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Ahmadizar F, Vijverberg SJ, Arets HG, de Boer A, Lang JE, Kattan M, Palmer CN, Mukhopadhyay S, Turner S, Maitland-van der Zee AH. Childhood obesity in relation to poor asthma control and exacerbation: a meta-analysis. Eur Respir J 2016; 48:1063-1073. [DOI: 10.1183/13993003.00766-2016] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 06/11/2016] [Indexed: 01/08/2023]
Abstract
To estimate the association between obesity and poor asthma control or risk of exacerbations in asthmatic children and adolescents, and to assess whether these associations are different by sex.A meta-analysis was performed on unpublished data from three North-European paediatric asthma cohorts (BREATHE, PACMAN (Pharmacogenetics of Asthma medication in Children: Medication with Anti-inflammatory effects) and PAGES (Pediatric Asthma Gene Environment Study)) and 11 previously published studies (cross-sectional and longitudinal studies). Outcomes were poor asthma control (based on asthma symptoms) and exacerbations rates (asthma-related visits to the emergency department, asthma-related hospitalisations or use of oral corticosteroids). Overall pooled estimates of the odds ratios were obtained using fixed- or random-effects models.In a meta-analysis of 46 070 asthmatic children and adolescents, obese children (body mass index ≥95th percentile) compared with non-obese peers had a small but significant increased risk of asthma exacerbations (OR 1.17, 95% CI 1.03–1.34; I2: 54.7%). However, there was no statistically significant association between obesity and poor asthma control (n=4973, OR 1.23, 95% CI 0.99–1.53; I2: 0.0%). After stratification for sex, the differences in odds ratios for girls and boys were similar, yet no longer statistically significant.In asthmatic children, obesity is associated with a minor increased risk of asthma exacerbations but not with poor asthma control. Sex does not appear to modify this risk.
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202
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Turner S. Antenatal origins of reduced lung function-but not asthma? Respirology 2016; 21:574-5. [PMID: 27099098 DOI: 10.1111/resp.12794] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 03/07/2016] [Indexed: 01/08/2023]
Affiliation(s)
- Steve Turner
- Child Health, Royal Aberdeen Children's Hospital, University of Aberdeen, Aberdeen, UK
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203
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Federico MJ, Hoch HE, Anderson WC, Spahn JD, Szefler SJ. Asthma Management for Children: Risk Identification and Prevention. Adv Pediatr 2016; 63:103-26. [PMID: 27426897 DOI: 10.1016/j.yapd.2016.04.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Monica J Federico
- Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, 13123 East 16th Avenue, Aurora, CO 80045, USA
| | - Heather E Hoch
- Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, 13123 East 16th Avenue, Aurora, CO 80045, USA
| | - William C Anderson
- Pediatric Allergy & Immunology, University of Colorado School of Medicine, Children's Hospital Colorado, 13123 East 16th Avenue, Aurora, CO 80045, USA
| | - Joseph D Spahn
- Pediatric Allergy & Immunology, University of Colorado School of Medicine, Children's Hospital Colorado, 13123 East 16th Avenue, Aurora, CO 80045, USA
| | - Stanley J Szefler
- Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, 13123 East 16th Avenue, Aurora, CO 80045, USA.
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204
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Abstract
BACKGROUND The influence of maternal infection during pregnancy on allergic disorders in offspring is not well understood. We performed a systematic review and meta-analysis to evaluate current evidence on the association between maternal infection during pregnancy and asthma or eczema in offspring. METHODS We searched databases (PubMed, EMBASE, Medline, and Web of Science) for all relevant studies published before March 2016. Any cohort studies, case-control studies, or cross-sectional studies published in English and focused on the association between maternal infection during pregnancy and the risk of asthma or eczema in offspring were included. Random-effects models were used for combined analyses. RESULTS A total of 10 studies with 299,830 participants were included. Maternal infection was associated with an increased risk for asthma (odds ratio [OR]: 1.55; 95% confidence interval [CI]: 1.24-1.92; P < 0.01) and eczema (OR: 1.36; 95% CI: 1.13-1.64; P < 0.01). Further analyses showed associations between asthma and several specific maternal infections: fever episode (OR: 1.73; 95% CI: 1.35-2.23), chorioamnionitis (OR: 1.42; 95% CI: 0.96-2.11), respiratory infection (OR: 1.49; 95% CI: 0.94-2.36), and urogenital infection (OR: 1.39; 95% CI: 1.18-1.64). CONCLUSION The results from this meta-analysis and systematic review provide evidence that maternal infection during pregnancy might be related to subsequent asthma and eczema in offspring. However, there was variation of included studies with regard to type of maternal infection, age of children, and methods of exposure ascertainment. Additional studies are needed to further confirm these associations.
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Affiliation(s)
- Tingting Zhu
- Department of Pediatrics, West China Second University Hospital Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, Sichuan, P.R. China Department of Pediatrics, University of California, San Francisco, San Francisco, CA
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205
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Liu W, Huang C, Hu Y, Fu Q, Zou Z, Sun C, Shen L, Wang X, Cai J, Pan J, Huang Y, Chang J, Sun Y, Sundell J. Associations of gestational and early life exposures to ambient air pollution with childhood respiratory diseases in Shanghai, China: A retrospective cohort study. ENVIRONMENT INTERNATIONAL 2016; 92-93:284-293. [PMID: 27128713 DOI: 10.1016/j.envint.2016.04.019] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 04/12/2016] [Accepted: 04/13/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Associations of ambient air pollutants with respiratory health are inconsistent. OBJECTIVES We analyzed the associations of gestational and early life exposures to air pollutants with doctor-diagnosed asthma, allergic rhinitis, and pneumonia in children. METHODS We selected 3358 preschool children who did not alter residences after birth from a cross-sectional study in 2011-2012 in Shanghai, China. Parents reported children's respiratory health history, home environment, and family lifestyle behaviors. We collected daily concentrations of sulphur dioxide (SO2), nitrogen dioxide (NO2), and particulate matter with an aerodynamic diameter ≤10μm (PM10) during the child's total lifetime (2006-2012) for each district where the children lived. We analyzed the associations using logistic regression models. RESULTS After adjusting for covariates and the other studied pollutants, we found that exposure to NO2 (increment of 20μg/m(3)) during the first year of life was significantly associated with asthma [odds ratio (OR)=1.77; 95% confidence interval (CI): 1.29-2.43] and allergic rhinitis (OR=1.67; 95% CI: 1.07-2.61). Exposure to NO2 during gestation, the first two and three years, and over total lifetimewas all consistently associated with increased odds of allergic rhinitis. Quartiles of NO2 concentration during different exposure periods showed a slight dose-response relationship with the studied diseases. These diseases had significant associations with pollutant mixtures that included NO2, but had no significant association with exposures to SO2 and PM10 individually or in mixtures. CONCLUSIONS Gestational and early life exposures to ambient NO2 are risk factors for childhood respiratory diseases.
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Affiliation(s)
- Wei Liu
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Chen Huang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China.
| | - Yu Hu
- Tongji Architectural Design (Group) Company Limited (TJAD), Shanghai, China
| | - Qingyan Fu
- Shanghai Environmental Monitoring Center (SEMC), Shanghai, China
| | - Zhijun Zou
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Chanjuan Sun
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Li Shen
- R&B Technology (Shanghai) Company Limited, Shanghai, China
| | - Xueying Wang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Jiao Cai
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Jun Pan
- Shanghai Environmental Monitoring Center (SEMC), Shanghai, China
| | - Yanmin Huang
- Shanghai Environmental Monitoring Center (SEMC), Shanghai, China
| | - Jing Chang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China; Department of Thermal Energy and Power Engineering, Shandong Jiaotong University, Jinan, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Jan Sundell
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China; Department of Building Science, Tsinghua University, Beijing, China
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206
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Popovic M, Pizzi C, Rusconi F, Galassi C, Gagliardi L, De Marco L, Migliore E, Merletti F, Richiardi L. Infant weight trajectories and early childhood wheezing: the NINFEA birth cohort study. Thorax 2016; 71:1091-1096. [DOI: 10.1136/thoraxjnl-2015-208208] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 05/16/2016] [Accepted: 06/07/2016] [Indexed: 12/14/2022]
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207
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Tourino LFPG, Corrêa-Faria P, Ferreira RC, Bendo CB, Zarzar PM, Vale MP. Association between Molar Incisor Hypomineralization in Schoolchildren and Both Prenatal and Postnatal Factors: A Population-Based Study. PLoS One 2016; 11:e0156332. [PMID: 27280451 PMCID: PMC4900662 DOI: 10.1371/journal.pone.0156332] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 05/12/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although studies throughout the world have investigated potential factors involved in the occurrence of molar incisor hypomineralization (MIH), the findings are varied and inconclusive. OBJECTIVE The aim of the present study was to evaluate the prevalence of MIH and identify associated prenatal, perinatal and postnatal factors among Brazilian schoolchildren aged 8 and 9 years. METHODS A cross-sectional study was conducted with a randomly selected population-based sample of 1181 schoolchildren. Information on demographic and socioeconomic characteristics as well as prenatal, perinatal and postnatal aspects was obtained through questionnaires. The clinical examination included the investigation of MIH based on the criteria of the European Academy of Paediatric Dentistry. Dental caries in the permanent dentition and developmental defects of enamel (DDE) on the primary second molars were also recorded. Data analysis involved descriptive statistics, bivariate tests and Poisson regression with robust variance. RESULTS The prevalence of MIH was 20.4%. MIH was more frequent among children with dental caries in the permanent dentition (PR: 2.67; 95% CI: 1.98-3.61), those with DDE on the primary second molars (PR: 2.54; 95% CI: 1.87-3.45) and those who experienced asthma/bronchitis in the first four years of life (PR: 1.93; 95% CI: 1.45-2.56). CONCLUSIONS The prevalence of MIH was high and was associated with dental caries, the presence of DDE on primary second molars and the experience of asthma/bronchitis in early life. These findings could be useful in the identification of children in need of shorter recall intervals to prevent the consequences of MIH, such as enamel breakdown dental caries.
