Early childhood infection and atopic disorder

作者：I. Sadaf Farooqi, J. M. Hopkin · 发表于：Thorax · 年份：1998 · DOI：10.1136/thx.53.11.927 · 被引用次数：377 · 研究领域：Dermatology and Skin Diseases、Asthma and respiratory diseases、Pediatric health and respiratory diseases

BACKGROUND: Atopy is of complex origins but the recent rise in atopic diseases in westernized communities points to the action of important environmental effects. One candidate mechanism is the changing pattern of microbial exposure in childhood. This epidemiological study investigated the relationship between childhood infections and subsequent atopic disease, taking into account a range of social and medical variables. METHODS: A total of 1934 subjects representing a retrospective 1975-84 birth group at a family doctor practice in Oxfordshire were studied. Public health and practice records were reviewed; temporal records were made of all diagnoses of infections and their treatments, all immunisations, and diagnoses of asthma, hay fever and eczema; maternal atopy and a number of other variables were documented. RESULTS: Logistic regression analysis identified three statistically significant predictors of subsequent atopic disease: maternal atopy (1.97, 95% CI 1.46 to 2.66, p < 0.0001), immunisation with whole-cell pertussis vaccine (1.76, 95% CI 1.39 to 2.23, p < 0.0001), and treatment with oral antibiotics in the first two years of life (2.07, 95% CI 1.64 to 2.60, p < 0.0001). There was no significant association found for maternal smoking, bottle feeding, sibship size, or social class. CONCLUSIONS: The prediction of atopic disease by maternal atopy mainly reflects the effect of acknowledged genetic factors. Interpretation of the prediction of atopic disorders by immunisat...