Meta-analysis And Clinical Study On The Relationship Between Childhood Asthma And Antibiotic Exposure Before 1 Year Old

Objective:Meta-analysis of prospective cohort studies resulted in relevant evidence-based medical evidence to assess the relationship between antibiotic use and childhood asthma in one year after birth.And then through the corresponding case-control study to verify whether the results of this meta-analysis for domestic children.Help to regulate the rational application of early antibiotics in life for the future to find ways to prevent and treat asthma and provide a basis for the target.Methods:1.The Chinese and English databases CNKI,Wanfang Data,VIP,PubMed,and EBSCO were searched for prospective cohort studies on the association between the use of antibacterial agents in the first years of life and childhood asthma.Stata12.0 software was used to analyze the association through a Meta analysis.2.Children with the first diagnosis of asthma were enrolled in our hospital as experimental group during 2016.6-2016.12.At the same time,four healthy children in the vicinity of kindergartens and nursery schoolswere selected as the control group.Using the questionnaire survey,according to the International Children's Asthma Allergy Research(ISAAC)recognized the incidence of asthma to investigate.The relationship between exposure and disease was analyzed by using multivariate logistic regression model.The relationship between exposure to antibiotics and asthma was analyzed.And the trend of chi-square test to analyze the use of antibiotics within 1 year of age and the first time to accept the relationship between antibiotics and asthma.Results:1.The articles with a high quality score and adjusted effective values for factors for respiratory tract infection were pooled,and a total of 7studies were included.The results of the Meta analysis showed that the use of antibacterial agents in the first years of life increased the risk of childhood asthma(OR=1.13,95%CI: 1.10-1.17,P<0.05).Compared with the children who used antibacterial agents 0-1 times in the first years of life,those who used more than 4 times had an increased risk of asthma(OR=1.28,95%CI: 1.19-1.38,P<0.05).High-risk children(at least one immediate family member had asthma)who used antibacterial agents had an increased risk of asthma(OR=1.47,95%CI: 1.20-1.81,P<0.05).2.Analysis of the experimental group included 196 children,the control group 205 for healthy children.Analysis of the exposure factors showed that cesarean section,nearly 12 months of respiratory tractinfection is greater than 6 times,within 1 year of age and neonatal antibiotic exposure is considered a risk factor,breastfeeding is a protective factor.Of which more than 6 months of respiratory infection more than 6times the impact of the model,adjust the respiratory tract infection factors within 1 year of antibiotic analysis results for the OR = 2.354,95% CI(1.478 ~ 3.750).In addition,the use of antibiotics in the age of 1 and 2-3times compared with the use of a comparison,although P> 0.05,OR =1.131,95% CI(0.574 ~ 2.228)use 4 times with the use of a significant statistical difference,OR = 2.320,95% CI(1.237 ~ 4.352).It can be seen that the risk of asthma increases with the increase with the number of antibiotics used.Conclusion:1.The use of antibacterial agents in the first years of life increases the risk of childhood asthma.High-risk children who use antibacterial agents have an increased risk of asthma.The increased frequency of use of antibacterial agents in the first years of life is associated with an increased risk of childhood asthma,but the detailed dose relationship needs further investigation.2.Exposure to antibiotics within one year of age increases the risk of asthma in childhood,and the greater the number of antibiotics used,the increased risk of asthma in childhood.However,due to the small sample size of this study,only to a certain extent,explain the problem,the future tobe further studied.