目的: 探讨母亲剖宫产与孕期抗生素使用之间的交互作用对子代儿童变应性鼻炎发病的影响。方法: 本研究采用病例对照研究方法,按性别频数1∶1配对原则,选取239例确诊为变应性鼻炎的儿童作为病例组,239例未患过变应性鼻炎的儿童作为对照组。应用Logistic回归分析模型分析母亲剖宫产与孕期抗生素使用与子代儿童变应性鼻炎发病风险的关联强度,并分析相加模型和相乘模型交互作用。结果: 病例组的剖宫产率（50.7%）和孕期抗生素使用率（20.1%）显著高于对照组（35.1%和14.9%）。经Logistic回归分析,剖宫产（OR=1.917,95%CI：1.316~2.792,P<0.05）和孕期抗生素使用（OR=2.369,95%CI：1.380~4.066,P<0.05）均为子代变应性鼻炎的独立危险因素。此外,剖宫产且孕期抗生素使用的后代患儿童变应性鼻炎的风险是非剖宫产且孕期抗生素使用者的9.629倍,具有显著的相乘交互作用（OR=4.359,95%CI：1.192~15.941,P=0.026）。结论: 剖宫产与孕期抗生素使用协同增加子代儿童变应性鼻炎发病风险,提示在预防儿童变应性鼻炎时,应综合考虑剖宫产率和孕期抗生素使用的降低策略。
Abstract
Objective To investigate the interaction between cesarean delivery and antenatal antibiotic use in the development of allergic rhinitis in children. Methods This study adopted a case-control research design, with a 1∶1 gender frequency matching principle. We enrolled 239 children diagnosed with allergic rhinitis as the case group and 239 children without a history of allergic rhinitis as the control group. Logistic regression analysis was applied to evaluate the association between cesarean delivery, antenatal antibiotic use, and the risk of allergic rhinitis in children. Both additive and multiplicative interaction models were analyzed. Results The cesarean delivery rate (50.7%) and antenatal antibiotic use rate (20.1%) in the case group were significantly higher than those in the control group (35.1% and 14.9%, respectively). Logistic regression analysis revealed that cesarean delivery (OR=1.917, 95% CI: 1.316-2.792, P<0.05) and antenatal antibiotic use (OR=2.369, 95% CI: 1.380-4.066, P<0.05) were independent risk factors for allergic rhinitis in children. Furthermore, the risk of allergic rhinitis in children born by cesarean delivery and exposed to antenatal antibiotics was 9.629 times higher than that in children not exposed to either factor. A significant multiplicative interaction was observed between cesarean delivery and antenatal antibiotic use (OR=4.359, 95% CI: 1.192-15.941, P=0.026). Conclusion Cesarean delivery and antenatal antibiotic use exhibit a synergistic effect on the development of allergic rhinitis in children. These findings suggest that reducing cesarean delivery rates and antenatal antibiotic use may be critical strategies for preventing allergic rhinitis in children.
关键词
儿童变应性鼻炎 /
剖宫产 /
孕期抗生素使用 /
交互作用
Key words
allergic rhinitis in children /
cesarean delivery /
antenatal antibiotic use /
interaction
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基金
湖北省宜昌市科技局基金“基于CRISPR/Cas9的P2RX2 c.178G>T（p.V60L）基因矫正及致聋机理研究”（A21-2-012）
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