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Affiliation(s)
| | - Patrícia Corrêa-Faria
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Raquel Conceição Ferreira
- Department of Public Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Cristiane Baccin Bendo
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Patrícia Maria Zarzar
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Miriam Pimenta Vale
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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208
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Raheleh Z, Ahmad A, Abtin H, Roghaye Z, Sara H, Siavash R. The Association between Birth Weight and Gestational Age and Asthma in 6-7- and 13-14-Year-Old Children. SCIENTIFICA 2016; 2016:3987460. [PMID: 27379196 PMCID: PMC4917703 DOI: 10.1155/2016/3987460] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 04/06/2016] [Accepted: 05/04/2016] [Indexed: 06/06/2023]
Abstract
Background. Previous studies that assessed the role of birth weight and gestational age in the risk of asthma have been conflicting. Objectives. To examine the association between birth weight and gestational age and symptoms of asthma. Patients and Methods. Subjects were 6656 school children of ages 6-7 and 13-14 years from urban districts of Mazandaran, Iran. ISAAC questionnaires were used. Results. There was an increased risk of "wheeze ever" in both age groups with birth weight under 2.5 kg and in all subgroups of low birth weight (LBW). Birth weight more than 3.5 kg was associated with lower risk of "severe asthma" in age group 6-7 years. With respect to gestational age, higher risks of "wheeze ever," "asthma ever," and "night cough in the past 12 months" were found in age group 13-14 years born before 37 weeks and the risk of "severe asthma" was higher in younger group (6-7 years). A lower risk of "asthma ever" was also found in 6-7-year-old children and 13-14-year-old girls who were born after 40 weeks. Conclusions. This study showed that there is a direct relation between "wheeze ever" and LBW and an inverse relation between risk of "severe asthma" and birth weight more than 3.5 kg.
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Affiliation(s)
- Zamani Raheleh
- Department of Pediatrics, Faculty of Medicine, Mazandaran University of Medical Sciences, International Branch, Basij Avenue, P.O. Box 4815733971, Juybar, Sari, Iran
| | - Alikhani Ahmad
- Infectious Diseases Department and Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Basij Avenue, P.O. Box 4815733971, Juybar, Sari, Iran
| | - Heydarzadeh Abtin
- Community Medicine Department, Gilan University of Medical Sciences, Rasht, Iran
| | - Zare Roghaye
- Epidemiology & Biostatistics Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Hashemain Sara
- Ramsar Branch of Mazandaran University of Medical Sciences, Basij Avenue, P.O. Box 4815733971, Juybar, Sari, Iran
| | - Rahimi Siavash
- Ramsar Branch of Mazandaran University of Medical Sciences, Basij Avenue, P.O. Box 4815733971, Juybar, Sari, Iran
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209
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Edwards MO, Kotecha SJ, Lowe J, Richards L, Watkins WJ, Kotecha S. Management of Prematurity-Associated Wheeze and Its Association with Atopy. PLoS One 2016; 11:e0155695. [PMID: 27203564 PMCID: PMC4874578 DOI: 10.1371/journal.pone.0155695] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 05/03/2016] [Indexed: 11/30/2022] Open
Abstract
Introduction Although preterm birth is associated with respiratory morbidity in childhood, the role of family history of atopy and whether appropriate treatment has been instituted is unclear. Thus we assessed (i) the prevalence of respiratory symptoms, particularly wheezing, in childhood; (ii) evaluated the role of family history of atopy and mode of delivery, and (iii) documented the drug usage, all in preterm-born children compared to term-born control children. Methods We conducted a cross-sectional population-based questionnaire study of 1–10 year-old preterm-born children (n = 13,361) and matched term-born controls (13,361). Data (n = 7,149) was analysed by gestational groups (24–32 weeks, 33–34 weeks, 35–36 weeks and 37–43 weeks) and by age, <5 years old or ≥ 5 years. Main Results Preterm born children aged <5 years (n = 2,111, term n = 1,402) had higher rates of wheeze-ever [odds ratio: 2.7 (95% confidence intervals 2.2, 3.3); 1.8 (1.5, 2.2); 1.5 (1.3, 1.8) respectively for the 24–32 weeks, 33–34 weeks, 35–36 weeks groups compared to term]. Similarly for the ≥5 year age group (n = 2,083, term n = 1,456) wheezing increased with increasing prematurity [odds ratios 3.3 (2.7, 4.1), 1.8 (1.5, 2.3) and 1.6 (1.3, 1.9) for the three preterm groups compared to term]. At both age groups, inhaler usage was greater in the lowest preterm group but prematurity-associated wheeze was independent of a family history of atopy. Conclusions Increasing prematurity was associated with increased respiratory symptoms, which were independent of a family history of atopy. Use of bronchodilators was also increased in the preterm groups but its efficacy needs careful evaluation.
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Affiliation(s)
- Martin O. Edwards
- Department of Child Health, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Sarah J. Kotecha
- Department of Child Health, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - John Lowe
- Department of Child Health, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Louise Richards
- Department of Child Health, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - W. John Watkins
- Department of Child Health, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Sailesh Kotecha
- Department of Child Health, Cardiff University School of Medicine, Cardiff, United Kingdom
- * E-mail:
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210
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Belfort MB, Cohen RT, Rhein LM, McCormick MC. Preterm infant growth and asthma at age 8 years. Arch Dis Child Fetal Neonatal Ed 2016; 101:F230-4. [PMID: 26354369 DOI: 10.1136/archdischild-2015-308340] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 08/19/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To examine associations of gain in body mass index (BMI) and linear growth from term to 18 months with asthma at age 8 years in a cohort of preterm infants. We hypothesised that rapid BMI gain would increase asthma risk, whereas rapid linear growth would be protective. DESIGN Observational secondary analysis of data from the Infant Health and Development Program. SETTING 8 centres in the USA. PATIENTS 863 preterm (≤37 weeks), low birthweight (≤2500 g) children. MAIN EXPOSURE VARIABLES Gain in BMI and linear growth from term to 4 months, 4-12 months and 12-18 months, in z-scores. MAIN OUTCOME MEASURE Asthma at age 8 years, assessed by parent report of the child ever receiving the diagnosis from a doctor. RESULTS At age 8 years, 149 (17%) had ever been diagnosed with asthma. Adjusting for maternal and child factors in logistic regression, for each additional z-score gain in BMI from term to 4 months, odds of asthma at age 8 years were higher (OR 1.3, 95% CI 1.1 to 1.5); findings were similar for BMI gain from 4-12 months. More rapid linear growth from term to 4 months was not associated with lower odds of asthma (OR 1.1, 95% CI 0.9 to 1.3), with similar findings for 4-12 months and 12-18 months. CONCLUSIONS More rapid BMI gain in the 1st year of life was associated with higher odds of asthma, whereas linear growth did not appear protective. Our results add to mounting evidence that excess weight gain after term may be harmful to preterm infants.
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Affiliation(s)
- Mandy B Belfort
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Robyn T Cohen
- Division of Pediatric Pulmonary and Allergy, Boston Medical Center, Boston, Massachusetts, USA
| | - Lawrence M Rhein
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA Division of Pulmonary and Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Marie C McCormick
- Department of Neonatology, Beth Israel Deaconess Medical Center, Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, USA
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211
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The recurrently wheezing preschool child-benign or asthma in the making? Ann Allergy Asthma Immunol 2016; 115:463-70. [PMID: 26653278 DOI: 10.1016/j.anai.2015.09.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 09/21/2015] [Accepted: 09/26/2015] [Indexed: 12/28/2022]
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212
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Grieger JA, Clifton VL, Tuck AR, Wooldridge AL, Robertson SA, Gatford KL. In utero Programming of Allergic Susceptibility. Int Arch Allergy Immunol 2016; 169:80-92. [PMID: 27044002 DOI: 10.1159/000443961] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Around 30-40% of the world's population will experience allergy, the most common and earliest-onset noncommunicable disease. With a steady rise in the incidence of allergic disease over recent decades, up to 18% of children will suffer a respiratory, food or skin allergy before their 18th birthday. There is compelling evidence that the risk of developing allergy is influenced by early life events and particularly in utero exposures. METHODS A comprehensive literature review was undertaken which outlines prenatal risk factors and potential mechanisms underlying the development of allergy in childhood. RESULTS Exposures including maternal cigarette smoking, preterm birth and Caesarean delivery are implicated in predisposing infants to the later development of allergy. In contrast, restricted growth in utero, a healthy maternal diet and a larger family size are protective, but the mechanisms here are unclear and require further investigation. CONCLUSION To ameliorate the allergy pandemic in young children, we must define prenatal mechanisms that alter the programming of the fetal immune system and also identify specific targets for antenatal interventions.
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Affiliation(s)
- Jessica A Grieger
- Robinson Research Institute and School of Medicine, University ofAdelaide, Adelaide, S.A., Australia
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213
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Wise PH. Child Poverty and the Promise of Human Capacity: Childhood as a Foundation for Healthy Aging. Acad Pediatr 2016; 16:S37-45. [PMID: 27044700 DOI: 10.1016/j.acap.2016.01.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 01/19/2016] [Accepted: 01/20/2016] [Indexed: 02/07/2023]
Abstract
The effect of child poverty and related early life experiences on adult health outcomes and patterns of aging has become a central focus of child health research and advocacy. In this article a critical review of this proliferating literature and its relevance to child health programs and policy are presented. This literature review focused on evidence of the influence of child poverty on the major contributors to adult morbidity and mortality in the United States, the mechanisms by which these associations operate, and the implications for reforming child health programs and policies. Strong and varied evidence base documents the effect of child poverty and related early life experiences and exposures on the major threats to adult health and healthy aging. Studies using a variety of methodologies, including longitudinal and cross-sectional strategies, have reported significant findings regarding cardiovascular disorders, obesity and diabetes, certain cancers, mental health conditions, osteoporosis and fractures, and possibly dementia. These relationships can operate through alterations in fetal and infant development, stress reactivity and inflammation, the development of adverse health behaviors, the conveyance of child chronic illness into adulthood, and inadequate access to effective interventions in childhood. Although the reviewed studies document meaningful relationships between child poverty and adult outcomes, they also reveal that poverty, experiences, and behaviors in adulthood make important contributions to adult health and aging. There is strong evidence that poverty in childhood contributes significantly to adult health. Changes in the content, financing, and advocacy of current child health programs will be required to address the childhood influences on adult health and disease. Policy reforms that reduce child poverty and mitigate its developmental effects must be integrated into broader initiatives and advocacy that also attend to the health and well-being of adults.
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Affiliation(s)
- Paul H Wise
- March of Dimes Center for Prematurity Research, the Division of Neonatology, Department of Pediatrics, School of Medicine, and the Centers for Health Policy/Primary Care and Outcomes Research, Stanford University, Calif.
