儿童过敏性鼻炎的危险因素：系统评价与Meta分析的伞状综述。
Risk factors for allergic rhinitis in children: an umbrella review of systematic review and meta-analysis.
文献信息
| PMID | 42769384 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Yuzhu Dou |
| 作者单位 | Department of Pediatrics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China. |
| 期刊 | Frontiers in immunology |
| SCI 分区 | Q1 |
| IF | 7.4 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 本研究评估儿童过敏性鼻炎（AR）相关危险因素的研究设计质量、潜在偏倚和证据强度，同时总结已识别的关键因素。
方法： 本综述的方案已在PROSPERO注册（CRD420251248436）。从PubMed、Web of Science、Embase和Cochrane系统评价数据库中系统检索相关文献，覆盖从建库至2025年5月。使用AMSTAR和GRADE独立评估方法学质量和证据确定性。
结果： 本综述识别出75个危险因素：22个与儿童AR风险升高相关，7个为保护性因素，46个证据不足以确定关联。总体证据质量为低或极低，仅有一个因素得到中等质量证据支持。关键发现表明，生命早期抗生素使用、剖宫产、孕期吸烟、空气污染、ADHD诊断、ASD诊断、川崎病和母亲口服避孕药暴露与风险升高相关，而宠物暴露、生牛奶和鱼类摄入、出生顺序≥2以及兄弟姐妹数量≥2与风险降低相关。
结论： 这是首个伞状综述，系统汇总了所有关于儿童AR危险因素的Meta分析数据，提供了一个初步证据图谱，优先列出未来研究可干预的候选靶点。生命早期食物致敏是唯一具有中等确定性的因素。然而，证据总体确定性较低，凸显出迫切需要更严格和标准化的原始研究及Meta分析，以加强临床和公共卫生干预的基础。
系统综述注册： https://www.crd.york.ac.uk/PROSPERO/，标识符CRD420251248436。
英文摘要
BACKGROUND: This study evaluates the quality of study design, potential biases, and evidence strength for childhood risk factors associated with allergic rhinitis (AR), while summarizing the key identified factors.
METHODS: The protocol for this review was registered in PROSPERO (CRD420251248436). Relevant literature was systematically retrieved from PubMed, Web of Science, Embase, and the Cochrane Database of Systematic Reviews, covering the period from inception to May 2025. Methodological quality and evidence certainty were independently evaluated using AMSTAR and GRADE.
RESULTS: This review identified 75 risk factors: 22 were linked to a higher risk of AR in children, 7 were protective, and 46 showed insufficient evidence to determine an association. Overall, evidence quality was low or very low, with only one factor supported by moderate-quality evidence. Key findings indicate that early-life antibiotic use, cesarean section, smoking during pregnancy, air pollution, ADHD diagnosis, ASD diagnosis, Kawasaki disease and maternal OCP exposure were associated with higher risk, while pet exposure, raw milk and fish consumption, birth order ≥ 2, and number of siblings ≥ 2 are associated with reduced risk.
CONCLUSION: This first umbrella review systematically compiles all available meta-analytic data on pediatric AR risk factors, offering a provisional evidence map that prioritizes candidate modifiable targets for future research. Earlylife food sensitization is the only factor with moderate certainty. However, the generally low certainty of evidence underscores an urgent need for more rigorous and standardized primary studies and meta-analyses to strengthen the foundation for clinical and public health interventions.
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251248436.