| ObjectivesTo investigate the prevalence of mode of delivery and childhood asthma in Anqing,Tongling,Wuhu and Yangzhou in the middle and lower reaches of the Yangtze River.To examine the association between Cesarean section(CS)and childhood asthma in preschool children.MethodsA total of 9 103 children who were aged from 3 to 6 years were recruited in Anqing,Tongling,Wuhu and Yangzhou.Information of the mode of delivery,asthma and potential confounders for the present study were collected by questionnaires completed by the parents,and 8 900(97.8%)questionnaires were remained.Without twins,there are 8704 children in this study,included 4 602(52.9%)of boys.There are2 198 children in 9 kindergartens from Anqing included 1 154(52.5%)of boys,2 136 children in 11 kindergartens from Tongling included 1 134(53.1%)of boys,1 882 children in 9 kindergartens from Wuhu included 982(52.2%)of boys,and 2 488 children in 7 kindergartens from Yangzhou included 1 332(53.5%)of boys.Information of baseline characteristics,mode of delivery,breastfeeding,matenal age,mother smoking and drinking,BMI of children,GDP and the concentration of PM2.5 were collected.All asthma cases were diagnosed by major hospitals.Mode of delivery was categorized according to the questionnaires about vaginal delivery(VD)or CS? If the children were born of CS,the mode of CS was classified into CS at maternal request and CS with medical indications(belong to elective CS),CS followed vaginal birth(belong to non-elective CS).One-way analysis of variance(ANOVA)and c2 test were used to evaluate continuous and categorical variables in groups,binary logistic regression was used to explore the relationship between VD,elective CS and non-elective CS.ResultsThe prevalence of childhood asthma was 7.0%.Besides,the prevalence of VD,elective CS and non-elective CS were 2 868(33.0%),5 060(58.1%)and 776(8.9%).The highest rate of CS is Anqing(78.5%)and the lowest is Tongling(21.1%);the highest rate of elective CS is Anqing(69.9%)and the lowest is Tongling(42.9%);the highest rate of non-elective CS is Wuhu(10.4%)and the lowest is Yangzhou(7.3%).The highest rate of childhood asthma is Yangzhou(8.8%)and the lowest is Wuhu(4.0%).The concentration of PM2.5 is higher had higer prevalence of childhood asthma in 4 cities(P<0.01).The GDP was highest,followed by the rate of VD,whereas the rate of CS and elective CS were lowest(P<0.01).The single factor chi-square analysis discovered that the risk of chidhood asthma was associated with parents’ education,maternal age,sex,mode of delivery,premature delivery,breastfeeding and BMI of children.The results suggested that compared with Wuhu had the best quality of air quality,the risk of childhood asthma is higer in Yangzhou,Anqing and Tongling,OR values(95%CI)were 2.31(95%CI: 1.77-3.03),1.88(95%CI: 1.41-2.49)and 1.87(95%CI: 1.41-2.49).After controlling for region,the results suggested that compare with VD,CS was the risk of childhood asthma,OR value(95%CI)was 1.21(95%CI: 1.01-1.45).After controlling for region,sex,premature delivery and breastfeeding,the results suggested that compare with VD,CS was the risk of childhood asthma,OR value(95%CI)was 1.20(95%CI:1.00-1.45).After controlling for region,sex,premature delivery,breastfeeding,childhood obesity,birth weight,the results suggested that OR value(95%CI)was 1.20(95%CI:1.00-1.44).Compared with VD,there is no difference in elective CS and non-elective CS(P>0.05).ConclusionCS and childhood asthma were prevalent now,the characteristics of children and parents were the factor of childhood asthma.Generally,the prevalence of asthma was higher in boys and the children delivered by CS.These findings also highlight the need attention of reduce rates of childhood asthma and CS. |
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