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214
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Jensen ET, Bertelsen RJ. Assessing Early Life Factors for Eosinophilic Esophagitis: Lessons From Other Allergic Diseases. ACTA ACUST UNITED AC 2016; 14:39-50. [PMID: 26801504 DOI: 10.1007/s11938-016-0083-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OPINION STATEMENT Few studies have been conducted to investigate possible early life determinants for eosinophilic esophagitis. An improved understanding of the etiologic factors implicated in disease development would further elucidate possible disease pathogenesis, inform therapeutic targets for disease treatment, and identify possible modifiable factors for disease prevention in genetically susceptible individuals. Although eosinophilic esophagitis is increasing in incidence and prevalence, the disease remains relatively rare, posing challenges for studying etiologic factors in disease development. Eosinophilic esophagitis is believed to be antigen-mediated, and most patients with EoE have concomitant atopic disease. In recent years, the evolution of our understanding of possible etiologic mechanisms in allergic disease has been informed by our understanding of how early life perturbations can lead to dysbiosis in the colonization of the microflora in the gastrointestinal tract and subsequent dysregulated immune development. Perturbations include factors such as antibiotic use, including prenatal, intra-antepartum, and infancy use of antibiotics, Cesarean delivery, preterm delivery, and neonatal intensive care admission. This article provides a review of these recent developments, as they relate to atopic disease, to inform future directions in the study of early life etiologic factors in the development of eosinophilic esophagitis.
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Affiliation(s)
- Elizabeth T Jensen
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, NC, USA. .,Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA. .,Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
| | - Randi J Bertelsen
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
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215
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Taylor-Robinson DC, Pearce A, Whitehead M, Smyth R, Law C. Social inequalities in wheezing in children: findings from the UK Millennium Cohort Study. Eur Respir J 2016; 47:818-28. [PMID: 26677938 PMCID: PMC4771620 DOI: 10.1183/13993003.01117-2015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 10/13/2015] [Indexed: 01/31/2023]
Abstract
Wheezing in childhood is socially patterned, but it is unclear what factors explain the social differences.Regression analysis of the UK Millennium Cohort Study, based on 11 141 singleton children who participated at ages 9 months and 3, 5 and 7 years. Relative risk ratios (RRR) for early and persistent/relapsing wheeze were estimated using multinomial regression, according to measures of socioeconomic circumstances. Maternal, antenatal and early-life characteristics were assessed as potential mediators.Children of mothers with no educational qualifications were more likely to have both wheeze types, compared to children of mothers with degree-level qualifications (RRR 1.53, 95% CI 1.26-1.86 for early wheeze; 1.32 95% CI 1.04-1.67 for persistent/relapsing wheeze). Controlling for maternal age, smoking during pregnancy and breastfeeding removed the elevated risk of wheezing. Male sex, maternal age, body mass index, atopy, smoking during pregnancy, preterm birth, breastfeeding, exposure to other children and furry pets were independently associated with wheezing, but the pattern of association varied between wheezing types.In this representative UK cohort, adjustment for maternal smoking during pregnancy and breastfeeding removed the socioeconomic inequalities in common wheezing phenotypes. Policies to reduce the social gradient in these risk factors may reduce inequalities in wheezing and asthma.
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Affiliation(s)
- David C Taylor-Robinson
- Dept of Public Health and Policy, University of Liverpool, Liverpool, UK UCL Institute of Child Health, London, UK
| | | | - Margaret Whitehead
- Dept of Public Health and Policy, University of Liverpool, Liverpool, UK
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216
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Wang H, Hu YF, Hao JH, Chen YH, Wang Y, Zhu P, Zhang C, Xu YY, Tao FB, Xu DX. Maternal Serum Zinc Concentration during Pregnancy Is Inversely Associated with Risk of Preterm Birth in a Chinese Population. J Nutr 2016; 146:509-15. [PMID: 26817714 DOI: 10.3945/jn.115.220632] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 12/11/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Evidence exists that maternal zinc status during pregnancy is linked to adverse pregnancy outcomes including abortion, fetal growth restriction, and neural tube defects. However, it remains unclear whether maternal serum zinc concentration (SZC) during pregnancy is associated with risk of preterm birth. OBJECTIVE This study was designed to investigate the association between maternal SZC during pregnancy and risk of preterm birth. METHODS For this substudy of the China-Anhui Birth Cohort Study, 3081 maternal-singleton pairs with detailed birth records and available serum samples were identified. The maternal SZC was determined with flame atomic absorption spectroscopy. A total of 169 preterm births were identified. In this study, the women were divided into tertiles on the basis of their SZC: low (<76.7 μg/dL), medium (76.7-99.6 μg/dL), and high (≥99.7 μg/dL). The ORs for preterm birth were estimated by using multiple logistic regression models. RESULTS The median SZC was 87.3 μg/dL (range: 11.1-211 μg/dL). Incidences of preterm birth were 7.3% and 6.0% among subjects with low and medium SZCs, respectively, which were significantly higher than 3.1% among subjects with a high SZC [ORs (95% CIs) for low and medium SZCs: 2.45 (1.60, 3.74), P < 0.001, and 2.00 (1.29, 3.09), P < 0.01, respectively]. After adjustment for prepregnancy body mass index, maternal age, time of serum collection, gravidity, parity, and monthly income, adjusted ORs were 2.41 (95% CI: 1.57, 3.70; P < 0.001) and 1.97 (95% CI: 1.27, 3.05; P < 0.01) among subjects with low and medium maternal SZCs. CONCLUSIONS Maternal serum zinc concentration during pregnancy is inversely associated with risk of preterm birth in the Chinese population, and the results are driven by maternal SZC in the first trimester.
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Affiliation(s)
- Hua Wang
- School of Public Health and Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | | | - Jia-Hu Hao
- School of Public Health and Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Yuan-Hua Chen
- School of Public Health and Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | | | - Peng Zhu
- School of Public Health and Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Cheng Zhang
- School of Public Health and Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Yuan-Yuan Xu
- School of Public Health and Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Fang-Biao Tao
- School of Public Health and Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - De-Xiang Xu
- School of Public Health and Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
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217
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Leung JYY, Lam HS, Leung GM, Schooling CM. Gestational Age, Birthweight for Gestational Age, and Childhood Hospitalisations for Asthma and Other Wheezing Disorders. Paediatr Perinat Epidemiol 2016; 30:149-59. [PMID: 26739588 DOI: 10.1111/ppe.12273] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Preterm birth, early term birth, and low birthweight are associated with childhood wheezing disorders in developed Western settings, but observed associations could be confounded by socio-economic position. This study aims to clarify such associations in a developed non-Western setting with a different confounding structure. METHODS Using Cox regression, we examined the adjusted associations of gestational age and birthweight for gestational age with time to first public hospital admission for asthma, bronchitis, and bronchiolitis (International Classification of Diseases, Ninth Version Clinical Modification 466, 490, and 493) from 9 days to 12 years in a population-representative birth cohort of 8327 Chinese children in Hong Kong, a developed setting with less clear social patterning of prematurity or birthweight. Analyses were adjusted for infant and parental characteristics and socio-economic position. RESULTS Children born late preterm (34 to <37 weeks) had higher risk of hospitalisation for asthma and other wheezing disorders [hazard ratio (HR) 1.99, 95% confidence interval (CI) 1.48, 2.67] than children born full term (39 to <41 weeks). Early term births (37 to <39 weeks) had HR 1.01 (95% CI 0.84, 1.22), late term births (41 to <42 weeks) had HR 0.77 (95% 0.59, 1.01), and post-term births (≥42 weeks) had HR 0.56 (95% CI 0.32, 0.98). Large for gestational age was associated with lower risk of hospitalisation (HR 0.76, 95% CI 0.57, 0.99). CONCLUSION The association of preterm birth with childhood wheezing could be biologically mediated. We cannot rule out an association for early term births.
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Affiliation(s)
- June Y Y Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Hugh S Lam
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Gabriel M Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,School of Public Health and Hunter College, City University of New York, New York
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218
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Siracusa CM, Brewington JJ, Brockbank JC, Guilbert TW. Update in Pediatric Lung Disease 2014. Am J Respir Crit Care Med 2016; 192:918-23. [PMID: 26469841 DOI: 10.1164/rccm.201504-0752up] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
- Christopher M Siracusa
- Division of Pulmonary Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - John J Brewington
- Division of Pulmonary Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Justin C Brockbank
- Division of Pulmonary Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Theresa W Guilbert
- Division of Pulmonary Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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219
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Shaheen SO, Macdonald-Wallis C, Lawlor DA, Henderson AJ. Hypertensive disorders of pregnancy, respiratory outcomes and atopy in childhood. Eur Respir J 2016; 47:156-65. [PMID: 26541530 PMCID: PMC4884643 DOI: 10.1183/13993003.00643-2015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 08/27/2015] [Indexed: 11/05/2022]
Abstract
Few epidemiological studies have investigated the role of hypertensive disorders of pregnancy in the aetiology of childhood respiratory and atopic outcomes.In the Avon Longitudinal Study of Parents and Children we examined associations of maternal gestational hypertension, hypertension before pregnancy and pre-eclampsia with wheezing at 18 months, wheezing and asthma at 7 years and lung function at 8-9 years, after controlling for potential confounders (n=5322-8734, depending on outcome).Gestational hypertension was not associated with any of the outcomes. There was weak evidence for a positive association between pre-eclampsia and early wheezing (adjusted OR 1.31, 95% CI 0.94-1.82, compared to normotensive pregnancies) and for negative associations between pre-eclampsia and forced expiratory volume in 1 s (adjusted mean difference in sd score -0.14, 95% CI -0.33-0.06) and maximal mid-expiratory flow (-0.15, 95% CI -0.34-0.04). Hypertension before pregnancy was positively associated with wheezing (OR 1.63, 95% CI 1.16-2.31) and asthma (OR 1.34, 95% CI 1.00-1.79).Gestational hypertension is unlikely to be a risk factor for childhood respiratory disorders; hypertension before pregnancy may be a risk factor for childhood wheezing and asthma, but this finding needs replication. Larger studies are needed to confirm whether pre-eclampsia is associated with impaired childhood lung function.
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Affiliation(s)
- Seif O Shaheen
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, London, UK
| | - Corrie Macdonald-Wallis
- School of Social and Community Medicine, University of Bristol, Bristol, UK MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Debbie A Lawlor
- School of Social and Community Medicine, University of Bristol, Bristol, UK MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - A John Henderson
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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220
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Sonnenschein-van der Voort AMM, Gaillard R, de Jongste JC, Hofman A, Jaddoe VWV, Duijts L. Foetal and infant growth patterns, airway resistance and school-age asthma. Respirology 2015; 21:674-82. [PMID: 26699232 DOI: 10.1111/resp.12718] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 10/14/2015] [Accepted: 11/08/2015] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Preterm birth, low birth weight and rapid infant weight gain are associated with increased risks of asthma symptoms in childhood. The underlying mechanism may include persistently higher airway resistance (Rint). The aim of our study was to examine the associations of longitudinally measured foetal and infant growth characteristics with Rint and asthma outcomes in school-age children. METHODS This study was embedded in a population-based prospective cohort study in Rotterdam, The Netherlands. Foetal growth was estimated by ultrasound in the second and third trimesters. Infant growth was measured at birth, 3, 6 and 12 months. At age 6 years, Rint was measured, and information about wheezing and asthma was obtained by questionnaires. The number of subjects per analysis differed per available outcome (3954-5066 subjects). RESULTS Longitudinal growth analyses showed that school-age children with increased Rint had lower foetal length growth and weight gain, and lower infant length growth. Children with persistent wheezing until age 6 years and physician-diagnosed asthma had a higher Rint compared with children who never wheezed or without asthma (difference z-scores Rint: 0.58 (0.19, 0.97) and 0.55 (0.15, 0.95), respectively). CONCLUSION Rint in school-age children is influenced by foetal growth restriction and is associated with asthma outcomes. See article, page 574.
