婴儿和儿童食物过敏发展的危险因素:系统性审查和元分析
Nazmul Islam1,2, Alexandro W L Chu1,3,4, Falana Sheriff1,5
1Evidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada.
JAMA pediatrics
|February 9, 2026
概括
早期的过敏状况,延迟的食物引入,遗传学和抗生素暴露是儿童食物过敏的关键危险因素. 这些因素,以及人口和出生变量,对过敏的发展有很大影响.
科学领域:
- 儿科过敏和免疫学
- 过敏疾病的流行病学
- 食物过敏的遗传学 食物过敏的遗传学
背景情况:
- 早期食物过敏的发病率和预测性风险因素仍然不完全理解.
- 准确识别风险因素对于制定有效的预防策略至关重要.
研究的目的:
- 系统地估计6岁以下儿童食物过敏的发病率.
- 量化各种因素与食物过敏的发展之间的联系.
主要方法:
- 在MEDLINE和Embase数据库中的系统文献搜索.
- 对190项涉及28万参与者的研究进行了元分析.
- 包括通过食物挑战证实食物过敏的研究,并评估6岁以下儿童的风险因素.
主要成果:
- 食品过敏的总体发病率估计为4.7% (中等确定性).
- 最强的危险因素包括先前的过敏状况 (例如,亚托皮性皮肤炎,过敏性鼻炎,喘息),延迟固体食物的引入,婴儿使用抗生素,男性性别和家族病史.
- 其他重要因素包括皮肤水分流失增加, filaggrin 基因变异,父母迁移,黑人种族和剖腹产.
结论:
- 儿童食物过敏的发展与主要和次要风险因素的组合有关.
- 确定的关键因素包括早期的过敏状况 (atopic march),延迟的过敏原引入,遗传倾向,抗生素暴露,人口特征和与出生相关的变量.
- 这些发现突出了导致食物过敏的因素的复杂相互作用,并告知了潜在的预防措施.
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