婴儿牛奶蛋白过敏的危险因素：多中心调查分析

Risk factors for cow's milk protein allergy in infants: a multicenter survey

摘要:

目的 通过多中心临床研究了解婴儿牛奶蛋白过敏（CMPA）发生的危险因素。方法 以2016年6月至2017年5月于深圳市6家医院儿科门诊就诊的1 829例1~12月龄婴儿为调查对象，通过问卷调查，筛选CMPA可疑病例，然后进行食物回避激发试验以确诊CMPA。采用多因素logistic回归分析调查婴儿CMPA发生的危险因素。结果 1 829例患儿中，82例确诊为CMPA（4.48%）。多因素logistic回归分析显示，母亲食物过敏（OR=4.91，95% CI：2.24~10.76）、母亲孕期使用抗生素（OR=3.18，95% CI：1.32~7.65）、开始添加辅食月龄小于 < 4个月（OR=3.55，95% CI：1.52~8.27）是CMPA的独立危险因素（P < 0.05），而纯母乳喂养（OR=0.21，95% CI：0.08~0.58）和 > 6个月添加辅食（OR=0.38，95% CI：0.17~0.86）是CMPA的保护因素（P < 0.05）。结论 小于4月龄添加辅食、母亲食物过敏、母孕期使用抗生素是婴儿CMPA发生的危险因素。

Abstract:

Objective To investigate the risk factors for cow's milk protein allergy (CMPA) among infants through a multicenter clinical study. Methods A total of 1 829 infants, aged 1-12 months, who attended the outpatient service of the pediatric department in six hospitals in Shenzhen, China from June 2016 to May 2017 were enrolled as subjects. A questionnaire survey was performed to screen out suspected cases of CMPA. Food avoidance and oral food challenge tests were used to make a confirmed diagnosis of CMPA CMPA. A multivariate logistic regression analysis was used to investigate the risk factors for CMPA. Results Among the 1 829 infants, 82 (4.48%) were diagnosed with CMPA. The multivariate logistic regression analysis showed that maternal food allergy (OR=4.91, 95% CI:2.24-10.76, P < 0.05), antibiotic exposure during pregnancy (OR=3.18, 95% CI:1.32-7.65, P < 0.05), and the introduction of complementary food at an age of < 4 months (OR=3.55, 95% CI:1.52-8.27, P < 0.05) were risk factors for CMPA, while exclusive breastfeeding (OR=0.21, 95% CI:0.08-0.58, P < 0.05) and the introduction of complementary food at an age of > 6 months (OR=0.38, 95% CI:0.17-0.86, P < 0.05) were protective factors. Conclusions The introduction of complementary food at an age of < 4 months, maternal food allergy, and antibiotic exposure during pregnancy are risk factors for CMPA in infants.