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Affiliation(s)
- Agnes M M Sonnenschein-van der Voort
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Division of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Romy Gaillard
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Johan C de Jongste
- Department of Pediatrics, Division of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Liesbeth Duijts
- Department of Pediatrics, Division of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Division of Neonatology, Erasmus University Medical Center, Rotterdam, The Netherlands
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221
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Wang X, Liu W, Hu Y, Zou Z, Shen L, Huang C. Home environment, lifestyles behaviors, and rhinitis in childhood. Int J Hyg Environ Health 2015; 219:220-31. [PMID: 26712524 DOI: 10.1016/j.ijheh.2015.11.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 11/05/2015] [Accepted: 11/25/2015] [Indexed: 11/24/2022]
Abstract
The prevalence of children allergic rhinitis has been increasing in China and associated factors still are not clear. In the present paper, we selected 13,335 parent-reported questionnaires of 4-6 years-old children, in a cross-sectional study from April 2011 to April 2012 in Shanghai city, and investigated associations of various factors with parent-reported allergic rhinitis (doctor-diagnosed) and rhinitis symptoms in childhood. After adjusted by age, sex, family history of atopy, and respondent of questionnaire, we find that no siblings, mother in older age during pregnancy, shorter breastfeeding, using antibiotics in the first year, and home dampness-related exposures, had significant associations with increased prevalence of the studied diseases. Location, type, building area, decoration materials and construction period of the residence, also had significant associations with these diseases. Current parental smoking and pet-keeping had no significant associations with the studied diseases. Incense-burning and using mosquito coils had significant associations with reduced risk of allergic rhinitis and with increased risk of rhinitis symptoms. Using air cleaner and cleaning the residence in high frequency had associations with increased risk, but eating fast food and ice cream often had associations with the reduced risk, of the studied diseases. Families with children being diagnosed allergic rhinitis likely change their lifestyle behaviors. In conclusion, childhood rhinitis could be influenced by heredity and many "environmental exposures". Avoidance behaviors and reverse causation in parental smoking, pet-keeping, and dietary habits for childhood rhinitis should be carefully considered.
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Affiliation(s)
- Xueying Wang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, PR China
| | - Wei Liu
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, PR China
| | - Yu Hu
- Tongji Architectural Design (Group) Company Limited (TJAD), Shanghai, PR China
| | - Zhijun Zou
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, PR China
| | - Li Shen
- R&B Technology (Shanghai) Company Limited, Shanghai, PR China
| | - Chen Huang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, PR China.
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222
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den Dekker HT, Sonnenschein-van der Voort AMM, de Jongste JC, Anessi-Maesano I, Arshad SH, Barros H, Beardsmore CS, Bisgaard H, Phar SC, Craig L, Devereux G, van der Ent CK, Esplugues A, Fantini MP, Flexeder C, Frey U, Forastiere F, Gehring U, Gori D, van der Gugten AC, Henderson AJ, Heude B, Ibarluzea J, Inskip HM, Keil T, Kogevinas M, Kreiner-Møller E, Kuehni CE, Lau S, Mélen E, Mommers M, Morales E, Penders J, Pike KC, Porta D, Reiss IK, Roberts G, Schmidt A, Schultz ES, Schulz H, Sunyer J, Torrent M, Vassilaki M, Wijga AH, Zabaleta C, Jaddoe VWV, Duijts L. Early growth characteristics and the risk of reduced lung function and asthma: A meta-analysis of 25,000 children. J Allergy Clin Immunol 2015; 137:1026-1035. [PMID: 26548843 DOI: 10.1016/j.jaci.2015.08.050] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 08/11/2015] [Accepted: 08/15/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND Children born preterm or with a small size for gestational age are at increased risk for childhood asthma. OBJECTIVE We sought to assess the hypothesis that these associations are explained by reduced airway patency. METHODS We used individual participant data of 24,938 children from 24 birth cohorts to examine and meta-analyze the associations of gestational age, size for gestational age, and infant weight gain with childhood lung function and asthma (age range, 3.9-19.1 years). Second, we explored whether these lung function outcomes mediated the associations of early growth characteristics with childhood asthma. RESULTS Children born with a younger gestational age had a lower FEV1, FEV1/forced vital capacity (FVC) ratio, and forced expiratory volume after exhaling 75% of vital capacity (FEF75), whereas those born with a smaller size for gestational age at birth had a lower FEV1 but higher FEV1/FVC ratio (P < .05). Greater infant weight gain was associated with higher FEV1 but lower FEV1/FVC ratio and FEF75 in childhood (P < .05). All associations were present across the full range and independent of other early-life growth characteristics. Preterm birth, low birth weight, and greater infant weight gain were associated with an increased risk of childhood asthma (pooled odds ratio, 1.34 [95% CI, 1.15-1.57], 1.32 [95% CI, 1.07-1.62], and 1.27 [95% CI, 1.21-1.34], respectively). Mediation analyses suggested that FEV1, FEV1/FVC ratio, and FEF75 might explain 7% (95% CI, 2% to 10%) to 45% (95% CI, 15% to 81%) of the associations between early growth characteristics and asthma. CONCLUSIONS Younger gestational age, smaller size for gestational age, and greater infant weight gain were across the full ranges associated with childhood lung function. These associations explain the risk of childhood asthma to a substantial extent.
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Affiliation(s)
- Herman T den Dekker
- Department of Pediatrics, Division of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Agnes M M Sonnenschein-van der Voort
- Department of Pediatrics, Division of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Johan C de Jongste
- Department of Pediatrics, Division of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Isabella Anessi-Maesano
- EPAR, UMR-S 707 INSERM Paris, France; EPAR, UMR-S 707, Université Pierre et Marie Curie Paris, France
| | - S Hasan Arshad
- David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport, Isle of Wight, United Kingdom; Faculty of Medicine, University of Southampton, Southampton, United Kingdom; NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Henrique Barros
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - Caroline S Beardsmore
- Division of Child Health, Department of Infection, Immunity & Inflammation, University of Leicester and Institute for Lung Health, Leicester, United Kingdom
| | - Hans Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC2000), Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Denmark
| | - Sofia Correia Phar
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - Leone Craig
- Public Health Nutrition Research Group, University of Aberdeen, Aberdeen, United Kingdom; Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | - Graham Devereux
- Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | - C Kors van der Ent
- Department of Pediatric Pulmonology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ana Esplugues
- Faculty of Nursing and Chiropody, Valencia, Spain; FISABIO, Valencia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Maria P Fantini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Claudia Flexeder
- Helmholtz Zentrum München, Institute of Epidemiology I, Neuherberg, Germany
| | - Urs Frey
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
| | | | - Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Davide Gori
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Anne C van der Gugten
- Department of Pediatric Pulmonology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A John Henderson
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Barbara Heude
- CESP Inserm, UMRS 1018, Team 10, Villejuif, France; Université Paris-Sud, UMRS 1018 Team 10, Villejuif, France
| | - Jesús Ibarluzea
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Public Health Division of Gipuzkoa, San Sebastian, Spain
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany; Institute for Clinical Epidemiology and Biometry, University of Würzburg, Wurzburg, Germany
| | - Manolis Kogevinas
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; National School of Public Health, Athens, Greece; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Eskil Kreiner-Møller
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC2000), Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Denmark
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Susanne Lau
- Department of Pediatric Pneumology and Immunology, Charité University Medical Centre, Berlin, Germany
| | - Erik Mélen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, and Sach's Children Hospital, Stockholm, Switzerland
| | - Monique Mommers
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Eva Morales
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - John Penders
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Katy C Pike
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Daniela Porta
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Irwin K Reiss
- Department of Pediatrics, Division of Neonatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Graham Roberts
- David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport, Isle of Wight, United Kingdom; Faculty of Medicine, University of Southampton, Southampton, United Kingdom; NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Anne Schmidt
- University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland; Division of Respiratory Medicine, Department of Pediatrics, Inselspital, University of Bern, Bern, Switzerland
| | - Erica S Schultz
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, and Sach's Children Hospital, Stockholm, Switzerland
| | - Holger Schulz
- Helmholtz Zentrum München, Institute of Epidemiology I, Neuherberg, Germany
| | - Jordi Sunyer
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Matias Torrent
- IB-SALUT, Area de Salut de Menorca, Balearic Islands, Spain
| | - Maria Vassilaki
- Department of Social Medicine, School of Medicine, University of Crete, Crete, Greece
| | - Alet H Wijga
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Carlos Zabaleta
- Nuestra Señora de la Antigua Hospital, OSAKIDETZA Basque Health Service, San Sebastian, Spain
| | - Vincent W V Jaddoe
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Liesbeth Duijts
- Department of Pediatrics, Division of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Division of Neonatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
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223
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Johnson CC, Peterson EL, Joseph CL, Ownby DR, Breslau N. Birth weight and asthma incidence by asthma phenotype pattern in a racially diverse cohort followed through adolescence. J Asthma 2015; 52:1006-12. [PMID: 26374620 PMCID: PMC4831062 DOI: 10.3109/02770903.2015.1054405] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Low birth weight (LBW) has been shown to be an independent risk factor for asthma. We hypothesized that LBW would have its greatest impact on early onset disease. METHODS A racially diverse cohort of children born from 1983 to 1985 at two hospitals, one urban and one suburban in the same metropolitan area, and oversampled for babies weighing ≤2500 g, was identified retrospectively when the children were 6 years of age and followed periodically. At the age 17 years study visit, cohort members and their parent/guardians were separately interviewed face-to-face regarding the subject's history of asthma using the standardized ISAAC questionnaire. We measured the cumulative incidence of asthma from birth through adolescence defined by age of diagnosis and persistence/remittance. RESULTS Six-hundred and eighty teens (82.6% of the original cohort) were included in the analyses, 387 with LBW and 293 of normal birth weight. The prevalence of physician-diagnosed "Current Asthma" was associated with LBW (p = 0.003 for trend), with patterns stronger in males and whites. LBW was associated most strongly with Late Onset Persistent asthma (current asthma that was diagnosed after 8 years); p for trend 0.032. This trend was again most evident in males and whites. None of the asthma categories classified as "remittent" were statistically associated with LBW. CONCLUSIONS LBW was not associated with diagnosed asthma that remitted before age 17 years. LBW was associated with asthma diagnosis in mid-childhood that persisted through adolescence, suggesting that the asthmagenic effects of LBW can become evident post the early years of childhood and persist into adulthood.
