婴幼儿湿疹影响因素分析:一项五省市的前瞻性队列研究

  目的  了解婴幼儿湿疹的发病现状，从多角度探索其发病因素。  方法  以中国孕产妇队列研究-子代项目中的681名婴幼儿为研究对象，在孕期收集父母亲的一般人口学信息、孕期膳食摄入及婴幼儿出生信息，随访调查其家居环境和婴幼儿湿疹状况，应用多因素非条件logistic回归分析模型分析婴幼儿湿疹发病的影响因素。  结果  研究对象婴幼儿湿疹的发生率为23.79%。logistic回归分析模型分析结果显示，相比初产妇，经产妇(OR=0.601, 95% CI:0.398~0.908)所分娩的孩子患湿疹风险会降低47.6%。母亲有过敏史(OR=2.191, 95% CI:1.393~3.447)和父亲有过敏史(OR=2.008, 95% CI:1.244~3.239)的孩子更容易患湿疹。相比于母乳喂养，人工喂养(OR=4.165, 95% CI:1.450~11.963)和混合喂养(OR=8.151, 95% CI:5.165~12.866)增加婴幼儿患湿疹的风险。孕期禽肉摄入频率越高的孕妇，产后孩子患湿疹的风险增高(OR=1.145, 95% CI:1.011~1.297)。家庭地板、窗台、墙壁有褪色、变黑或霉变(OR=2.051, 95% CI:1.094~3.843)会使婴幼儿湿疹的发病风险增高。  结论  产次、喂养方式、父母过敏史、孕期禽肉摄入频率及居家环境对于婴幼儿湿疹发病有影响，应加强开展针对性宣传指导，有效预防婴幼儿湿疹发生。

Analysis of influencing factors of eczema in preschoolers in China: a prospective cohort study in five provinces

  Objective  To investigate the incidence of eczema in preschoolers in China, and to explore its risk factors.  Methods  In this study, 681 children in Chinese Pregnant Women Cohort Study and Offspring Follow-up were included. The demographic information of parents during pregnancy and home environmental factors were investigated by questionnaire. Logistic regression was applied to analyze the influencing factors of eczema in preschoolers.  Results  The incidence of eczema in preschoolers was 23.79%. Our result showed that the risk of eczema in preschoolers whose mothers were multiparae (OR=0.601, 95% CI: 0.398-0.908) is lower than primiparae. 3 to 5 year old children whose mothers (OR=2.191, 95% CI: 1.393-3.447) or fathers (OR=2.008, 95% CI: 1.244-3.239) have an allergic history are more likely to suffer from eczema. Compared with breast feeding, artificial feeding (OR=4.165, 95% CI: 1.450-11.963) and mixed feeding (OR=8.151, 95% CI: 5.165-12.866) were risk factors of infantile eczema. Faded, blackened or mildewed household floors, windowsills or walls also increase the risk of eczema in preschoolers (OR=2.051, 95% CI: 1.094-3.843). Compared to the lower frequency, higher frequency of intake of poultry was significantly associated with an increased risk of eczema (OR=1.145, 95% CI: 1.011-1.297).  Conclusions  Parity, parents' allergic history, feeding patterns, frequency of poultry intake during pregnancy and home environment are associated with eczema in preschoolers, and targeted health education should be strengthened to effectively prevent the occurrence of eczema in 3 to 5 year old children.