| Background: The bronchial asthma is the an airway chronic inflammatory disease in childhood, it is an important part of children non-infectious diseases. The prevalence of pediatric asthma has been growing rapidly during recent decades. It has already become a major threat to the health of children. The pathogenesis and risk factors is unclear fully now. According to the current research, genetic susceptibility and environmental trigger participates the pathogenesis of the asthma. As the development of every system is immature, the infantile ability against microbial attack is limited. Bacterial infection is frequently during infancy stage, especially the respiratory tract infection, therefore, exposure to antibiotics is more frequent. In the epidemiological investigation and cross-section study about risk factors of asthma, Antibiotic exposure in the first year of life is a risk factor of asthma in childhood. After consulting of reference about this conclusion, the result of Case-control and cohort studies is different. Therefore, it is necessary to evaluate the relationship between antibiotic exposure in the first year of life and asthma byMeta-analysis. Aims to find the risk factor of children, s asthma for preventing asthma and guiding rational sue of antibiotics in early life.Materials and Method: Systematically search for studies about association between exposure to antibiotic during infancy and asthma in childhood. Source of literature include the following data base: Pubmed,EMBASE, Cochrane Library, Ovid, Chinese Biomedical Literature Database(CBMdisc) and Wan fang database. Two persons collect and evaluate the quality of the researches independently. It is the Reviewer manager 5.3 statistical software that analysis the data to achieve the Meta-analysis. Firstly, testing the heterogeneity of the including data;Meta-analysis was performed by using random-effects and fixed-effects models; the fixed effects models were only used when low or moderate heterogeneity was detected. When not otherwise specified, pooled estimates mentioned in the text are from a random-effects model; Secondly,combining the effect measure. The effect measure used in the meta-analysis was the adjusted odds ratio(OR), and 95% confidence interval(CI) for asthma. Lastly, do sensitivity analysis and evaluate the publication bias via draw funnel plot. Lastly, Calculate the Fail-safe number to evaluate the stability of the research.Results: After searching all the database, there were 6566 articles in both Chinese and English literature retrieved.12 researches were included finally after screening all articles, containing 2 references in Chinese, and10 in English; The result of test for heterogeneity is P=0.08,I2=39%,which indicates the heterogeneity between the included studies. After subgroup analysis, the heterogeneity roots in the case-control studies. Further sensitivity analysis finds that one of the case-control studies is the cause of heterogeneity. After deleting this study, analysis the rest of studies, the finally result : OR=1.61, 95%CI : 1.53-1.68, P<0.00001) 。 The funnel polt prompts that there exists publication bias. The Fail-safe number indicates that both the stability and reliability are well.Conclusion: Exposure to antibiotics during infancy period seem to slightly increase the risk of childhood asthma according to this Meta-analysis. |
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