Carolina, Columbia, SC, USA. 查看其他 6 条单位信息 School of Medicine and Public Health, University of Newcastle, NSW, Australia; Asthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia. Electronic address: bronwyn.brew@newcastle.edu.au.；School of Medicine and Public Health, University of Newcastle, NSW, Australia; Asthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia.；School of Medicine and Public Health, University of Newcastle, NSW, Australia; Asthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia; Department of Respiratory Medicine, John Hunter Children's Hospital, Newcastle, NSW, Australia.；Children's Health and Environment Program, Child Health Research Centre, University of Queensland, QLD, Australia; Department of Respiratory Medicine, Queensland Children's Hospital, QLD, Australia.；Children's Health and Environment Program, Child Health Research Centre, University of Queensland, QLD, Australia.；School of Medicine and Public Health, University of Newcastle, NSW, Australia; Asthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia; Department of Respiratory & Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia.
期刊	Respiratory medicine
SCI 分区	Q2
IF	3.6
研究类型	临床研究 · 临床
所属专科	鼻科

中文摘要

目的： 母亲哮喘是儿童早期发生喘息和过敏性疾病的主要风险因素。我们旨在描述哮喘母亲所生婴儿的特应性表型，并评估哪些早期生活因素与这些表型相关。
方法： 参与者来自“呼吸生命试验出生队列”，该队列在妊娠23周前招募了患有哮喘的孕妇（n=549）。父母在儿童12个月大时完成了一份经过验证的问卷，内容涉及儿童需要医疗利用的喘息（因喘息住院、急诊就诊、专科医生转诊和初级保健就诊、哮喘药物使用）、呼吸道感染、湿疹和鼻炎。采用潜在类别分析来识别婴儿中的特应性表型。逻辑回归评估了早期生活风险因素，包括母亲特征、围产期因素和环境暴露。
结果： 识别出三种表型：低特应性/低喘息（35.2%）、特应性轻度喘息（38.6%）和特应性重度喘息（26.2%）。与低特应性/低喘息相比，母亲肥胖（aOR 3.22 95% CI 1.90, 5.44）、妊娠期吸烟（aOR 2.60 95%CI 1.36, 4.97）、妊娠期哮喘急性发作（aOR 1.98 95%CI 1.30, 3.02）、早产（aOR 2.50 1.34, 4.66）和新生儿重症监护室入住（aOR 2.71 95%CI 1.14, 6.46）与特应性重度喘息相关。与低特应性/低喘息相比，母亲肥胖（aOR 2.02 95%CI 1.26, 3.24）和妊娠期吸烟（aOR 2.55 95%CI 1.37, 4.72）与特应性轻度喘息相关。
结论： 多种可改变因素（母亲肥胖、吸烟和母亲哮喘急性发作）以及不良出生结局与哮喘母亲所生婴儿的喘息严重程度相关，为预防日后儿童哮喘提供了干预机会。

英文摘要

OBJECTIVE: Maternal asthma is the leading risk factor for children developing wheeze and allergic disease in early life. We aimed to describe atopic phenotypes in infants of mothers with asthma and assess which early-life factors were associated with these phenotypes.
METHODS: Participants were part of the Breathing for Life Trial Birth Cohort, which recruited pregnant women with asthma prior to 23 weeks gestation (n=549). Parents completed a validated questionnaire about their child's wheeze requiring healthcare utilisation (hospitalisation, emergency department visits, consultant referral and primary care visits for wheeze, asthma medication use), respiratory infections, eczema and rhinitis at 12 months of age. Latent class analysis was used to identify the atopic phenotypes among infants. Logistic regression assessed early-life risk factors including maternal characteristics, perinatal factors and environmental exposures.
RESULTS: Three phenotypes were identified: low-atopy/low-wheeze (35.2%), atopic mild-wheeze (38.6%) and atopic high-wheeze (26.2%). Maternal obesity (aOR 3.22 95% CI 1.90, 5.44), smoking in pregnancy (aOR 2.60 95%CI 1.36, 4.97), asthma exacerbations in pregnancy (aOR 1.98 95%CI 1.30, 3.02), preterm birth (aOR 2.50 1.34, 4.66), and NICU admission (aOR 2.71 95%CI 1.14, 6.46) were associated with atopic high-wheeze compared to low-atopy/low-wheeze. Maternal obesity (aOR 2.02 95%CI 1.26, 3.24) and smoking in pregnancy (aOR 2.55 95%CI 1.37, 4.72) were associated with atopic mild-wheeze compared to low-atopy/low-wheeze.
CONCLUSION: Multiple modifiable factors (maternal obesity, smoking and maternal asthma exacerbations) and adverse birth outcomes are associated with the severity of wheeze in infants of mothers with asthma, providing an opportunity for intervention to prevent later childhood asthma.