This study aims to analyze the differentiating factors between only allergic rhinitis and allergic rhinitis combined with other allergic diseases in pre-school children and to explore the impact of relevant family and maternal factors during pregnancy on pediatric allergic diseases.The study employed an epidemiological cross-sectional survey design, conducted from January to June 2022 at the Helong Street Health Service Center in Baiyun District, Guangzhou City, China. This cross-sectional investigation focused on 15 preschool education centers within the jurisdiction. It encompassed a total of 4 661 pre-school children aged 3-6 years within the district, resulting in the collection of 3 437 valid questionnaires. The study utilized an online survey, covering aspects such as children's birth conditions, early living environment, maternal lifestyle and emotional state during pregnancy, and paternal information. The questionnaire was designed by an expert team and incorporated advanced logic functions to ensure data accuracy. Diagnosis of allergic diseases included evaluation of symptoms such as rhinitis, asthma, eczema and along with collecting family member's allergy information. Factors like maternal emotional stress during pregnancy, premature birth, and breastfeeding were also considered. The analysis of frequency differences between groups was conducted using the Chi-square test. The distribution differences between two groups were examined using the t-test or Mann-Whitney U test. Additionally, binary logistic regression analysis was employed to identify risk factors for the occurrence of allergic diseases. To illustrate the distribution and co-occurrence of different allergic diseases in children, upset plots were created. Furthermore, forest plots were utilized to analyze the risk factors. The study included 455 children with only allergic rhinitis and 759 children with rhinitis combined with other allergic diseases. The results showed no significant demographic differences between the two groups. Logistic model results indicated that children with allergic rhinitis who had suffered from severe eczema within the first 12 months had a OR(95%CI):19.818 times (2.670-147.095) higher probability of developing combined allergic diseases than those without eczema, while the probability increased 2.345 times (1.825-3.013) for those with mild to moderate eczema. A higher level of maternal education was also identified as a risk factor, increasing the risk by about 1.5 times. Additionally, the risk of developing combined allergic diseases in children with one allergic parent was OR(95%CI):1.662 times (1.273-2.170) higher than in those with non-allergic parents, and 2.181 times (1.504-3.163) higher if both parents had allergies. Moreover, negative maternal emotional stress during pregnancy was more significant in children with combined allergic diseases. In conclusion, severe eczema in the first 12 months, mild to moderate eczema; allergies in one or both parents; parents' educational level, household disposable income level; firstborn status; and negative maternal emotions during pregnancy are risk factors for children with allergic rhinitis combined with other allergic diseases.
分析学前教育儿童中单纯过敏性鼻炎与过敏性鼻炎合并其他过敏性疾病之间的差异性因素，并探讨家庭和母亲妊娠期对儿童过敏性疾病的影响因素。采用流行病学横断面调查研究设计，于2022年1—6月在广州市白云区鹤龙街卫生服务中心针对辖区内15所学前教育中心开展，涵盖了该辖区内的4 661名3~6岁学龄前儿童，回收有效问卷3 437份。研究采用在线问卷方式，内容包括孩子的出生条件、早期生活环境、母亲孕期生活方式及情绪状态和父亲信息等。问卷设计由专家团队负责，采用了logistic回归分析儿童过敏性鼻炎合并其他过敏性疾病的危险因素。过敏性疾病的诊断涉及对鼻炎、哮喘、湿疹等症状的评估，并收集了家庭成员的过敏信息，同时考察了母亲妊娠期情绪压力、早产、母乳喂养等因素。使用卡方检验分析组间频率差异，采用t检验或Mann-Whitney U检验分析两组间的分布差异，以及采用二元logistic回归分析过敏性疾病发生的危险因素。并绘制upset图展示儿童不同过敏性疾病患病及交叉患病的分布情况，采用森林图分析风险因素。结果显示，单纯过敏性鼻炎学前教育儿童为455例，过敏性鼻炎合并其他过敏性疾病儿童为759例。两组儿童在基本人口学特征上无显著差异。logistic模型结果显示，12月龄内患重度湿疹的过敏性鼻炎儿童合并其他过敏性疾病的概率是无湿疹儿童的OR（95%CI）值为19.818（2.670~147.095）倍，而患轻-中度湿疹的儿童增加2.345（1.825~3.013）倍。母亲的更高的学历也是过敏性鼻炎儿童合并其他过敏性疾病的风险因素，并增加约1.5倍的风险。另一方面，家长一方过敏的过敏性鼻炎儿童合并其他过敏性疾病的风险是父母亲均无过敏的鼻炎儿童的OR（95%CI）值为1.662（1.273~2.170）倍，而父母亲双方均过敏的鼻炎儿童则增加2.181（1.504~3.163）倍。此外，母亲妊娠期间的负面情绪在合并其他过敏性疾病的儿童中更为显著。综上，12月龄内曾患重度湿疹、患轻-中度湿疹，父母亲有一方过敏或双方过敏，父母亲的文化程度、家庭月可支配金额水平，第一胎出生，母亲孕期负向情绪可能是过敏性鼻炎儿童合并其他过敏性疾病的危险因素。.