1
|
Bakoyan Z, Cao Y, Hansson SR, Karlsson JP, Lodefalk M. Childhood atopic disorders in relation to placental changes-A systematic review and meta-analysis. Pediatr Allergy Immunol 2024; 35:e14141. [PMID: 38773752 DOI: 10.1111/pai.14141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 04/15/2024] [Accepted: 04/22/2024] [Indexed: 05/24/2024]
Abstract
Fetal programming may arise from prenatal exposure and increase the risk of diseases later in life, potentially mediated by the placenta. The objective of this systematic review was to summarize and critically evaluate publications describing associations between human placental changes and risk of atopic disorders during childhood. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The inclusion criteria were original research articles or case reports written in English describing a human placental change in relation to disease occurring in offspring during childhood. The MEDLINE and EMBASE databases were searched for eligible studies. Risk of bias (RoB) was assessed using the ROBINS-I tool. The results were pooled both in a narrative way and by a meta-analysis. Nineteen studies were included (n = 12,997 participants). All studies had an overall serious RoB, and publication bias could not be completely ruled out. However, five studies showed that histological chorioamnionitis in preterm-born children was associated with asthma-related problems (pooled odds ratio = 3.25 (95% confidence interval = 2.22-4.75)). In term-born children, a large placenta (≥750 g) increased the risk of being prescribed anti-asthma medications during the first year of life. Placental histone acetylation, DNA methylation, and gene expression differences were found to be associated with different atopic disorders in term-born children. There is some evidence supporting the idea that the placenta can mediate an increased risk of atopic disorders in children. However, further studies are needed to validate the findings, properly control for confounders, and examine potential mechanisms.
Collapse
Affiliation(s)
- Zaki Bakoyan
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Stefan R Hansson
- Department of Obstetrics and Gynecology, Institute of Clinical Science Lund, Lund University, Lund, Sweden
| | | | - Maria Lodefalk
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Pediatrics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| |
Collapse
|
2
|
Caffarelli C, Gracci S, Giannì G, Bernardini R. Are Babies Born Preterm High-Risk Asthma Candidates? J Clin Med 2023; 12:5400. [PMID: 37629440 PMCID: PMC10455600 DOI: 10.3390/jcm12165400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/12/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Among preterm infants, the risk of developing asthma is a matter of debate. This review discusses the state of the art of poorly understood prematurity-associated asthma. Impaired pulmonary function is common in children born prematurely. Preterm infants are prone to developing viral respiratory tract infections, bronchiolitis in the first year of life, and recurrent viral wheezing in preschool age. All of these conditions may precede asthma development. We also discuss the role of both atopic sensitization and intestinal microbiome and, consequently, immune maturation. Diet and pollution have been considered to better understand how prematurity could be associated with asthma. Understanding the effect of factors involved in asthma onset may pave the way to improve the prediction of this asthma phenotype.
Collapse
Affiliation(s)
- Carlo Caffarelli
- Clinica Pediatrica, Azienda Ospedaliero-Universitaria, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Serena Gracci
- Pediatric Unit, San Giuseppe Hospital, 50053 Empoli, Italy
| | - Giuliana Giannì
- Clinica Pediatrica, Azienda Ospedaliero-Universitaria, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | | |
Collapse
|
3
|
Crump C, Sundquist J, Sundquist K. Preterm or early term birth and long-term risk of asthma into midadulthood: a national cohort and cosibling study. Thorax 2023; 78:653-660. [PMID: 35907641 PMCID: PMC9884998 DOI: 10.1136/thorax-2022-218931] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/13/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Preterm birth is associated with pulmonary complications early in life; however, long-term risks of asthma into adulthood are unclear. OBJECTIVE To determine asthma risks from childhood into adulthood associated with gestational age at birth in a large population-based cohort. METHODS A national cohort study was conducted of all 4 079 878 singletons born in Sweden during 1973-2013, followed up for asthma identified from primary care, specialty outpatient and inpatient diagnoses in nationwide registries through 2018 (up to 46 years). Cox regression was used to adjust for potential confounders, and cosibling analyses assessed the influence of unmeasured shared familial (genetic and/or environmental) factors. RESULTS In 91.9 million person-years of follow-up, 607 760 (14.9%) persons were diagnosed with asthma. Preterm birth was associated with increased risk of asthma at ages <10 years (adjusted HR 1.73; 95% CI 1.70 to 1.75), 10-17 years (1.29; 1.27 to 1.32) and 18-46 years (1.19; 1.17 to 1.22). Across all ages, adjusted HRs further stratified were 3.01 (95% CI 2.88 to 3.15) for extremely preterm (22-27 weeks), 1.76 (1.72 to 1.79) for very or moderately preterm (28-33 weeks), 1.31 (1.29 to 1.32) for late preterm (34-36 weeks) and 1.13 (1.12 to 1.14) for early term (37-38 weeks), compared with full-term (39-41 weeks) birth. These findings were not explained by shared familial factors. Asthma risks were elevated after spontaneous or medically indicated preterm birth and with or without perinatal respiratory complications. CONCLUSIONS In this large national cohort, preterm and early term birth were associated with increased risks of asthma from childhood into midadulthood. Persons born prematurely need long-term follow-up into adulthood for timely detection and treatment of asthma.
