苏艳艳 1耿刚 2付文龙 2龚财惠 3汪东海 2代继宏2
作者信息
- 1. 重庆医科大学附属儿童医院儿童发育与疾病教育部重点实验室 重庆,400014
- 2. 重庆医科大学附属儿童医院 呼吸中心 重庆,400014
- 3. 重庆医科大学附属儿童医院 肺功能室 重庆,400014
- 折叠
摘要
Abstract
Objective To evaluate the association between the antibiotic use during pregnancy and childhood asthma. Methods The Chinese and English databases CNKI, Wanfang Data, Chinese VIP science and technology periodical database, PubMed, EMBASE, Cochrane and ovid were searched for cohort studies on the association between the use of antibacterial agents in pregnancy and childhood asthma. This meta-analysis with Stata12. 0 software explored the relationship between antibiotic and asthma.ResuIts There were 9 studies with the prevalence of childhood asthma and asthma exposure results related factors ( OR, RR or HR) and were adjusted for maternal asthma, smoking and other confounding factors.The results of the meta-analysis showed that the use of antibacterial agents in pregnancy increased the risk of childhood asthma (OR=1.14, 95％CI:1.13-1.15).Because of the high heterogeneity(I2=96.5％),analysis of the heterogeneity among literatures was carried out: the sensitivity analysis was made by removing each article,and the pooled risk estimates of asthma ( OR=1.27, 95％ CI:1.17-1.38, I2=0) after excluding the studies of high heterogeneity that did not affect the final result;analysis of clinical heterogeneity:the subgroup analysis with the age of 3 years of asthma onset was performed ,and the pooled effect size OR of studies with < 3 years and ≥3 years respectively was 1.85(95％CI:0.80-4.29, I2=78.8％) and OR=1.19 (95％CI:1.08-1.31, I2=96.8％);stratified by trimesters of pregnancy, the OR was 1.29(95％CI: 1.23-1.34), 1.30(95％CI: 1.25-1.35) and 1.26(95％CI: 1.21-1.31) for the early-, mid-and late-pregnancy, respectively, and I2=0;stratified by antibiotic assessment, the pooled OR from self reporting(interviews) and from the database was 1.27 (95％CI: 1.10-1.48, I2=71.2％), and 1.20 (95％CI:1.08-1.32, I2=98.6％) respectively; stratified by antibiotic tepy,the OR was 1.18(95％CI:1.08-1.30,I2=0) for Beta-lactam antibiotics and 1.19(95％CI:0.78-1.83,I2=83.5％) for Sulfonamides and trimethoprim.②In sibling analyses, the pooled OR was 0.91 (95％CI:0.79-1.06, I2=93.3％). There was no publication bias by the Begg rank correlation test and the Egger linear regression test. ConcIusion This meta-analysis suggested that antibiotic exposure during pregnancy may increase the risk of asthma in offspring. But in the sibling control analysis the associations disappeared, indicating the residual factors such as family environment,heredity and so on were important confounding factors that may lead to reverse causality. Therefore, the causal relationship between antibiotic use during pregnancy and risk of asthma in offspring needs further investigation.关键词
抗生素/哮喘/母孕/后代/儿童/Meta分析Key words
Antibiotics/Asthma/Prenatal/Offspring/Childhood/Meta-analysis
