原標(biāo)題：剖腹產(chǎn)、早產(chǎn)和食物過(guò)敏風(fēng)險(xiǎn)：瑞典全國(guó)100多萬(wàn)兒童群組研究
　　背景：我們對(duì)兒童生命早期食物過(guò)敏的危險(xiǎn)因素知之甚少。
　　方法：這項(xiàng)瑞典全國(guó)性群組研究，使用了來(lái)自衛(wèi)生保健登記簿中2001-2012年在瑞典出生的1086378名兒童的前瞻性記錄數(shù)據(jù)。我們采用Cox回歸分析，估計(jì)95%置信區(qū)間的危險(xiǎn)比（HRs）于衛(wèi)生保健登記簿中的圍產(chǎn)期特征（如剖腹產(chǎn)和早產(chǎn)）和確診的食物過(guò)敏之間的關(guān)系，并對(duì)嬰兒性別和母親因素進(jìn)行了校正（分娩年齡、出生地、產(chǎn)次、吸煙、體重指數(shù)、哮喘/肺?。?。
　　結(jié)果：在13年的隨訪中，26732名兒童（2.5%）被診斷為食物過(guò)敏。食物過(guò)敏與剖腹產(chǎn)（HR，1.21；95% CI，1.18-1.25）、胎齡大（HR，1.15；95% CI，1.10-1.19）和新生兒5分鐘Apgar評(píng)分低（HR，1.22；95% CI，1.10-1.36）呈正相關(guān)，但與極早產(chǎn)（妊娠<32周：HR，0.74；95% CI，0.56-0.98）呈負(fù)相關(guān)。未發(fā)現(xiàn)食物過(guò)敏與中度早產(chǎn)、低出生體重或小于胎齡之間存在關(guān)聯(lián)。當(dāng)結(jié)果僅限于2個(gè)診斷食物過(guò)敏記錄時(shí)，風(fēng)險(xiǎn)估計(jì)是相似的。1000名接受剖腹產(chǎn)的兒童與對(duì)照組相比，額外5名兒童出現(xiàn)食物過(guò)敏，這表明通過(guò)剖宮產(chǎn)出生的兒童中17%的食物過(guò)敏可以通過(guò)這種方式（歸因分?jǐn)?shù)）來(lái)解釋。
　　結(jié)論：剖腹產(chǎn)與食物過(guò)敏風(fēng)險(xiǎn)增加相關(guān)，而極早產(chǎn)降低了風(fēng)險(xiǎn)。


延伸閱讀
JACI：
[IF:13.258]
Cesarean delivery, preterm birth, and risk of food allergy: Nationwide Swedish cohort study of more than 1 million children
DOI: org/10.1016/j.jaci.2018.06.044
Abstract:
Background:
Little is known about early-life risk factors for food allergy in children .
Methods:
This nationwide Swedish cohort study of 1,086,378 children born in Sweden in 2001-2012 used prospectively recorded data from health care registers. Using Cox regression,we estimated hazard ratios (HRs) with 95% CIs for the association between perinatal characteristics (eg, cesarean delivery and preterm birth) and food allergy as defined by diagnoses in the National Patient Register, adjusting for infant sex and maternal factors (age at delivery, country of birth, parity, smoking, body mass index, and asthma/pulmonary disease).
Results:
During the 13-year follow-up, 26,732 (2.5%) children were given a diagnosis of food allergy. Food allergy was positively associated with cesarean delivery (HR, 1.21; 95% CI, 1.18-1.25), large for gestational age (HR, 1.15; 95% CI,1.10-1.19), and low 5-minute Apgar score (HR, 1.22; 95% CI, 1.10-1.36) but negatively associated with very preterm birth (<32 weeks of gestation: HR, 0.74; 95% CI, 0.56-0.98). No association was found between food allergy and moderately preterm birth, low birth weight, or small for gestational age.Risk estimates were similar when the outcome was restricted to 2 records of diagnosed food allergy. In 1,000 children undergoing cesarean delivery, an extra 5 developed food allergy compared with the reference group, suggesting that 17% of food allergy in children born by means of cesarean delivery can be explained by this exposure (attributable fraction).
Conclusions:
Cesarean delivery was associated with increasedrisk of food allergy, whereas very preterm birth decreased risk.
First Author:
Niki Mitselou
Correspondence:
Department of Pediatrics, Orebro University € Hospital, S€ odra Grev Rosengatan, Orebro 701 85, Sweden
All Authors:
Niki Mitselou, Jenny Hallberg,  Olof Stephansson, Catarina Almqvist, Erik Melen, and Jonas F. Ludvigsson
　　創(chuàng)建過(guò)敏性疾病的科研、科普知識(shí)交流平臺(tái)，為過(guò)敏患者提供專業(yè)診斷、治療、預(yù)防的共享平臺(tái)。