Collapse
Affiliation(s)
- Casey Crump
- Departments of Family Medicine and Community Health and of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | | |
Collapse
|
4
|
Pulakka A, Risnes K, Metsälä J, Alenius S, Heikkilä K, Nilsen SM, Näsänen-Gilmore P, Haaramo P, Gissler M, Opdahl S, Kajantie E. Preterm birth and asthma and COPD in adulthood: a nationwide register study from two Nordic countries. Eur Respir J 2023; 61:2201763. [PMID: 36990472 PMCID: PMC10285109 DOI: 10.1183/13993003.01763-2022] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/28/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Preterm birth affects lungs in several ways but few studies have follow-up until adulthood. We investigated the association of the entire spectrum of gestational ages with specialist care episodes for obstructive airway disease (asthma and chronic obstructive pulmonary disease (COPD)) at age 18-50 years. METHODS We used nationwide registry data on 706 717 people born 1987-1998 in Finland (4.8% preterm) and 1 669 528 born 1967-1999 in Norway (5.0% preterm). Care episodes of asthma and COPD were obtained from specialised healthcare registers, available in Finland for 2005-2016 and in Norway for 2008-2017. We used logistic regression to estimate odds ratios (ORs) for having a care episode with either disease outcome. RESULTS Odds of any obstructive airway disease in adulthood for those born at <28 or 28-31 completed weeks were 2-3-fold of those born full term (39-41 completed weeks), persisting after adjustments. For individuals born at 32-33, 34-36 or 37-38 weeks, the odds were 1.1- to 1.5-fold. Associations were similar in the Finnish and the Norwegian data and among people aged 18-29 and 30-50 years. For COPD at age 30-50 years, the OR was 7.44 (95% CI 3.49-15.85) for those born at <28 weeks, 3.18 (95% CI 2.23-4.54) for those born at 28-31 weeks and 2.32 (95% CI 1.72-3.12) for those born at 32-33 weeks. Bronchopulmonary dysplasia in infancy increased the odds further for those born at <28 and 28-31 weeks. CONCLUSION Preterm birth is a risk factor for asthma and COPD in adulthood. The high odds of COPD call for diagnostic vigilance when adults born very preterm present with respiratory symptoms.
Collapse
Affiliation(s)
- Anna Pulakka
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Kari Risnes
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Children's Clinic, St. Olavs University Hospital, Trondheim, Norway
| | - Johanna Metsälä
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Suvi Alenius
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Katriina Heikkilä
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sara Marie Nilsen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Center for Health Care Improvement, St. Olavs University Hospital, Trondheim, Norway
| | - Pieta Näsänen-Gilmore
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Faculty of Medicine, and Health Technology, Tampere Center for Child, Adolescent, and Maternal Health Research: Global Health Group, Tampere University, Tampere, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Peija Haaramo
- Finnish Social and Health Data Permit Authority Findata, Helsinki, Finland
| | - Mika Gissler
- Department of Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland
- Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Signe Opdahl
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Eero Kajantie
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
5
|
Banda PDNP, Amarasinghe GS, Agampodi SB. Determinants of birthweight in rural Sri Lanka; a cohort study. BMC Pediatr 2023; 23:40. [PMID: 36690991 PMCID: PMC9869565 DOI: 10.1186/s12887-022-03830-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 12/29/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Identifying determinants of birthweight among disadvantaged communities is critical to further reducing the inequitable burden of perinatal health issues in low-and-middle income settings. Therefore, we adopted a bio-psycho-social approach to identify the determinants of birthweight in a mother-infant cohort from a rural setting in Sri Lanka, a lower-middle-income country. METHODS All third-trimester pregnant women with a singleton pregnancy registered for the national antenatal care programme at Ipalogama health division in 2017 were invited for a prospective cohort study. Data was collected using a self-completed questionnaire and data extraction from health records. The mother-infant cohort was followed up until one month after delivery. A principal component analysis was performed using economic, social, and psychological variables, and two composite variables were achieved. Care from