杭州浙大迪迅生物基因工程有限公司

——浙大迪迅 译

背景：产前饮食对儿童喘息和随后哮喘风险的作用尚无定论，这可能部分与喘息表型的异质性相关。我们的目的是确定儿童早期的喘息轨迹，并检查它们与围产期母亲饮食质量的关系。

方法：分析了来自日本环境与儿童研究所的70530对活产单胎母婴的数据。从1岁到4岁，护理人员每年使用一份经过修改的儿童哮喘和过敏国际研究问卷报告喘息，并使用基于群体的轨迹模型推导出这些轨迹。使用有效的食物频率问卷评估孕妇在妊娠前三个月的饮食；总体饮食质量是根据日本膳食指南陀螺的均衡饮食评分来确定的。采用多项logistic回归模型的贝叶斯推理来检验母亲饮食质量与幼儿期喘息轨迹之间的关系。

结果：我们确定了四种喘息轨迹：“从不/不频繁”(69.1%)；参照组)、“儿童早期发病”(6.2%)、“短暂性早期发病”(16.5%)和“持续性发病”(8.2%)。在对混杂因素进行调整后，与“从不/不频繁”喘息轨迹相比，在“短暂性早期”和“持续性”喘息轨迹中母亲均衡饮食得分较高的风险降低10%。母亲均衡饮食得分与属于“儿童早期”喘息轨迹无关。

结论：在怀孕前改善母亲的饮食质量可能会减少儿童早期的某些喘息表型。

原始出处
Allergy
Periconceptional maternal diet quality and offspring wheeze trajectories: Japan Environment and Children's Study
DOI: 10.1111/all.15916
Abstract:
Background:The role of prenatal diet on childhood wheezing and subsequent risk of asthma is inconclusive, which may be partly due to the heterogeneity in wheezing phenotypes. We aimed to identify wheeze trajectories in early childhood and to examine their associations with periconceptional maternal diet quality.
Methods:Data from 70,530 mother–child pairs of liveborn singletons from the Japan Environment and Children's Study were analysed. Wheezing was reported by caregivers using a modified International Study of Asthma and Allergies in Childhood questionnaire yearly from 1 to 4 years of age, from which trajectories were derived using group-based trajectory modelling. Maternal diet in the year preceding the first trimester of pregnancy was assessed using a validated food frequency questionnaire; overall diet quality was determined using the balanced diet score based on the Japanese Food Guide Spinning Top. Bayesian inference of multinomial logistic regression models was performed to examine the association between maternal diet quality and wheeze trajectory in early childhood.
Results:We identified four wheeze trajectories: ‘never/infrequent’ (69.1%; reference group), ‘early-childhood onset’ (6.2%), ‘transient early’ (16.5%) and ‘persistent’ (8.2%). After adjustment for confounders, a higher quartile of maternal balanced diet score was associated with a lower risk of belonging to the ‘transient early’ and ‘persistent’ wheeze trajectories compared with the ‘never/infrequent’ wheeze trajectory by 10% of both. Maternal balanced diet score was not associated with belonging to the ‘early-childhood onset’ wheeze trajectory.
Conclusion:Improving maternal diet quality prior to conception may reduce certain wheeze phenotypes in early childhood.
First Author:
Hitomi Okubo
Corresponding author:
Shoji F. Nakayama
Correspondence:
Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan.
Email: fabre@nies.go.jp