医師の一分

アクセスカウンタ

zoom RSS 帝王切開で喘息のリスクが増大

<<   作成日時 : 2008/12/08 20:15   >>

なるほど(納得、参考になった、ヘー) ブログ気持玉 1 / トラックバック 0 / コメント 0

 3000人の子どもについてのオランダの研究。帝王切開で生まれた場合、8歳時の喘息の発症率が80%増加していた。
 2917人のうち、247人が帝王切開で出生した。全体では、12.4% (362人)の子どもが8才時に喘息であった。
 両親がアレルギーの場合は、両親がそうでない場合に比べ3倍喘息であった。
 先進国で帝王切開の割合が1970年代の5%から2000年には30%以上となったことと平行して。喘息の発症が増加している。
 他の研究で、帝王切開で出生した子どもは経膣分娩の子どものようにすぐには細菌に曝されない事が示されている。
 (細菌エンドトキシンの暴露とアレルギーの関係が先日NHKの特集番組で放送された。乳幼児期に家畜に接触することでアレルギーの発症が減るという)
-------------------------------------------------
Page last updated at 00:10 GMT, Tuesday, 2 December 2008
Caesarean increases asthma risk
http://news.bbc.co.uk/2/hi/health/7755439.stm

画像Newborn baby
One in four births in the UK is by Caesarean

Babies born by Caesarean section are more prone to developing asthma, say Dutch researchers.

In a study of almost 3,000 children, birth by Caesarean was associated with a 80% increased risk of asthma by age eight compared with vaginal birth.
The association was even stronger in children whose parents had allergies, suggesting a genetic predisposition to the disease, it is reported in Thorax.
Previous research has linked Caesareans with the development of allergies.
In total, the team looked at 2,917 children, 247 of whom were born by caesarean.

The mother should be informed of the risk of asthma for her child, especially when the parents have a history of allergy or asthma
Dr Caroline Roduit

Around 12% of the children were diagnosed with asthma for which they were treated with inhaled steroids by the time they were eight years old.
The researchers found that the 9% of children who had two allergic parents were almost three times more likely to be asthmatic by the time they were eight compared with children whose parents were not allergic.

Immunity
Study leader, Dr Caroline Roduit, now based at the Children's Hospital of Zurich, Switzerland, said rates of asthma had soared in industrialised countries in parallel with a rise in Caesarean section births, which have increased from 5% in the 1970s to more than 30% in 2000.
She suggested that one reason for the association between Caesareans and asthma could be the priming of the immune system after birth.
Other research has shown babies born by Caesarean are not exposed to microbes as soon as babies born by vaginal delivery.
Previous studies in this area have produced conflicting results but the authors said the size of the study, the long monitoring period and and the definition of asthma to include inhaled steroids, strengthened the findings.
"The increased rate of Caesarean section is partly due to maternal demand without medical reason," said Dr Roduit.
"In this situation the mother should be informed of the risk of asthma for her child, especially when the parents have a history of allergy or asthma."
Dr Mike Thomas, chief medical adviser to the charity Asthma UK, said previous studies had also suggested that Caesarean section might increase the risk of asthma.
He said: "Sometimes a Caesarean section is needed for medical reasons, but where possible a natural birth is better."

-----------------------------------------------
Thorax. Published Online First: 3 December 2008. doi:10.1136/thx.2008.100875
Copyright © 2008 BMJ Publishing Group Ltd & British Thoracic Society

Asthma at 8 years of age in children born by cesarean section
Caroline Roduit 1, Salome Scholtens 2, Johan C de Jongste 3, Alet H Wijga 1, Jorrit Gerritsen 4, Dirkje S Postma 5, Bert Brunekreef 2, Maarten O Hoekstra 6, Rob Aalberse 7 and Henriette A Smit 1*

1 National Institute for Public Health and the Environment, Bilthoven, Netherlands
2 Institute for Risk Assessment Sciences, Utrecht University, Netherlands
3 Department of Pediatrics, Division of Respiratory Medicine, Erasmus MC – Sophia, Rotterdam, Netherlands
4 Beatrix Children’s Hospital, University Medical Centre Groningen, Netherlands
5 University Medical Centre Groningen, Netherlands
6 Centre for Paediatric Allergology, Wilhelmina Children's Hospital, Netherlands
7 Sanquin Research, Amsterdam, Netherlands

* To whom correspondence should be addressed. E-mail: jet.smit@rivm.nl.

Accepted 7 September 2008


* Abstract

Background: Cesarean section might be a risk factor for asthma due to a delayed microbial colonization, but the association remains controversial.

Objective: To investigate prospectively whether children born by cesarean section are more at risk of having asthma in childhood, and sensitization at the age of 8 years taking into account the parental allergic status.

Methods: We studied 2,917 children, who participated in a birth cohort study and followed for 8 years. The definition of asthma included wheeze, dyspnea and prescription of inhaled steroids. In a subgroup (n=1,454), serum IgE antibodies for inhalant and food allergens were measured at 8 years.

Results: In the total study population, 12.4% (362) of the children had asthma at the age of 8 years. Cesarean section, with a total prevalence of 8.5%, was associated with an increased risk of asthma (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.27-2.51). This association was stronger among predisposed children (with two allergic parents: OR, 2.91; 95% CI, 1.20-7.05; with only one: OR, 1.86; 95% CI, 1.12-3.09) than in children with non-allergic parents (OR, 1.36; 95% CI, 0.77-2.42). The association between cesarean section and sensitization at the age of 8 years was significant only in children of non-allergic parents (OR, 2.14; 95% CI, 1.16-3.98).

Conclusions: Children born by cesarean section have a higher risk of asthma than those born by vaginal delivery, particularly children of allergic parents. Cesarean section increases the risk for sensitization to common allergens, in children with non-allergic parents only.

テーマ

関連テーマ 一覧


月別リンク

ブログ気持玉

クリックして気持ちを伝えよう!
ログインしてクリックすれば、自分のブログへのリンクが付きます。
→ログインへ
気持玉数 : 1
なるほど(納得、参考になった、ヘー)

トラックバック(0件)

タイトル (本文) ブログ名/日時

トラックバック用URL help


自分のブログにトラックバック記事作成(会員用) help

タイトル
本 文

コメント(0件)

内 容 ニックネーム/日時

コメントする help

ニックネーム
本 文
帝王切開で喘息のリスクが増大 医師の一分/BIGLOBEウェブリブログ
文字サイズ:       閉じる