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目的分析剖宫产与学龄前儿童哮喘的关联,总结剖宫产与儿童哮喘的相关性,指导临床及孕产妇对剖宫产的认识。方法选取安庆、芜湖、铜陵、扬州4个城市共8 900名3~6岁儿童作为研究对象。通过对儿童带养者问卷调查的形式收集儿童出生方式、哮喘患病情况、人口学资料和体格测量资料等。哮喘病例由县级以上医院确诊,孕妇分娩方式分为阴道分娩、医学指征剖宫产和选择剖宫产。运用多分类Logistic回归分析剖宫产与学龄前儿童哮喘的关联。结果8 900名学龄前儿童中,剖宫产率为67.3%,哮喘患病率为7.0%,哮喘儿童中28.5%出生于自然分娩,71.5%出生于剖宫产。在控制地区、性别、早产、母亲怀孕年龄、父母文化程度、母乳喂养和儿童BMI后,医学指征剖宫产与学龄前儿童哮喘相关联(OR=1.25,95%CI:1.03~1.52,P<0.05),而选择性剖宫产与学龄前儿童哮喘的关联无统计学意义(OR=1.19,95%CI:0.94~1.51,P>0.05)。结论剖宫产和学龄前儿童哮喘有关联,并且医学指征剖宫产会增加儿童哮喘发生的风险。
Objective To analyze the association between cesarean section and preschool children asthma, summarize the correlation between cesarean section and childhood asthma, and guide clinical and maternal understanding of cesarean section. Methods A total of 8 900 children from 3 to 6 years old in 4 cities of Anqing, Wuhu, Tongling and Yangzhou were selected as the research object. Child birth patterns, asthma prevalence, demographic data, and physical measurement data were collected in the form of a questionnaire survey on child-bearing children. Cases of asthma were diagnosed by hospitals above the county level. Pregnant women were divided into vaginal delivery, cesarean section and cesarean section. Logistic regression analysis was used to analyze the association between cesarean section and asthma in preschool children. Results Among 8 900 pre-school children, the rate of cesarean section was 67.3%, the prevalence of asthma was 7.0%, 28.5% of children with asthma were born in spontaneous delivery, and 71.5% were born in cesarean section. Cesarean section with prescriptive cesarean section was associated with preschool-age asthma (OR = 1.25, 95% CI: 1.03-1.52, P <0.05) in controlled areas, sex, premature birth, mother’s gestational age, parental education, breastfeeding and children’s BMI <0.05). However, there was no significant correlation between selective cesarean section and preschool children’s asthma (OR = 1.19, 95% CI: 0.94-1.51, P> 0.05). Conclusion Cesarean section is associated with asthma in preschool children, and medical indication of cesarean section increases the risk of asthma in children.