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研究生:蘇意淳
研究生(外文):SU,YI-CHUN
論文名稱:媽媽懷孕期間素食飲食與兒童異位性皮膚炎之關係
論文名稱(外文):The association between maternal vegetarian diets during pregnancy and atopic dermatitis in children
指導教授:謝佳容謝佳容引用關係
指導教授(外文):HSIEH,CHIA-JUNG
口試委員:謝佳容張慈桂張榮華
口試委員(外文):HSIEH,CHIA-JUNGCHANG,TZU-KUEIJAN,RONG-HWA
口試日期:2023-04-28
學位類別:碩士
校院名稱:慈濟大學
系所名稱:公共衛生學系碩士班
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2023
畢業學年度:111
語文別:中文
論文頁數:86
中文關鍵詞:素食飲食異位性皮膚炎懷孕期間出生世代
外文關鍵詞:Vegetarian dietAtopic dermatitisPregnancyBirth Cohort
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研究背景:異位性皮膚炎為常見易復發且慢性皮膚發炎疾病,且近年來全球異位 性皮膚炎盛行率有逐年上升趨勢,過去研究指出空氣污染、塵蟎、家族過敏疾病 史與飲食等皆會誘發過敏反應發生。先前研究指出子宮內暴露會影響兒童早期免 疫系統發育,且懷孕期間攝入較多蔬果對後代罹患過敏疾病具有保護作用。然而 目前較少研究針對懷孕期間素食飲食與異位性皮膚炎之探討。因此本研究欲透過 臺灣出生世代資料庫探討媽媽懷孕期間素食飲食與兒童異位性皮膚炎之關係。 材料與方法:本研究使用臺灣出生世代資料庫。針對民國 94 年 1 至 12 月期間, 全臺灣 369 個鄉鎮中分層隨機抽出 85 個鄉鎮市區作為樣本地區,最終以 24,200 位出生通報之新生兒作為研究對象,並在新生兒出生後 6 個月及 18 個月時進行 第一及第二次追蹤調查,本研究採用同時具有 6 個月及 18 個月之問卷資料。於6 個月問卷中詢問媽媽懷孕期間飲食習慣(非素食、蛋奶素與全素),以及 6 個月 與 18 個月中收集兒童異位性皮膚炎之診斷情形。本研究依照媽媽年齡、教育程 度與兒童性別以 1:10 配對方式進行分析,配對後素食組有 408 位,非素食組有 4080 位,最終共 4488 位納入分析。統計方法使用獨立樣本 t 檢定、單因子變異 數分析、卡方檢定分析媽媽與兒童基本人口學特徵及兒童異位性皮膚炎分佈情形, 再使用複羅吉斯迴歸探討媽媽懷孕期間素食飲食與兒童異位性皮膚炎之相關性; 此外,利用分層分析控制各干擾因子與其之影響。
結果:本研究素食飲食比例佔 2.4%。相較於非素食組,素食組在家庭月收入及 二手菸暴露較低,有母乳哺餵顯著較高。懷孕期間素食飲食與兒童異位性皮膚炎 之探討主要發現,素食組(8.8%)兒童 18 個月前異位性皮膚炎相較於非素食組 (13.4%)呈顯著較低。分析素食飲食與兒童異位性皮膚炎關係之羅吉斯斯迴歸結 果發現,媽媽懷孕期間素食組相較非素食組,兒童 18 個前月患有異位性皮膚炎 之風險低 35% (OR=0.65, 95%CI=0.45-0.93, p=0.02)。
結論:根據本研究結果發現,懷孕期間素食飲食與兒童 18 個月前異位性皮膚炎 具有保護作用。由於本研究素食族群樣本數較小,建議未來能增加素食飲食個案 數,提高樣本解釋力;此外,可持續追蹤及進一步釐清同一出生世代兒童之媽媽 懷孕期間飲食與後代過敏疾病的長期健康效應。
Background: Atopic dermatitis is a common and easily recurring inflammatory disease of the skin. Over the last few years, the global prevalence of atopic dermatitis has been increasing annually. Past research has indicated that air pollution, mites, a family history of allergic diseases, and diet are some of the factors that can cause allergic reactions. Previous research has also indicated that in-utero exposure can affect the development of the immune system in early childhood. Additionally, consuming more vegetables and fruits during pregnancy has protective effects for offspring with allergic diseases. However, there is currently limited research on the relationship between vegetarian diets during pregnancy and atopic dermatitis. Therefore, this study aims to explore the association between maternal vegetarian diet during pregnancy and atopic dermatitis in children through the Taiwan Birth Cohort Study.