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Affiliation(s)
| | - Edward L. Peterson
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI
| | | | - Dennis R. Ownby
- Section of Allergy-Immunology, Georgia Regents University, Augusta, GA
| | - Naomi Breslau
- Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing, MI
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224
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Abstract
Asthma is one of the most common diseases in the world, resulting in a substantial burden of disease. Although rates of deaths due to asthma worldwide have reduced greatly over the past 25 years, no available therapeutic regimens can cure asthma, and the burden of asthma will continue to be driven by increasing prevalence. The reasons for the increase in asthma prevalence have not been defined, which limits the opportunities to develop targeted primary prevention measures. Although associations are reported between a wide range of risk factors and childhood asthma, substantiation of causality is inherently difficult from observational studies, and few risk factors have been assessed in primary prevention studies. Furthermore, none of the primary prevention intervention strategies that have undergone scrutiny in randomised controlled trials has provided sufficient evidence to lead to widespread implementation in clinical practice. A better understanding of the factors that cause asthma is urgently needed, and this knowledge could be used to develop public health and pharmacological primary prevention measures that are effective in reducing the prevalence of asthma worldwide. To achieve this it will be necessary to think outside the box, not only in terms of risk factors for the causation of asthma, but also the types of novel primary prevention strategies that are developed, and the research methods used to provide the evidence base for their implementation. In the interim, public health efforts should remain focused on measures with the potential to improve lung and general health, such as: reducing tobacco smoking and environmental tobacco smoke exposure; reducing indoor and outdoor air pollution and occupational exposures; reducing childhood obesity and encouraging a diet high in vegetables and fruit; improving feto-maternal health; encouraging breastfeeding; promoting childhood vaccinations; and reducing social inequalities.
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Affiliation(s)
- Richard Beasley
- Medical Research Institute of New Zealand, Wellington, New Zealand.
| | - Alex Semprini
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Edwin A Mitchell
- Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland New Zealand
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225
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den Dekker HT, Voort AMMSVD, de Jongste JC, Reiss IK, Hofman A, Jaddoe VW, Duijts L. Tobacco Smoke Exposure, Airway Resistance, and Asthma in School-age Children. Chest 2015; 148:607-617. [DOI: 10.1378/chest.14-1520] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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226
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He H, Butz A, Keet CA, Minkovitz CS, Hong X, Caruso DM, Pearson C, Cohen RT, Wills-Karp M, Zuckerman BS, Hughes ME, Wang X. Preterm Birth with Childhood Asthma: The Role of Degree of Prematurity and Asthma Definitions. Am J Respir Crit Care Med 2015; 192:520-3. [PMID: 26278798 PMCID: PMC4595670 DOI: 10.1164/rccm.201503-0522le] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Huan He
- 1 Johns Hopkins Bloomberg School of Public Health Baltimore, Maryland
| | - Arlene Butz
- 2 Johns Hopkins School of Medicine Baltimore, Maryland
| | | | - Cynthia S Minkovitz
- 1 Johns Hopkins Bloomberg School of Public Health Baltimore, Maryland
- 2 Johns Hopkins School of Medicine Baltimore, Maryland
| | - Xiumei Hong
- 1 Johns Hopkins Bloomberg School of Public Health Baltimore, Maryland
| | - Deanna M Caruso
- 1 Johns Hopkins Bloomberg School of Public Health Baltimore, Maryland
| | - Colleen Pearson
- 3 Boston University School of Medicine Boston, Massachusetts and
- 4 Boston Medical Center Boston, Massachusetts
| | - Robyn T Cohen
- 3 Boston University School of Medicine Boston, Massachusetts and
- 4 Boston Medical Center Boston, Massachusetts
| | - Marsha Wills-Karp
- 1 Johns Hopkins Bloomberg School of Public Health Baltimore, Maryland
| | - Barry S Zuckerman
- 3 Boston University School of Medicine Boston, Massachusetts and
- 4 Boston Medical Center Boston, Massachusetts
| | - Mary E Hughes
- 1 Johns Hopkins Bloomberg School of Public Health Baltimore, Maryland
| | - Xiaobin Wang
- 1 Johns Hopkins Bloomberg School of Public Health Baltimore, Maryland
- 2 Johns Hopkins School of Medicine Baltimore, Maryland
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227
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Abstract
It has been recognized for centuries that allergic disease runs in families, implying a role for genetic factors in determining individual susceptibility. More recently, a range of evidence shows that many of these genetic factors, together with in utero environmental exposures, lead to the development of allergic disease through altered immune and organ development. Environmental exposures during pregnancy including diet, nutrient intake and toxin exposures can alter the epigenome and interact with inherited genetic and epigenetic risk factors to directly and indirectly influence organ development and immune programming. Understanding of these factors will be essential in identifying at-risk individuals and possible development of therapeutic interventions for the primary prevention of allergic disease. In this review, we summarize the evidence that suggests allergic disease begins in utero, together with possible mechanisms for the effect of environmental exposures during pregnancy on allergic disease risk, including epigenetics.
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Affiliation(s)
- Gabrielle A Lockett
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Johanna Huoman
- Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Sciences, Unit of Autoimmunity and Immune Regulation, Linköping University, Linköping, Sweden
| | - John W Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.,Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,International Inflammation network (in-FLAME) of the World Universities Network
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228
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Pescatore AM, Spycher BD, Beardsmore CS, Kuehni CE. "Attacks" or "Whistling": Impact of Questionnaire Wording on Wheeze Prevalence Estimates. PLoS One 2015; 10:e0131618. [PMID: 26114296 PMCID: PMC4482591 DOI: 10.1371/journal.pone.0131618] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 06/02/2015] [Indexed: 11/29/2022] Open
Abstract
Background Estimates of prevalence of wheeze depend on questionnaires. However, wording of questions may vary between studies. We investigated effects of alternative wording on estimates of prevalence and severity of wheeze, and associations with risk factors. Methods White and South Asian children from a population-based cohort (UK) were randomly assigned to two groups and followed up at one, four and six years (1998, 2001, 2003). Parents were asked either if their child ever had “attacks of wheeze” (attack group, N=535), or “wheezing or whistling in the chest” (whistling group, N=2859). All other study aspects were identical, including questions about other respiratory symptoms. Results Prevalence of wheeze ever was lower in the attack group than in the whistling group for all surveys (32 vs. 40% in white children aged one year, p<0.001). Prevalence of other respiratory symptoms did not differ between groups. Wheeze tended to be more severe in the attack group. The strength of association with risk factors was comparable in the two groups. Conclusions The wording of questions on wheeze can affect estimates of prevalence, but has less impact on measured associations with risk factors. Question wording is a potential source of between-study-heterogeneity in meta-analyses.
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Affiliation(s)
- Anina M. Pescatore
- Institute of Social and Preventive Medicine, University Bern, Bern, Switzerland
| | - Ben D. Spycher
- Institute of Social and Preventive Medicine, University Bern, Bern, Switzerland
| | - Caroline S. Beardsmore
- Division of Child Health, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, United Kingdom
| | - Claudia E. Kuehni
- Institute of Social and Preventive Medicine, University Bern, Bern, Switzerland
- * E-mail:
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Danansuriya MN, Rajapaksa LC, Weerasinghe A. Genetic, familial and environmental correlates of asthma among early adolescents in Sri Lanka: a case control study. World Allergy Organ J 2015; 8:19. [PMID: 26140077 PMCID: PMC4469255 DOI: 10.1186/s40413-015-0068-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 03/30/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Despite advances in management, the mortality and morbidity due to asthma are increasing globally. Identification of specific correlates in the local context is useful in disease management. The objective of this study was to estimate the prevalence and to describe selected correlates of asthma among12-14 year old school children in a district in Sri Lanka. METHOD A school based cross-sectional study was conducted using a self administered questionnaire. Multi-staged stratified cluster sampling was used to select 42 classes in grades 7, 8 and 9. "Current asthma" (CA)(case) was defined as 'having Physician Diagnosed Asthma (PDA) and having had wheezing during the previous 12 months'. For each case, two healthy controls were selected from the same class to assess correlates. Information on correlates was collected by trained field midwives during home visits. Backward stepwise logistic regression model was used for analysis of correlates. Skin Prick Testing was carried out among asthmatics together with their healthy siblings using standard extracts of House Dust Mite (HDM), cockroach and Blomia. Ethical clearance was obtained from Ethical Review Committee, Faculty of Medicine, Colombo. RESULTS Out of 1483 subjects participated, 753 were females (50.8%). The prevalence rates for current wheezing (CW), ever wheezing (EW), current asthma (CA), and physician diagnosed asthma (PDA) were 16.7%, 19.4%, 10.7% and 14.5% respectively. A total of 158 CA cases were identified. Information on correlates of asthma was collected for 145 CA cases (97.9%) and for 285 controls (96.6%). The unconfounded predictors of having CA among adolescents in the present sample were; only child in the family (OR = 4.2, 95% CI: 1.7-9.9); first born of the family (OR = 2.6 95% CI: 1.3-5.2); presence of allergic rhinitis (OR = 2.7, 95% CI: 1.6-4.6); family history of asthma (OR = 1.8, 95% CI: 1.1-3.2); family history of allergic rhinitis (OR = 1.9, 95% CI: 1.1-3.2); family history of eczema (OR = 1.8, 95% CI: 1.0-3.2). Higher risk of sensitization to cockroach, HDM and Blomia was seen among asthmatics compared to healthy siblings. CONCLUSION A significant proportion of students reported to have asthma. Atopy and other genetic and environmental correlates should be considered as important correlates in asthma management among early adolescents in Sri Lanka.