husband and household members, perceived wellbeing, frequency of abuse, and affect during the third trimester strongly loaded to the variable 'psychosocial wellbeing'. Monthly income, husband's education level, and use of biomass fuel strongly loaded to the variable 'socioeconomic status'. Hierarchical logistic regression was used to predict factors associated with birthweight. Maternal age, parity, baby's sex, and gestational period at pregnancy registration were entered at the first step. BMI, psychosocial wellbeing, socioeconomic status, hypertensive disorders, and gestational/chronic diabetes were entered at step two. Preterm birth was entered at step three. RESULTS 532 women were recruited, and 495 were retained at the postpartum follow-up. 421 (74.8%) had reported being abused at least once during the preceding month. Birthweight was approximately normally distributed (mean 2912 g, SD 456.6 g). Low birthweight was present in 72 (14.6%, 95% CI 11.7,17.9), and 46 (9.3%, 95% CI 7.0,12.1) had birthweights > 3500 g. The regression model explained 13.2% of the variance in birthweight. Preterm birth, maternal BMI, and mid-pregnancy psychosocial wellbeing could explain 6.9%(p < 0.001), 3.9(p < 0.001), and 1.2%(p = 0.02) of unique variance, respectively. CONCLUSIONS In a setting where a large proportion of pregnant women suffer 'abuse' in their homes, psychosocial wellbeing during pregnancy was an important determinant of birthweight of babies. Expanding routine maternal care services, especially at the primary care level, to cater to the psychosocial issues of pregnant women would help reduce inequities in perinatal health.
Collapse
Affiliation(s)
| | - Gayani Shashikala Amarasinghe
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka.
| | - Suneth Buddhika Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saiyapura, Sri Lanka
| |
Collapse
|
6
|
Jin C, Zhang T, Li Y, Shi W. Early-Life Exposure to Malnutrition From the Chinese Famine on Risk of Asthma and Chronic Obstructive Pulmonary Disease in Adulthood. Front Nutr 2022; 9:848108. [PMID: 35711537 PMCID: PMC9194571 DOI: 10.3389/fnut.2022.848108] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/29/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives Intrauterine malnutrition has a long-term effect on respiratory and lung function. However, few studies have explored the association between early-life exposure to famine with asthma and chronic obstructive pulmonary disease (COPD) in adulthood. Therefore, we aimed to investigate the association of early-life exposure to the Chinese famine of 1959–1962 with asthma and COPD later in life. Methods This national population-based study included 6,771 participants from the baseline survey of the China Health and Retirement Longitudinal Study (CHARLS) who were born around the time of the Chinese famine. The famine exposure groups were determined according to the participants' birth year as non-exposed (1964–1967), fetal-exposed (1959–1962), preschool-exposed (1954–1957), and school-age exposed (1950–1953). Information about the demographic characteristics, self-reported doctor-diagnosed asthma and COPD, behavior and lifestyles, and indoor pollution were collected using validated questionnaires. In addition, peak expiratory flow (PEF) was measured to assess pulmonary function. Multivariable logistic regression and generalized linear mixed models were performed to explore the risk of adult asthma and COPD, PEF changes during various famine exposure periods compared with the non-exposed group. Stratified and sensitivity analyses were conducted to examine the modification and robustness of the association. Results The prevalence of doctor-diagnosed asthma and COPD was 2.8 and 8.1%, respectively. Compared with the non-exposed group, the risk was significantly higher in the fetal-exposed group for asthma [adjusted odds ratio, (aOR) = 1.87, 95% confidence interval (CI):1.14–3.07] and the school-age exposed group [1.30 (1.00–1.69)] for COPD after controlling for confounders. Furthermore, we observed that fetal exposure to famine was significantly associated with a decrement of PEF in adulthood [β = −11.38 (−22.75 to −0.02)] compared with the non-exposed group. Stratified analyses showed that the association of asthma was stronger in men, who resided in severely famine-affected areas, smoked, and used solid fuels for cooking. No clearly consistent association was observed for subsequent COPD. Conclusions Our results suggest that fetal exposure to the Chinese famine is significantly associated with the increased risk of asthma in adulthood. Future prospective studies are warranted to examine the association and mechanisms.
