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首页> 外文期刊>Pediatric allergy and immunology: official publication of the European Society of Pediatric Allergy and Immunology >Anthelminthic treatment during pregnancy is associated with increased risk of infantile eczema: randomised-controlled trial results.
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Anthelminthic treatment during pregnancy is associated with increased risk of infantile eczema: randomised-controlled trial results.

机译：妊娠期驱虫药治疗与婴儿湿疹风险增加相关：随机对照试验结果。

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BACKGROUND: Allergy is commoner in developed than in developing countries. Chronic worm infections show inverse associations with allergy, and prenatal exposures may be critical to allergy risk. OBJECTIVE: To determine whether anthelminthic treatment during pregnancy increases the risk of allergy in infancy. METHODS: A randomised, double-blind, placebo-controlled trial on treatment in pregnancy with albendazole versus placebo and praziquantel versus placebo was conducted in Uganda, with a 2 x 2 factorial design; 2507 women were enrolled; infants' allergy events were recorded prospectively. The main outcome was doctor-diagnosed infantile eczema. RESULTS: Worms were detected in 68% of women before treatment. Doctor-diagnosed infantile eczema incidence was 10.4/100 infant years. Maternal albendazole treatment was associated with a significantly increased risk of eczema [Cox HR (95% CI), p: 1.82 (1.26-2.64), 0.002]; this effect was slightly stronger among infants whose mothers had no albendazole-susceptible worms than among infants whose mothers had such worms, although this difference was not statistically significant. Praziquantel showed no effect overall but was associated with increased risk among infants of mothers with Schistosoma mansoni [2.65 (1.16-6.08), interaction p = 0.02]. In a sample of infants, skin prick test reactivity and allergen-specific IgE were both associated with doctor-diagnosed eczema, indicating atopic aetiology. Albendazole was also strongly associated with reported recurrent wheeze [1.58 (1.13-2.22), 0.008]; praziquantel showed no effect. CONCLUSIONS: The detrimental effects of treatment suggest that exposure to maternal worm infections in utero may protect against eczema and wheeze in infancy. The results for albendazole are also consistent with a direct drug effect. Further studies are required to investigate mechanisms of these effects, possible benefits of worms or worm products in primary prevention of allergy, and the possibility that routine deworming during pregnancy may promote allergic disease in the offspring.
机译：背景：过敏症在发达国家比在发展中国家更普遍。慢性蠕虫感染显示与过敏呈反比关系，产前暴露可能对过敏风险至关重要。目的：确定妊娠期驱虫治疗是否会增加婴儿过敏的风险。方法：在乌干达进行了一项随机，双盲，安慰剂对照试验，该试验在乌干达进行了阿苯达唑与安慰剂，吡喹酮与安慰剂的治疗，采用2 x 2因子设计。登记了2507名妇女;前瞻性记录婴儿的过敏事件。主要结局是医生诊断的婴儿湿疹。结果：68％的女性在治疗前发现了蠕虫。医生诊断的婴儿湿疹发生率为10.4 / 100婴儿年。孕妇阿苯达唑治疗与湿疹风险显着增加有关[Cox HR（95％CI），p：1.82（1.26-2.64），0.002];母亲没有阿苯达唑敏感性蠕虫的婴儿的这种效果比母亲没有阿苯达唑易感蠕虫的婴儿的效果要强一些，尽管这种差异在统计学上没有统计学意义。吡喹酮总体上无作用，但与曼氏血吸虫母亲的婴儿患病风险增加相关[2.65（1.16-6.08），相互作用p = 0.02]。在婴儿样本中，皮肤点刺试验反应性和过敏原特异性IgE均与医生诊断的湿疹有关，表明特应性病因。阿苯达唑还与反复发作的喘息密切相关[1.58（1.13-2.22），0.008];吡喹酮无作用。结论：治疗的不利影响表明，子宫内暴露于母体蠕虫感染可预防婴儿期的湿疹和喘息。阿苯达唑的结果也与直接药物作用一致。需要进一步的研究来研究这些影响的机制，蠕虫或蠕虫产品在初步预防过敏中的可能益处以及怀孕期间常规驱虫可能促进后代过敏性疾病的可能性。

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