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Affiliation(s)
| | - Lalini C Rajapaksa
- Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Anura Weerasinghe
- Medicine and Immunology Dr Neville Fernando Teaching Hospital, South Asian Institute of Medicine and Technology, Malabe, Sri Lanka
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Firestone R, Cheng S, Pearce N, Douwes J, Merletti F, Pizzi C, Pivetta E, Rusconi F, Richiardi L. Internet-Based Birth-Cohort Studies: Is This the Future for Epidemiology? JMIR Res Protoc 2015; 4:e71. [PMID: 26071071 PMCID: PMC4526937 DOI: 10.2196/resprot.3873] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 05/06/2015] [Accepted: 05/24/2015] [Indexed: 12/23/2022] Open
Abstract
Background International collaborative cohorts the NINFEA and the ELF studies are mother-child cohorts that use the internet for recruitment and follow-up of their members. The cohorts investigated the association of early life exposures and a wide range of non-communicable diseases. Objective The objective is to report the research methodology, with emphasis on the advantages and limitations offered by an Internet-based design. These studies were conducted in Turin, Italy and Wellington, New Zealand. Methods The cohorts utilized various online/offline methods to recruit participants. Pregnant women who became aware volunteered, completed an online questionnaire, thus obtaining baseline information. Results The NINFEA study has recruited 7003 pregnant women, while the ELF study has recruited 2197 women. The cohorts targeted the whole country, utilizing a range of support processes to reduce the attrition rate of the participants. For the NINFEA and ELF cohorts, online participants were predominantly older (35% and 28.9%, respectively), highly educated (55.6% and 84.9%, respectively), and were in their final trimester of pregnancy (48.5% and 53.6%, respectively). Conclusions Internet-based cohort epidemiological studies are feasible, however, it is clear that participants are self-selective samples, as is the case for many birth cohorts. Internet-based cohort studies are potentially cost-effective and novel methodology for conducting long-term epidemiology research. However, from our experience, participants tend to be self-selective. In marked time, if the cohorts are to form part of a larger research program they require further use and exploration to address biases and overcome limitations.
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Affiliation(s)
- Ridvan Firestone
- Centre for Public Health Research, Massey University, Wellington, New Zealand.
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Blaisdell CJ, Weinmann GG. NHLBI viewpoint: Lung health and disease prevention research starting in childhood. Pediatr Pulmonol 2015; 50:604-6. [PMID: 25857257 DOI: 10.1002/ppul.23198] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 02/27/2015] [Accepted: 03/05/2015] [Indexed: 11/08/2022]
Abstract
Lung health begins in utero when the complex structure of the airway, alveolar, and vascular structures are formed. To really impact the United States and global burden of chronic lung diseases in both adults and children, we must understand normal and abnormal development, the outcomes of disrupted development, and the effects of in utero and postnatal exposures on lung health. With increasing recognition of early life origins of adult diseases,(1) it is important to know what early events and interventions can alter the trajectory of lung development, growth, and decline to help promote lung health and reduce chronic lung disease.
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Affiliation(s)
- Carol J Blaisdell
- Division of Lung Diseases, National Heart, Lung, and Blood Institute, 6701 Rockledge Dr. 10-024, Bethesda, 20892, Maryland
| | - Gail G Weinmann
- Division of Lung Diseases, National Heart, Lung, and Blood Institute, 6701 Rockledge Dr. 10-024, Bethesda, 20892, Maryland
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Pike KC, Lucas JSA. Respiratory consequences of late preterm birth. Paediatr Respir Rev 2015; 16:182-8. [PMID: 25554628 DOI: 10.1016/j.prrv.2014.12.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 12/03/2014] [Accepted: 12/03/2014] [Indexed: 11/30/2022]
Abstract
In developed countries most preterm births occur between 34 and 37 weeks' gestation. Deliveries during this 'late preterm' period are increasing and, since even mild prematurity is now recognised to be associated with adverse health outcomes, this presents healthcare challenges. Respiratory problems associated with late preterm birth include neonatal respiratory distress, severe RSV infection and childhood wheezing. Late preterm birth prematurely interrupts in utero lung development and is associated with maternal and early life factors which adversely affect the developing respiratory system. This review considers 1) mechanisms underlying the association between late preterm birth and impaired respiratory development, 2) respiratory morbidity associated with late preterm birth, particularly long-term outcomes, and 3) interventions which might protect respiratory development by addressing risk factors affecting the late preterm population, including maternal smoking, early life growth restriction and vulnerability to viral infection.
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Affiliation(s)
- Katharine C Pike
- Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Tremona Road, Southampton SO16 6YD, UK; NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK; University College London, Institute of Child Health, 30 Guilford Street London WC1N 1EH, UK.
| | - Jane S A Lucas
- Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Tremona Road, Southampton SO16 6YD, UK; NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK.
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Noah TL, Yilmaz O, Nicolai T, Birnkrant D, Praud JP. Pediatric Pulmonology year in review 2014: Part 1. Pediatr Pulmonol 2015; 50:621-9. [PMID: 25891206 DOI: 10.1002/ppul.23202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 03/29/2015] [Indexed: 11/08/2022]
Abstract
Our discipline and our journal cover an extremely broad range of research and scholarly topics related to children's respiratory disorders. To better meet the needs of our readership for updated perspectives on the rapidly expanding knowledge in our field, we here summarize the past year's publications in our major topic areas, as well as selected publications in these areas from the core clinical journal literature outside our own pages.
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Affiliation(s)
- Terry L Noah
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Ozge Yilmaz
- Pediatric Allergy and Pulmonology, Celal Bayar University Department of Pediatrics, Manisa, Turkey
| | | | - David Birnkrant
- MetroHealth Medical Center Department of Pediatrics, Cleveland, Ohio
| | - Jean-Paul Praud
- University Sherbrooke Pediatrics, Sherbrooke, Quebec, Canada
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234
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A longitudinal study on early hospitalized airway infections and subsequent childhood asthma. PLoS One 2015; 10:e0121906. [PMID: 25919024 PMCID: PMC4412821 DOI: 10.1371/journal.pone.0121906] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 02/04/2015] [Indexed: 12/26/2022] Open
Abstract
Background Acute airway infections, including bronchiolitis, are common causes of early childhood hospitalization. The development of later asthma may be related to early airway infections in young children. This study is to investigate the relationship between hospitalized airway infections (HAI) in young children (< 3 years old) and later childhood asthma. Methods Hospitalized children (< 3 years old) with bronchiolitis or other acute airway infections (other HAI group) from 1997-2000 were retrieved from the National Health Insurance Research Database of Taiwan, and compared to age- and gender-matched subjects with regards to asthma until 10 years of age; and potential comorbidities and medical care conditions. Results In total, 3,264 children (1,981 with bronchiolitis; 1,283 with other HAIs) were compared to 18,527 controls. The incidence of childhood asthma was higher in the study (16.2%) than the control (11.7%) group, and most cases were diagnosed between 3-5 years old. The hazard ratios were 1.583 (95% CI: 1.414-1.772) and 1.226 (95% CI: 1.053-1.428) for the bronchiolitis and other HAI subgroups, respectively, compared to the control group, and 1.228 (95% CI: 1.075-1.542) in the bronchiolitis subgroup compared to the other HAIs subgroup. A significantly higher odds ratio (1.973, 95% CI: 1.193-3.263) for the children with congenital heart disease (CHD) in the bronchiolitis subgroup was found at an age of 3-5 years compared to the control group. Conclusions and Clinical Relevance Young children (< 3 years old) hospitalized due to acute HAIs are at a higher risk of developing childhood asthma at age 3 to 10 years. The parents of children with HAIs at age 0 to 2 years should be informed for the higher risk of developing childhood asthma, especially in children with CHD and bronchiolitis.
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Voraphani N, Martinez FD. Postnatal growth and the heterogeneity of preschool wheeze. J Pediatr 2015; 166:226-8. [PMID: 25466678 PMCID: PMC6609102 DOI: 10.1016/j.jpeds.2014.10.069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 10/29/2014] [Indexed: 12/19/2022]
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Szefler SJ. Advances in pediatric asthma in 2014: Moving toward a population health perspective. J Allergy Clin Immunol 2015; 135:644-52. [PMID: 25649079 DOI: 10.1016/j.jaci.2014.12.1921] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 12/29/2014] [Accepted: 12/29/2014] [Indexed: 01/30/2023]
Abstract
Last year's "Advances in pediatric asthma in 2013: Coordinating asthma care" concluded that, "Enhanced communication systems will be necessary among parents, clinicians, health care providers and the pharmaceutical industry so that we continue the pathway of understanding the disease and developing new treatments that address the unmet needs of patients who are at risk for severe consequences of unchecked disease persistence or progression." This year's summary will focus on further advances in pediatric asthma related to prenatal and postnatal factors altering the natural history of asthma, assessment of asthma control, and new insights regarding the management of asthma in children as indicated in Journal of Allergy and Clinical Immunology publications in 2014. A major theme of this review is how new research reports can be integrated into medical communication in a population health perspective to assist clinicians in asthma management. The asthma specialist is in a unique position to convey important messages to the medical community related to factors that influence the course of asthma, methods to assess and communicate levels of control, and new targets for intervention, as well as new immunomodulators. By enhancing communication among patients, parents, primary care physicians, and specialists within provider systems, the asthma specialist can provide timely information that can help to reduce asthma morbidity and mortality.
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Affiliation(s)
- Stanley J Szefler
- Pediatric Asthma Research Program, Section of Pediatric Pulmonary Medicine, Breathing Institute, Department of Pediatrics, Children's Hospital Colorado, and the Department of Pediatrics, University of Colorado Denver School of Medicine, Aurora, Colo.
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237
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Magnus MC, Stigum H, Håberg SE, Nafstad P, London SJ, Nystad W. Peak weight and height velocity to age 36 months and asthma development: the Norwegian Mother and Child Cohort Study. PLoS One 2015; 10:e0116362. [PMID: 25635872 PMCID: PMC4312021 DOI: 10.1371/journal.pone.0116362] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 12/08/2014] [Indexed: 12/04/2022] Open
Abstract
Background The immediate postnatal period is the period of the fastest growth in the entire life span and a critical period for lung development. Therefore, it is interesting to examine the association between growth during this period and childhood respiratory disorders. Methods We examined the association of peak weight and height velocity to age 36 months with maternal report of current asthma at 36 months (n = 50,311), recurrent lower respiratory tract infections (LRTIs) by 36 months (n = 47,905) and current asthma at 7 years (n = 24,827) in the Norwegian Mother and Child Cohort Study. Peak weight and height velocity was calculated using the Reed1 model through multilevel mixed-effects linear regression. Multivariable log-binomial regression was used to calculate adjusted relative risks (adj.RR) and 95% confidence intervals (CI). We also conducted a sibling pair analysis using conditional logistic regression. Results Peak weight velocity was positively associated with current asthma at 36 months [adj.RR 1.22 (95%CI: 1.18, 1.26) per standard deviation (SD) increase], recurrent LRTIs by 36 months [adj.RR 1.14 (1.10, 1.19) per SD increase] and current asthma at 7 years [adj.RR 1.13 (95%CI: 1.07, 1.19) per SD increase]. Peak height velocity was not associated with any of the respiratory disorders. The positive association of peak weight velocity and asthma at 36 months remained in the sibling pair analysis. Conclusions Higher peak weight velocity, achieved during the immediate postnatal period, increased the risk of respiratory disorders. This might be explained by an influence on neonatal lung development, shared genetic/epigenetic mechanisms and/or environmental factors.
