中国儿童保健杂志 ›› 2018, Vol. 26 ›› Issue (9): 985-990.DOI: 10.11852/zgetbjzz2018-26-09-15

• 荟萃分析 • 上一篇    下一篇

剖宫产可能增加儿童罹患过敏性疾病风险的Meta分析

胡芳1,卢建军2,胡艳1,邢艳菲1,蒋琳1,刘慧燕1,马颖1,林穗方1   

  1. 1 广州市妇女儿童医疗中心儿童保健部,广东 广州 510627;
    2 中山大学附属第一医院医务处,广东 广州 510080
  • 收稿日期:2017-12-13 发布日期:2018-09-10 出版日期:2018-09-10
  • 通讯作者: 林穗方,E-mail:739834696@qq.com
  • 作者简介:胡芳(1984-),女,江西人,主治医师,硕士学位,主要从事儿童保健工作。
  • 基金资助:
    中国疾病预防控制中心妇幼保健中心,合生元母婴营养与健康研究(2018FYH008)

Meta-analysis of caesarean section may increase the risk of childhood allergic diseases

HU Fang1, LU Jian-jun2, HU Yan1, XING Yan-fei1, JIANG Lin1, LIU Hui-yan1, MA Ying1, LIN Sui-fang1   

  1. 1 Child Health Department of Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong 510627, China;
    2 Medical Affairs Department of the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China
  • Received:2017-12-13 Online:2018-09-10 Published:2018-09-10
  • Contact: Corresponding author:LIN Sui-fang, E-mail:739834696@qq.com

摘要: 目的 利用Meta分析方法评价剖宫产与儿童过敏性疾病之间的关系,为儿童过敏性疾病防治提供循证依据。方法 检索五大数据库,最后一次检索时间为2017年9月5日,按照预先设定的标准检索、筛选、纳入和分析文献。采用Rev Man 5.3软件进行Meta分析,根据异质性结果选择相应的效应模型分析并进行亚组分析。结果 共有63篇文献纳入分析,总样本量为4 818 347人。与阴道分娩相比,剖宫产儿哮喘、食物过敏、过敏性鼻结膜炎、吸入性过敏、喘息、枯草热的患病率分别增加19%、31%、14%、29%、4%、16%(P<0.05)。亚组分析显示:对儿童哮喘而言,剖宫产不增加3岁以下儿童哮喘发生风险,其余各亚组差异均有统计学意义(P<0.05);对儿童喘息而言,队列研究、通过问卷调查(父母报告症状)、父母无过敏性疾病组,剖宫产与儿童喘息有关联,OR值分别为1.05(95%CI:1.01~1.08)、1.07(95%CI:1.01~1.14)、1.05(95%CI:1.00~1.10)。结论 剖宫产是儿童多种过敏性疾病的危险因素,应做好孕产妇健康宣教和产科质量管理,把好儿童生命质量第一关。

关键词: 剖宫产, 过敏性疾病, 儿童, Meta分析

Abstract: Objective To analyze the correlation between caesarean section and allergic diseases in childhood by conducting a meta-analysis, in order to provide evidence for the prevention of childhood allergic diseases. Methods Literatures published till 5th September, 2017 were searched in five databases, and were retrieved, filtered, incorporated and analyzed according to the preset standard.Meta-analysis was performed by using Rev Man 5.3 software.The corresponding effect model was selected according to the heterogeneity results and subgroup analysis was performed. Results Totally 63 studies were included, the sample size was 4 818 347.Compared with natural birth, caesarean section significantly increased the risks of having asthma, food allergy, allergic conjunctivitis, inhalation allergy, wheezing and hay fever in children by 19%, 31%, 14%, 29%, 4% and 16%, respectively(P<0.05).Subgroup analysis showed that cesarean section did not increase the risk of asthma in children under 3 years old, while other subgroups were statistically significant (P<0.05).Caesarean section was associated with children's wheezing among the subgroups of cohort study(OR=1.05,95%CI:1.01~1.08),questionnaire(parents reported symptoms)(OR=1.07,95%CI:1.01~1.14)and parents without allergic diseases(OR=1.05, 95%CI:1.00~1.10). Conclusion Caesarean section increases the risk of allergic diseases in childhood, so it is necessary to strengthen maternal health education and obstetric management to guarantee healthy life of children.

Key words: caesarean section, allergic disease, children, Meta-analysis

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