Collapse
Affiliation(s)
- Changbo Jin
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Tiantian Zhang
- School of Public Health, Fudan University, Shanghai, China
| | - Yongzhen Li
- Department of Nutrition and Food Science, School of Public Health, Fudan University, Shanghai, China
| | - Wenming Shi
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| |
Collapse
|
7
|
Nanishi M, Fujiogi M, Stevenson M, Liang L, Qi YS, Raita Y, Hasegawa K, Camargo CA. Association of Growth Trajectory Profiles with Asthma Development in Infants Hospitalized with Bronchiolitis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:723-731.e5. [PMID: 34788659 PMCID: PMC9239901 DOI: 10.1016/j.jaip.2021.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/26/2021] [Accepted: 11/01/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Little is known about the relationship of longitudinal growth trajectory in early life with asthma development, particularly in infants with bronchiolitis (a high-risk population). OBJECTIVE Among infants with bronchiolitis, we aimed to identify growth trajectory profiles and determine their longitudinal relationship with the risk for developing childhood asthma. METHODS A multicenter prospective study enrolled infants (aged <1 year) hospitalized for bronchiolitis. We identified growth trajectory profiles-derived from body mass index-for-age at ages 0, 6, 12, 15, 18, 24, and 36 months by using a longitudinal clustering method. We examined associations between growth trajectory profiles and asthma development by age 5 years. RESULTS The analytic cohort consists of 880 infants hospitalized for bronchiolitis (median age, 3 months). Overall, 26% developed asthma by age 5 years. The longitudinal clustering identified 5 distinct profiles: persistent low growth (27%), normative growth (33%), transient overweight (21%), late-onset overweight (16%), and persistent obesity (3%) profiles. In multivariable model, compared with children with a normative profile, those with a persistent obesity profile had significantly higher risks of developing asthma (24% vs 38%, odds ratio [OR]: 2.55, 95% confidence interval [CI]: 1.07-6.09, P = .03). Among children with a persistent obesity profile, those without allergic predisposition had significantly higher risks of asthma (OR: 3.02, 95% CI: 1.05-8.64, P = .04 in the nonparental allergic history group; OR: 3.18, 95% CI: 1.02-9.92, P = .047 in the non-IgE sensitization group), whereas those with allergic predisposition were not at increased risk. CONCLUSIONS This multicenter cohort study of infants with bronchiolitis demonstrated distinct growth trajectory profiles that have differential risks for developing asthma.
Collapse
Affiliation(s)
- Makiko Nanishi
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
| | - Michimasa Fujiogi
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - Liming Liang
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Ying Shelly Qi
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Yoshihiko Raita
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Kohei Hasegawa
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| |
Collapse
|
8
|
Ali GB, Lowe AJ, Perret JL, Walters EH, Lodge CJ, Johns D, James A, Erbas B, Hamilton GS, Bowatte G, Wood-Baker R, Abramson MJ, Bui DS, Dharmage SC. Impact of lifetime body mass index trajectories on the incidence and persistence of adult asthma. Eur Respir J 2022; 60:13993003.02286-2021. [PMID: 35210325 DOI: 10.1183/13993003.02286-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/30/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND High body mass index trajectories from childhood to adulthood are associated with development of some chronic diseases, but whether such trajectories influence adult asthma has not been investigated to date. Therefore, we investigated associations between body mass index trajectories from childhood to middle age (5-43 years) and incidence, persistence, and relapse of asthma from ages 43 to 53 years. METHODS In the Tasmanian Longitudinal Health Study (n= 4194), weight and height were recorded at 8-time points between 5 and 43 years. body mass index trajectories were developed using group-based trajectory modelling. Associations between body mass index trajectories and asthma incidence, persistence, and relapse from 43 to 53 years; bronchial hyper-responsiveness at 50 years; and bronchodilator responsiveness at 53 years were modelled using multiple logistic and linear regression. RESULTS Five distinct body mass index trajectories were identified: average, low, high, child high-decreasing, and child average-increasing. Compared to the average trajectory, child average-increasing and high trajectories were associated with increased risk of incident asthma (OR=2.6; 95%CI 1.1, 6.6 and OR=4.4; 1.7, 11.4, respectively) and bronchial hyper-responsiveness in middle age (OR= 2.9; 1.1, 7.5 and OR= 3.5;1.1, 11.4, respectively). No associations were observed for asthma persistence or relapse. CONCLUSION Participants with child average-increasing and high body mass index trajectories from childhood to middle age were at higher risk of incident adult asthma. Thus, encouraging individuals to maintain normal body mass index over the life course may help reduce the burden of adult asthma.