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Affiliation(s)
- Maria C. Magnus
- Department of Chronic Diseases, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
- * E-mail:
| | - Hein Stigum
- Department of Chronic Diseases, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine, Medical Faculty, University of Oslo, Oslo, Norway
| | - Siri E. Håberg
- Institute Management and Staff, Norwegian Institute of Public Health, Oslo, Norway
| | - Per Nafstad
- Department of Chronic Diseases, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine, Medical Faculty, University of Oslo, Oslo, Norway
| | - Stephanie J. London
- Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, United States of America
| | - Wenche Nystad
- Department of Chronic Diseases, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
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Hartwig I, Diemert A, Tolosa E, Hecher K, Arck P. Babies Galore; or recent findings and future perspectives of pregnancy cohorts with a focus on immunity. J Reprod Immunol 2015; 108:6-11. [PMID: 25639271 DOI: 10.1016/j.jri.2015.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 11/27/2014] [Accepted: 01/05/2015] [Indexed: 11/20/2022]
Abstract
Population-based pregnancy cohorts recruiting women before or at the moment of childbirth allow a longitudinal follow-up on children's health later in life. Important findings arising from pregnancy cohorts are discussed in the present review. These insights have led to revised guidelines on how to minimize disease risks in children, e.g., in the context of chronic immune diseases including allergies and asthma. Moreover, insights from pregnancy cohorts also unveiled a collateral effect of pregnancy on maternal immunity, mirrored by an ameliorated course of certain autoimmune diseases, but also an increased risk of infection with influenza A virus. Future pregnancy cohort studies are still required to close gaps in knowledge on how parameters involved in the developmental origin of health or poor immunity observed in children later in life are operational. We discuss here features that should be covered by future pregnancy cohort studies. Expected insights from such studies will then lay the foundation for biomarker discovery and offer opportunities for interventions to ameliorate adverse immune responses in humans.
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Affiliation(s)
- Isabel Hartwig
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg, Germany
| | - Anke Diemert
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg, Germany
| | - Eva Tolosa
- Department of Immunology, University Medical Center Hamburg, Germany
| | - Kurt Hecher
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg, Germany
| | - Petra Arck
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg, Germany.
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Abstract
Asthma is the most common inflammatory disease of the lungs. The prevalence of asthma is increasing in many parts of the world that have adopted aspects of the Western lifestyle, and the disease poses a substantial global health and economic burden. Asthma involves both the large-conducting and the small-conducting airways, and is characterized by a combination of inflammation and structural remodelling that might begin in utero. Disease progression occurs in the context of a developmental background in which the postnatal acquisition of asthma is strongly linked with allergic sensitization. Most asthma cases follow a variable course, involving viral-induced wheezing and allergen sensitization, that is associated with various underlying mechanisms (or endotypes) that can differ between individuals. Each set of endotypes, in turn, produces specific asthma characteristics that evolve across the lifecourse of the patient. Strong genetic and environmental drivers of asthma interconnect through novel epigenetic mechanisms that operate prenatally and throughout childhood. Asthma can spontaneously remit or begin de novo in adulthood, and the factors that lead to the emergence and regression of asthma, irrespective of age, are poorly understood. Nonetheless, there is mounting evidence that supports a primary role for structural changes in the airways with asthma acquisition, on which altered innate immune mechanisms and microbiota interactions are superimposed. On the basis of the identification of new causative pathways, the subphenotyping of asthma across the lifecourse of patients is paving the way for more-personalized and precise pathway-specific approaches for the prevention and treatment of asthma, creating the real possibility of total prevention and cure for this chronic inflammatory disease.
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Affiliation(s)
- Stephen T. Holgate
- Clinical and Experimental Sciences, Mail Point 810, Level F, Sir Henry Wellcome Building, ,grid.123047.30000000103590315Southampton General Hospital, Southampton, SO16 6YD UK
| | - Sally Wenzel
- grid.21925.3d0000 0004 1936 9000Subsection Chief of Allergy, Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Asthma Institute at UPMC/UPSOM, Pittsburgh, Pennsylvania USA
| | - Dirkje S. Postma
- grid.4494.d0000 0000 9558 4598Department of Pulmonology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Scott T. Weiss
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts USA
| | - Harald Renz
- grid.10253.350000 0004 1936 9756Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University Marburg, University Hospital Giessen and Marburg GmbH, Campus Marburg, Marburg, Germany
| | - Peter D. Sly
- grid.1003.20000 0000 9320 7537Queensland Children's Medical Research Institute and Centre for Child Health Research, University of Queensland, Brisbane, Australia
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Early origins of chronic obstructive lung diseases across the life course. Eur J Epidemiol 2014; 29:871-85. [PMID: 25537319 DOI: 10.1007/s10654-014-9981-5] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 12/06/2014] [Indexed: 12/12/2022]
Abstract
Chronic obstructive lung diseases, like asthma and chronic obstructive pulmonary disease, have high prevalences and are a major public health concern. Chronic obstructive lung diseases have at least part of their origins in early life. Exposure to an adverse environment during critical periods in early life might lead to permanent developmental adaptations which results in impaired lung growth with smaller airways and lower lung volume, altered immunological responses and related inflammation, and subsequently to increased risks of chronic obstructive lung diseases throughout the life course. Various pathways leading from early life factors to respiratory health outcomes in later life have been studied, including fetal and early infant growth patterns, preterm birth, maternal obesity, diet and smoking, children's diet, allergen exposure and respiratory tract infections, and genetic susceptibility. Data on potential adverse factors in the embryonic and preconception period and respiratory health outcomes are scarce. Also, the underlying mechanisms how specific adverse exposures in the fetal and early postnatal period lead to chronic obstructive lung diseases in later life are not yet fully understood. Current studies suggest that interactions between early environmental exposures and genetic factors such as changes in DNA-methylation and RNA expression patterns may explain the early development of chronic obstructive lung diseases. New well-designed epidemiological studies are needed to identify specific critical periods and to elucidate the mechanisms underlying the development of chronic obstructive lung disease throughout the life course.
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241
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Sasaki M, Yoshida K, Adachi Y, Furukawa M, Itazawa T, Odajima H, Saito H, Akasawa A. Factors associated with asthma control in children: findings from a national Web-based survey. Pediatr Allergy Immunol 2014; 25:804-9. [PMID: 25443716 DOI: 10.1111/pai.12316] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND Although achieving and maintaining control of asthma is considered to be the goal of asthma treatment, determinants of asthma control are not fully understood. Our aim was to assess factors associated with asthma control among paediatric patients in the general population. METHODS In June 2012, a Web-based survey was conducted to identify Japanese children aged 6 to 11 yr who currently have asthma and evaluate control of their disease using the Childhood Asthma Control Test (C-ACT). Associations were evaluated among uncontrolled asthma (C-ACT score <20) between environmental factors, demographics and comorbid allergic diseases. RESULTS Among the 3066 children with current asthma, 447 (14.6%) had uncontrolled asthma. Multivariable analysis identified factors such as low birthweight (adjusted OR 1.65, 95% CI 1.25-2.18), obesity (adjusted OR 1.44, 95% CI 1.05-1.99) and pet ownership before birth (adjusted OR 1.68, 95% CI 1.24-2.29) to be associated with uncontrolled disease. Comorbid allergic diseases, especially rhinitis were a significant risk of uncontrolled asthma (adjusted OR for severe rhinitis: 3.88, 95% CI 2.50-6.00). The severity of rhinitis symptoms was inversely correlated with the C-ACT score (p < 0.001). CONCLUSIONS A population-based Web survey showed an association between several factors and the control of paediatric asthma. The assessment of these factors may help identify the children at risk with uncontrolled asthma.
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Affiliation(s)
- Mari Sasaki
- Division of Allergy, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
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242
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Kocak M. Meta-analysis of bivariate P values. World J Meta-Anal 2014; 2:179-185. [DOI: 10.13105/wjma.v2.i4.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 05/08/2014] [Accepted: 10/29/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To propose a new meta-analysis method for bivariate P value which account for the paired structure.
METHODS: Studies that look to test two different features from the same sample gives rise to bivariate P value. A relevant example of this is testing for periodicity as well expression from time-course gene expression studies. Kocak et al (2010) uses George and Mudholkar’ (1983) “Difference of Two Logit-Sums” method to pool bivariate P value across independent experiments, assuming independence within a pair. As bivariate P value need not to be independent within a given study, we propose a new meta-analysis approach for pooling bivariate P value across independent experiments, which accounts for potential correlation between paired P-values. We compare the “Difference of Two Logit Sums”method with our novel approach in terms of their sensitivity and specificity through extensive simulations by generating P value samples from most commonly used tests namely, Z test, t test, chi-square test, and F test, with varying sample sizes and correlation structure.
RESULTS: The simulations results showed that our new meta-analysis approach for correlated and uncorrelated bivariate P value has much more desirable sensitivity and specificity features compared to the existing method, which treats each member of the paired P value as independent. We also compare these meta-analysis approaches on bivariate P value from periodicity and expression tests of 4936 S.Pombe genes from 10 independent time-course experiments and we showed that our new approach ranks the periodic, conserved, and cycling genes significantly higher, and detects many more periodic, “conserved” and “cycling” genes among the top 100 genes, compared to the ‘Difference of Two Logit-Sums’ method. Finally, we used our meta-analytic approach to compare the relative evidence in the association of pre-term birth with preschool wheezing versus pre-school asthma.
CONCLUSION: The new meta-analysis method has much better sensitivity and specific characteristics compared to the “Difference of Two-Logit Sums” method and it is not computationally more expensive.
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243
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Gibson PG, Foster PS. Asthma 2014: from monoclonals to the microbiome. THE LANCET RESPIRATORY MEDICINE 2014; 2:956-8. [PMID: 25466344 DOI: 10.1016/s2213-2600(14)70275-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Peter G Gibson
- Priority Research Centre for Asthma and Respiratory Disease, Faculty of Health and Medicine, The University of Newcastle, NSW 2305, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia.
| | - Paul S Foster
- Priority Research Centre for Asthma and Respiratory Disease, Faculty of Health and Medicine, The University of Newcastle, NSW 2305, Australia
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244
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Xu XF, Hu QY, Liang LF, Wu L, Gu WZ, Tang LL, Fu LC, Du LZ. Epigenetics of hyper-responsiveness to allergen challenge following intrauterine growth retardation rat. Respir Res 2014; 15:137. [PMID: 25391516 PMCID: PMC4233040 DOI: 10.1186/s12931-014-0137-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 10/23/2014] [Indexed: 01/07/2023] Open
Abstract
Background Epidemiological studies have revealed that intrauterine growth retardation (IUGR) or low birth weight is linked to the later development of asthma. Epigenetic regulatory mechanisms play an important role in the fetal origins of adult disease. However, little is known regarding the correlation between epigenetic regulation and the development of asthma following IUGR. Methods An IUGR and ovalbumin (OVA)-sensitization/challenge rat model was used to study whether epigenetic mechanisms play a role in the development of asthma following IUGR. Results Maternal nutrient restriction increased histone acetylation levels of the endothelin-1 (ET-1) gene promoter in lung tissue of offspring, but did not cause significant alterations of DNA methylation. The effect was maintained until 10 weeks after birth. Furthermore, these epigenetic changes may have induced IUGR individuals to be highly sensitive to OVA challenge later in life, resulting in more significant changes related to asthma. Conclusions These findings suggest that epigenetic mechanisms might be closely associated with the development of asthma following IUGR, providing further insight for improved prevention of asthma induced by environmental factors.
