新生兒黃疸兒童產前和產後暴露空氣污染增加非過敏性氣喘的風險

Prenatal and Postnatal Exposure to Air Pollution Increases Risk of Nonallergic Asthma in Children with Neonatal Jaundice

目的：許多研究指出空氣污染或新生兒黃疸與兒童日後罹患氣喘具有相關性。本研究預評估產前／產後暴露空氣污染，對於新生兒黃疸兒童，日後罹患氣喘的風險。方法：挑選新生兒黃疸兒童，進行回顧性病例對照研究。以空氣品質偵測站數據，分析平均環境空氣污染濃度。依照兒童免疫球蛋白E或嗜酸性白血球比例做分群，進一步分析病例組和對照組之間空氣污染物的差異。結果：在免疫球蛋白E小於100 IU/ml族群，有氣喘兒童，在第一、二孕期和出生後第一、二年，其各空氣污染物（SO_2、NO、NO_x、PM_(2.5)和PM_(10)）暴露濃度均顯著高於無氣喘兒童；大於100 IU/ml族群，兩組之間空氣污染暴露，並無差異。在嗜酸性白血球小於3%族群，有氣喘兒童在所有研究時間點中，各空氣污染暴露濃度均高於無氣喘兒童；大於3%族群，有氣喘兒童則是於第一孕期和出生後三個的時間點，空氣污染暴露濃度顯著高於無氣喘兒童。結論：無論是產前或是產後暴露於空氣污染中，明顯增加新生兒黃疸兒童罹患非過敏性氣喘的風險。

Objectives. Several studies have linked air pollution exposure or neonatal jaundice (NJ) to the development of childhood asthma. We investigated the association between prenatal/postnatal exposure to air pollution and the development of childhood asthma in children with NJ.
Methods. We performed a nested case-control retrospective study using data from infants with NJ. The average pollutant concentrations were collected in the first, second, and third pregnancy trimesters and at six months, one year, and two years after birth. The children with NJ were separated into groups with low and high immunoglobulin (Ig) E levels and percentages of eosinophils. The difference in air pollutant exposure concentrations was analyzed.
Results. In the group with an IgE level less than 100 IU/ml, the levels of all air pollutants in the first and second trimesters and the first and second years after birth were significantly higher in the asthmatic group than in the nonasthmatic group. However, the levels of all pollutants were not different between the asthmatic and nonasthmatic groups in the group with an IgE level greater than 100 IU/ml. In the group with a percentage of eosinophils less than 3%, the levels of all pollutants were significantly higher in the asthmatic group than in the nonasthmatic group. In addition, the levels of exposure to all pollutants after birth were significantly higher in the asthmatic group than in the nonasthmatic group in the children with a percentage of eosinophils greater than 3%.
Conclusion. Prenatal and postnatal exposure to air pollution significantly increased the risk of nonallergic asthma in children with NJ.