婴儿期抗生素使用与儿童喘发病率之间的关联:加拿大不列颠哥伦比亚省的一项人口级生态研究
Abdullah Al Mamun1,2, Carl Zou2, Hannah Lishman2
1School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
减少抗生素的使用和增加婴儿的母乳养与儿童喘发病率的显著下降有关. 这些因素解释了20多年来观察到的喘率人口趋势的大部分原因.
科学领域:
- 儿科健康 儿科健康
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 已发表的协会将抗生素使用与儿童喘发展联系起来.
- 2000-2019年不列颠哥伦比亚省 (BC) 的趋势显示,抗生素处方减少,母乳养增加.
- 在此期间,BC儿童的喘发病率也呈现下降趋势.
研究的目的:
- 为了模拟BC儿童中预测的喘发病率.
- 评估减少抗生素使用和增加母乳养对喘发病率的影响.
- 评估与抗生素暴露相关的喘的人口归因风险 (PAR).
主要方法:
- 一项以人口为基础的生态研究利用BC PharmaNet抗生素处方数据和慢性疾病注册表进行喘诊断.
- 哺乳期估计来源于加拿大社区健康调查 (CCHS).
- 负二项回归分析了婴儿抗生素处方和儿童喘发病率之间的关联,按时间段分层.
主要成果:
- 从2000年到2019年,婴儿的抗生素处方减少了77%,1至4岁儿童的喘发病率下降了41%.
- 不列颠哥伦比亚省母乳养率从46% (2005年) 增加到71% (2017年18年).
- 2019年预测的喘发病率 (18.8/1,000) 与观察到的发病率 (16.6/1,000) 相当,抗生素使用与随着时间的推移由于增加母乳养而导致的喘减弱之间的关联.
结论:
- 在20年内,婴儿抗生素暴露和儿童喘发病率的显著下降被观察到.
- 减少抗生素暴露和增加母乳养似乎解释了人口喘趋势的很大一部分.
- 虽然这些因素很重要,但其他环境和社会暴露仍然与喘病因相关.
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