Pediatric allergy and respiratory disease (소아알레르기 및 호흡기학회지)

The Korean Academy of Pediatric Allergy and Respiratory Diseasse (대한소아알레르기호흡기학회)
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Effects of Family History on the Occurrence of Atopic Dermatitis in Infants

알레르기 가족력이 영아기 아토피피부염 발생에 미치는 영향

Kim, Hye-Young;Jang, Eun-Young;Sim, Jae-Hoon;Kim, Ji-Hyun;Chung, Young-Hee;Park, Su-Hwa;Hwang, Eun-Mi;Han, Young-Shin;Ahn, Kang-Mo;Lee, Sang-Il
김혜영;장은영;심재훈;김지현;정영희;박수화;황은미;한영신;안강모;이상일

  • Published : 20090600
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Abstract

Purpose : The prevalence of atopic dermatitis (AD) has been increased in Korea. We aim to investigate the risk factors for development of AD in infants, especially those factors related to the family history. Methods : The data from 542 infants in our prospective birth cohort study were analyzed. The data from their parent were collected by questionnaires and skin prick tests. They were regularly followed up at 1 year of age when the presence of AD and allergen sensitization was determined. Various factors such as sex, cesarean section delivery, duration of breast feeding, presence of siblings, vaccination, antibiotic use and pet keeping were also assessed. Results : AD developed in 109 infants (20.4%). In univariate analysis, the presence of either maternal or paternal allergic diseases increased the risk for development of AD in their infants. Multivariate logistic analysis, however, showed that only the presence of maternal allergic diseases correlated with the development of AD (P=0.018). While AD developed in 14.7% in infants of parents with no allergic history, the incidences of AD in infants with a single parent allergy history and in those with 2 parent allergy history were 27.0% and 41.7%, respectively. Their adjusted relative risks (95% confidence intervals) were 1.85 (1.24-2.89) and 2.93 (1.68-4.96), respectively. Conclusion : Parental allergic diseases, especially maternal allergic diseases, are possible risk factors for development of AD in Korean infants.

목 적 : 국내 아토피피부염은 증가 추세로 위험 요인을 파악하는 것은 효율적인 예방과 치료 관리에 도움이 될 것이다. 전향적 출생 코호트 연구를 통하여 부모의 알레르기 병력에 따른 영아 아토피피부염의 발생률 및 위험도를 알아보고자 하였다. 방 법 : 2006년 7월부터 12월까지 재태주수 34주 이상된 산모를 모집한 후 설문조사 및 피부단자 시험을 시행하였고 이들로부터 출생하여 생후 12개월까지 추적 관찰이 가능했던 영아 542명을 대상으로 아토피피부염 발생 여부를 조사하였다. 출산 전 설문 조사를 통하여 부모의 알레르기 병력, 형제 수, 흡연력, 애완동물 여부 및 어머니의 학력을 조사하였고 출산 후 영아의 성별, 출생력, 수유형태, 예방접종력, 질환력 및 항생제 사용력을 조사하였다. 아토피피부염의 진단은 소아청소년과 알레르기 전문의의 진료를 통하여 이루어졌고 임상적 중증도는 SCORAD 점수를 사용하여 평가하였다. 아토피피부염으로 진단받은 환아들은 특이 IgE 유무에따라 외인성 및 내인성 아토피피부염으로 분류하였다. 결 과 : 총 542명 영아(남아 272명, 여아 270명)를 12개월까지 추적 관찰하였을 때 아토피피부염으로 진단받은 영아는 109명(20.1%)였다. 이들 중105명 영아의 혈청으로 특이 IgE 검사를 시행하였고 75명(71.4%)은 외인성 아토피피부염으로 30명(28.6%)은 내인성 아토피피부염으로 진단되었다. 다변량 분석시 엄마가 알레르기 질환력이 있는 경우 aRR (95% CI)는 2.03 (1.12-4.10)로 아토피피부염 발생이 가장 중요한 위험인자로 조사되었고 엄마의 아토피피부염 병력과 호흡기 알레르기 질환력은 모두 aRR 2.15 (1.44-3.25)과 1.85 (1.24-2.43)로 통계학적 유의성을 보였다. 부모의 알레르기 병력이 없는 군에서는 영아의 아토피피부염 발생률은 14.7%였고, 한쪽 부모만 병력이 있는 경우는 27.0% (aRR, 1.85, 95% CI : 1.24-2.89), 부모모두 병력이 있는 경우 41.7% (aRR, 2.93, 95% CI : 1.68-4.96)의 발생률을 보였다. 결 론 : 생후 12개월까지의 아토피피부염의 발생률은 20.1%였고 발생의 주된 위험인자는 어머니의 알레르기 질환력이었다. 또한 부모의 알레르기 질환력 유무에 따라 아토피피부염 발생의 위험도는 최고 2.93배 증가되어 아토피피부염 발생과 부모의 알레르기 질환력의 밀접한 연관성을 알 수 있었다.

Keywords

References

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