新生儿短暂性呼吸急促及其与学龄前哮喘的关系。

Mordechai Pollak, Moria Shapira, Dvir Gatt, Inbal Golan-Tripto, Aviv Goldbart, Guy Hazan
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摘要

理由:新生儿短暂性呼吸急促(TTN)以新生儿呼吸窘迫为特征,由胎儿肺液清除延迟引起。虽然传统上被认为是一种自限性疾病,但最近的研究表明,TTN与婴儿呼吸道感染风险增加之间存在潜在关联。目的:本研究探讨TTN与儿童哮喘医疗保健利用之间的可能联系。方法:这项回顾性病例对照研究使用了以色列Clalit医疗服务公司的全国电子记录。该研究包括2011年至2018年间出生的被诊断患有TTN (TTN+)的足月婴儿和没有TTN (TTN-)的对照组。主要结局是6岁前哮喘相关的医疗保健利用情况。倾向评分匹配用于调整潜在的混杂因素。结果:该研究包括645名TTN患儿和187,809名TTN-组患儿。在预配分析中,TTN+组剖宫产和男性的发生率较高。配对后、人口统计学和临床差异得到平衡。TTN+组儿童因哮喘急诊就诊的比率显著较高(2.05倍;P值Pv Pv = 0.002;95% CI, 1.1-2.89)高于对照组。在调整混杂因素后,这些关联仍然显著。结论:研究结果表明,TTN可能与儿童期患哮喘的高风险有关。本研究可以增强我们对TTN潜在的长期呼吸影响的理解,并可以为受影响婴儿的临床随访策略提供信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Transient Tachypnea of the Newborn and the Association with Preschool Asthma.

Rationale: Transient tachypnea of the newborn (TTN) is characterized by respiratory distress in neonates, resulting from delayed clearance of fetal lung fluid. Although traditionally considered a self-limited condition, recent studies have indicated a potential association between TTN and an increased risk for respiratory infections during infancy. Objectives: This study investigates the possible link between TTN and healthcare utilization for asthma during childhood. Methods: This retrospective, case-control study used nationwide electronic records from Clalit Healthcare Services, Israel. The study included term infants born between 2011 and 2018 who were diagnosed with TTN (TTN+) and a control group without TTN (TTN-). The primary outcomes were asthma-related healthcare utilization up to age 6 years. Propensity score matching was used to adjust for potential confounders. Results: The study included 645 children with TTN and 187,809 in the TTN- group. In prematching analysis, the TTN+ group had a higher incidence of cesarean delivery and male sex. Postmatching, demographic, and clinical differences were balanced. Children in the TTN+ group had significantly higher rates of emergency room visits for asthma (2.05 times higher; P value (Pv) < 0.001; 95% confidence interval [CI], 1.46-2.89), asthma diagnoses (38% increase; Pv < 0.001; 95% CI, 1.18-1.51), and prescriptions for short-acting β-agonists (28% increase; Pv = 0.002; 95% CI, 1.1-2.89) than control subjects. These associations remained significant after adjusting for confounders. Conclusions: The findings suggest that TTN may be associated with a higher risk of developing asthma in childhood. This study may enhance our understanding of the potential long-term respiratory implications of TTN and could inform clinical follow-up strategies for affected infants.

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