Materials and Methods: This study utilized data from the Taiwan Birth Cohort Study. Among 369 townships, 85 study areas were stratified and randomly selected. Finally, 24,200 newborns with birth notifications in Taiwan in 2005 were selected as research subjects. The first and second follow-up surveys were conducted at 6 months and 18 months after birth, respectively. Complete information collected from both the 6-month and 18-month questionnaires was used in this study. Mothers were asked about their eating habits (non-vegetarian, lacto-vegetarian, and vegan) during pregnancy in the 6-month questionnaire. The diagnosis of atopic dermatitis in children was collected in the 6-month and 18-month questionnaires. Statistical analysis included 1:10 matching based on maternal age, mother's education level, and baby's sex. After matching, there were 408 vegetarians and 4080 non-vegetarians, resulting in a total of 4488 subjects included in the analysis. Statistical methods, including independent sample t-tests, one-way analysis of variance, and chi-square tests, were used to analyze the basic demographic characteristics of mothers and children, as well as the distribution of atopic dermatitis in children. We utilized multiple logistic regression to analyze the relationship between maternal vegetarian diet during pregnancy and atopic dermatitis in children. Additionally, stratified analysis was used to control for confounding effects in the statistical results.
Results: In this study, the proportion of individuals following a vegetarian diet was 2.4% compared with the non-vegetarian group. The vegetarian group had significantly lower household monthly income, less exposure to second-hand smoke, and higher breastfeeding frequency. The main findings revealed that a maternal vegetarian diet during pregnancy was associated with a lower prevalence of atopic dermatitis in children. Children under 18 months of age had a significantly lower incidence of atopic dermatitis in the vegetarian group (8.8%) compared to the non-vegetarian group (13.4%). Logistic regression analysis examining the relationship between vegetarian diet during pregnancy and atopic dermatitis in children at different stages, found that the risk of atopic dermatitis in children under 18 months of age was lower in the vegetarian group compared to the non-vegetarian group (OR=0.65, 95% CI=0.45-0.93, p=0.02).
Discussion: According to the results of this study, there is a protective effect between vegetarian diet during pregnancy and atopic dermatitis in children before 18 months of age. Furthermore, it was found that vegetarian diet had protective effects. It is recommended to increase the number of vegetarian cases in the future studies to improve statistical power. Continue to track and further elucidate the long-term health effects of maternal diet during pregnancy on offspring allergic diseases in children of the same birth generation.
第一章 研究背景與動機..........................................................................................1
第二章 文獻探討......................................................................................................2
第一節 素食飲食...................................................................................................................... 2
第二節 異位性皮膚炎 .............................................................................................................. 4
第三節 素食飲食與其他健康效應之關係.............................................................................. 11
第四節 飲食與過敏疾病相關性 ............................................................................................. 14
第三章 材料與方法................................................................................................17
第一節 研究對象及研究設計................................................................................................. 17
第二節 研究資料收集 ............................................................................................................ 19
第三節 研究變項.................................................................................................................... 19
第四節 統計分析方法 ............................................................................................................ 21
第四章 結果 ...........................................................................................................22
第一節 媽媽及兒童基本人口學特徵...................................................................................... 22
第二節 兒童異位性皮膚炎之比例與媽媽及兒童基本人口學特徵 ........................................ 28
第三節 兒童不同時期異位性皮膚炎發生情形 ...................................................................... 33
第四節 素食飲食與兒童不同時期異位性皮膚炎之關係 ....................................................... 35
第五節 分層分析探討素食飲食與兒童異位性皮膚炎之關係................................................ 39
第五章 討論 ...........................................................................................................44
第一節 主要發現.................................................................................................................... 44
第二節 懷孕期間素食飲食與兒童異位性皮膚炎關係 ........................................................... 44
第三節 研究優勢與限制......................................................................................................... 46
第四節 結果與建議 ................................................................................................................ 46
附件一、研究許可書 ..............................................................................................75
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