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Affiliation(s)
- Xue-Feng Xu
- Department of Respiratory Medicine, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People's Republic of China.
| | - Qiong-Yao Hu
- Department of Neonatology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People's Republic of China.
| | - Ling-Fang Liang
- Department of Pediatric ICU, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People's Republic of China.
| | - Lei Wu
- Department of Respiratory Medicine, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People's Republic of China.
| | - Wei-Zhong Gu
- Department of Pathology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People's Republic of China.
| | - Li-Li Tang
- Department of Neonatology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People's Republic of China.
| | - Lin-Chen Fu
- Department of Neonatology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People's Republic of China.
| | - Li-Zhong Du
- Department of Neonatology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People's Republic of China.
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245
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Carraro S, Scheltema N, Bont L, Baraldi E. Early-life origins of chronic respiratory diseases: understanding and promoting healthy ageing. Eur Respir J 2014; 44:1682-96. [PMID: 25323240 DOI: 10.1183/09031936.00084114] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Chronic obstructive respiratory disorders such as asthma and chronic obstructive pulmonary disease often originate early in life. In addition to a genetic predisposition, prenatal and early-life environmental exposures have a persistent impact on respiratory health. Acting during a critical phase of lung development, these factors may change lung structure and metabolism, and may induce maladaptive responses to harmful agents, which will affect the whole lifespan. Some environmental factors, such as exposure to cigarette smoke, type of childbirth and diet, may be modifiable, but it is more difficult to influence other factors, such as preterm birth and early exposure to viruses or allergens. Here, we bring together recent literature to analyse the critical aspects involved in the early stages of lung development, going back to prenatal and perinatal events, and we discuss the mechanisms by which noxious factors encountered early on may have a lifelong impact on respiratory health. We briefly comment on the need for early disease biomarkers and on the possible role of "-omic" technologies in identifying risk profiles predictive of chronic respiratory conditions. Such profiles could guide the ideation of effective preventive strategies and/or targeted early lifestyle or therapeutic interventions.
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Affiliation(s)
- Silvia Carraro
- Women's and Children's Health Dept, University of Padua, Padua, Italy
| | - Nienke Scheltema
- Dept of Pediatrics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Louis Bont
- Dept of Pediatrics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Eugenio Baraldi
- Women's and Children's Health Dept, University of Padua, Padua, Italy
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246
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Hekking PPW, Bel EH. Developing and emerging clinical asthma phenotypes. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2014; 2:671-80; quiz 681. [PMID: 25439356 DOI: 10.1016/j.jaip.2014.09.007] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 09/19/2014] [Accepted: 09/21/2014] [Indexed: 01/14/2023]
Abstract
For more than a century, clinicians have attempted to subdivide asthma into different phenotypes based on triggers that cause asthma attacks, the course of the disease, or the prognosis. The first phenotypes that were described included allergic asthma, intrinsic or nonallergic asthma, infectious asthma, and aspirin-exacerbated asthma. These phenotypes are being reviewed elsewhere in this issue of the journal. The present article focuses on developing and emerging clinical asthma phenotypes. First, asthma phenotypes that are associated with environmental exposures (occupational agents, cigarette smoke, air pollution, cold dry air); second, asthma phenotypes that are associated with specific symptoms or clinical characteristics (cough, obesity, adult onset of disease); and third, asthma phenotypes that are based on biomarkers. This latter approach is the most promising because it attempts to identify asthma phenotypes with different underlying mechanisms so that therapies can be better targeted toward disease-specific features and disease outcomes can be improved.
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Affiliation(s)
- Pieter-Paul W Hekking
- The Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands.
| | - Elisabeth H Bel
- The Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands
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247
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Li S, Zhang M, Tian H, Liu Z, Yin X, Xi B. Preterm birth and risk of type 1 and type 2 diabetes: systematic review and meta-analysis. Obes Rev 2014; 15:804-11. [PMID: 25073871 DOI: 10.1111/obr.12214] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Revised: 06/14/2014] [Accepted: 06/14/2014] [Indexed: 11/27/2022]
Abstract
Preterm birth is suggested to play an important role in the development of diabetes. However, results have been inconsistent. We conducted a systematic review and meta-analysis to clarify the relationship between preterm birth and type 1 and type 2 diabetes. PubMed, Embase and ISI Web of Science were searched. A total of 18 studies (including 2,176,480 participants and 22,073 cases) for type 1 diabetes and five studies (including 31,478 participants and 1,898 cases) for type 2 diabetes were included in the current meta-analyses. We calculated pooled odds ratio (OR) and 95% confidence interval (CI) using fixed-effects model to evaluate the relations between preterm birth and type 1 and type 2 diabetes. The results suggested that preterm birth was significantly associated with increased risk of type 1 diabetes (OR = 1.18, 95% CI = 1.11-1.25), with no evidence of between-study heterogeneity (I(2) = 13.2%, P = 0.296). Preterm birth was also significantly associated with increased risk of type 2 diabetes (OR = 1.51, 95% CI = 1.32-1.72), with no evidence of (I(2) = 0.0%, P = 0.557). Subgroup analyses suggested that there was significant association in both case-control studies (OR = 1.16, 95% CI = 1.06-1.26) and cohort studies (relative risk = 1.20, 95% CI = 1.11-1.29) for type 1 diabetes, and similar results were found for type 2 diabetes. The results suggested that preterm birth was a significant and independent risk factor for both type 1 and type 2 diabetes.
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Affiliation(s)
- S Li
- Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China
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248
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Ha S, Hu H, Roussos-Ross D, Haidong K, Roth J, Xu X. The effects of air pollution on adverse birth outcomes. ENVIRONMENTAL RESEARCH 2014; 134:198-204. [PMID: 25173052 PMCID: PMC4262551 DOI: 10.1016/j.envres.2014.08.002] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 07/02/2014] [Accepted: 08/03/2014] [Indexed: 05/18/2023]
Abstract
BACKGROUND Air pollution has been shown to have adverse effects on many health outcomes including cardiorespiratory diseases and cancer. However, evidence on the effects of prenatal exposure is still limited. The purpose of this retrospective cohort study is to evaluate the effects of prenatal exposure to air pollutants including particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5) and ozone (O3) on the risk of adverse birth outcomes (ABOs) including term low birth weight (LBW), preterm delivery (PTD) and very PTD (VPTD). METHODS singleton births from 2004 to 2005 in Florida were included in the study (N=423,719). Trimester-specific exposures to O3 and PM2.5 at maternal residence at delivery were estimated using the National Environmental Public Health Tracking Network data, which were interpolated using Hierarchical Bayesian models. RESULTS After adjustment for potential confounders such as demographics, medical and lifestyle factors PM2.5 exposures in all trimesters were found to be significantly and positively associated with the risk of all ABOs. Second-trimester exposure had the strongest effects. For an interquartile range (IQR) increase in PM2.5 during the second trimester, the risk of term LBW, PTD and VPTD increased by 3% [95% confidence interval (CI): 1-6%)], 12% (11-14%) and 22% (18-25%), respectively. O3 was also found to be positively associated with PTD and VPTD with the strongest effects over the whole pregnancy period [3% (1-5%) for PTD and 13% (7-19%) for VPTD for each IQR increase]. However, O3 was observed to have protective effects on term LBW. Results were consistent for multi-pollutant models. CONCLUSION PM2.5 has consistent adverse effects on ABOs whereas O3 has inconsistent effects. These findings warrant further investigation.
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Affiliation(s)
- Sandie Ha
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, PO Box 100231, Gainesville, FL 32610, USA
| | - Hui Hu
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, PO Box 100231, Gainesville, FL 32610, USA
| | - Dikea Roussos-Ross
- Department of Obstetrics and Gynecology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Kan Haidong
- Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai 200433, China
| | - Jeffrey Roth
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Xiaohui Xu
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, PO Box 100231, Gainesville, FL 32610, USA.
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249
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Astle V, Broom M, Todd DA, Charles B, Ringland C, Ciszek K, Shadbolt B. Respiratory outcomes study (RESPOS) for preterm infants at primary school age. J Asthma 2014; 52:40-5. [PMID: 25162302 DOI: 10.3109/02770903.2014.952436] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Pulmonary function abnormalities and hospital re-admissions in survivors of neonatal lung disease remain highly prevalent. The respiratory outcomes study (RESPOS) aimed to investigate the respiratory and associated atopy outcomes in preterm infants <30 weeks gestational age (GA) and/or birth-weight (BWt) <1000 g at primary school age, and to compare these outcomes between infants with and without chronic lung disease (CLD). METHODS In the RESPOS 92 parents of preterm infants admitted to the Neonatal unit in Canberra Hospital between 1/1/2001 and 31/12/2003 were sent a questionnaire regarding their respiratory, atopy management and follow-up. RESULTS Fifty-three parents responded, including 28 preterm infants who had CLD and 25 who had no CLD. The gestational age was significantly lower in the CLD group compared to the non-CLD group [26.9 (26.3-27.5) CLD and 28.6 (28.3-29.0) non-CLD] [weeks [95% confidence interval (CI)]], as was the birth weight [973 (877.4-1068.8) CLD versus 1221 (1135.0-1307.0) non-CLD] [g (CI)]. CLD infants compared to non-CLD infants were significantly more likely to have been: given surfactant, ventilated and on oxygen at 28 days and 36 weeks. These neonates were also more likely to have: been discharged from the neonatal unit on oxygen, exhibit a history of PDA or sepsis and to have a current paediatrician. However, despite these differences, there was no significant difference in the proportion of asthma or atopic disease between the two groups. CONCLUSIONS The RESPOS could not demonstrate respiratory and/or atopy differences between the CLD and the non-CLD groups at primary school age.
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Affiliation(s)
- Valerie Astle
- Department of Neonatology , Centenary Hospital for Women and Children , Canberra , Australia
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250
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Bacharier LB. Early-life weight gain, prematurity, and asthma development. J Allergy Clin Immunol 2014; 133:1330-1. [PMID: 24766877 DOI: 10.1016/j.jaci.2014.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 03/18/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Leonard B Bacharier
- Department of Pediatrics, Washington University and St Louis Children's Hospital, St Louis, Mo.
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