Collapse
Affiliation(s)
- Gulshan Bano Ali
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Adrian J Lowe
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Jennifer L Perret
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,Institute for Breathing and Sleep (IBAS), Melbourne, Australia
| | - E Haydn Walters
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,School of Medicine, University of Tasmania, Hobart, Australia
| | - Caroline J Lodge
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - David Johns
- School of Medicine, University of Tasmania, Hobart, Australia
| | - Alan James
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia.,Medical School, University of Western Australia, Perth, Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Garun S Hamilton
- Sleep Medicine Research at Monash Medical Centre, Department of Lung and Sleep, Clayton, Australia.,School of Clinical Sciences, Monash University, Clayton, Australia
| | - Gayan Bowatte
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | | | - Michael J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Dinh S Bui
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,Equal Senior Authors
| | - Shyamali C Dharmage
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia .,Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia.,Equal Senior Authors
| |
Collapse
|
9
|
Qu X, Lee LC, Ladd-Acosta C, Hong X, Ji Y, Kalb LG, Volk HE, Wang X. Association between atopic diseases and neurodevelopmental disabilities in a longitudinal birth cohort. Autism Res 2022; 15:740-750. [PMID: 35112480 PMCID: PMC8995375 DOI: 10.1002/aur.2680] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/27/2021] [Accepted: 12/16/2021] [Indexed: 12/22/2022]
Abstract
Reports on the association between the prevalence of atopic diseases and neurodevelopmental disabilities (NDs) have been inconsistent in the literature. We investigated whether autism spectrum disorder (ASD), attention deficit-hyperactivity disorders (ADHD), and other NDs are more prevalent in children with asthma, atopic dermatitis (AD) and allergic rhinitis (AR) compared to those without specific atopic conditions. A total of 2580 children enrolled at birth were followed prospectively, of which 119 have ASD, 423 have ADHD, 765 have other NDs, and 1273 have no NDs. Atopic diseases and NDs were defined based on physician diagnoses in electronic medical records. Logistic regressions adjusting for maternal and child characteristics estimated the associations between NDs (i.e., ASD, ADHD, and other NDs) and asthma, AD and AR, respectively. Children with asthma, AD or AR had a greater likelihood of having ADHD or other NDs compared with children without specific atopic conditions. The association between ASD and asthma diminished after adjusting for maternal and child factors. Either mothers or children having atopic conditions and both mothers and children with atopic conditions were associated with a higher prevalence of ADHD in children, compared with neither mothers nor children having atopic conditions. Children diagnosed with multiple atopic diseases were more likely to have NDs compared with those without or with only one type of atopic disease. In conclusion, in this U.S. urban birth cohort, children with atopic diseases had a higher co-morbidity of NDs. The findings have implications for etiologic research that searches for common early life antecedents of NDs and atopic conditions. Findings from this study also should raise awareness among health care providers and parents about the possible co-occurrence of both NDs and atopic conditions, which calls for coordinated efforts to screen, prevent and manage NDs and atopic conditions.
Collapse
Affiliation(s)
- Xueqi Qu
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Li-Ching Lee
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Christine Ladd-Acosta
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Xiumei Hong
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yuelong Ji
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Luther G Kalb
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.,Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Heather E Volk
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Xiaobin Wang
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
10
|
Risk factors for current wheeze among school children (6–7 and 13–14 years old) in Khuzestan, Iran. PUBLIC HEALTH IN PRACTICE 2021; 2:100172. [PMID: 36101606 PMCID: PMC9461578 DOI: 10.1016/j.puhip.2021.100172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 07/12/2021] [Accepted: 07/26/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives In recent years, there has been a clear trend of increasing allergic diseases especially in children, and developing countries are no exception. Thepresentstudy sought to determine the risk factors associated with wheezing among school children aged 6–7 and 13–14 years living in Khuzestan Province, Iran. Study design Cross-sectional. Methods Data for this cross-sectional study is the history of wheeze in the last 12 months. The participants included 6-7- and 13-14-year-old girls and boys studying in urban schools in Khuzestan Province in 2019. We collected the data using the multi stage sampling technique as suggested in the International Study of Asthma and Allergies in Childhood (ISAAC). The research reviewed the literature and consulted experts to collect the risk factors for demographic and clinical information, environmental exposure and lifestyle. Results Eight thousand questionnaires were handed out to both age groups, of which 7344 were completed. Two hundred ninety-nine (4.1 %) of the participants had current wheeze. Three-point four percent (124 individuals) in the 6–7 year age group and 4.8 % in the 13–14-year-old age group had current wheezing. The results of the logistic regression model suggest that the most significant risk factors associated with the chance of developing current wheeze in the both age groups are: being male (OR: 1.46, 95 % CI: 1.12–1.88), being from employed mother families (OR: 1.50, 95 %, CI:1.05–2.08), property ownership (OR:1.36, 95 %, CI:1.04–1.79) bugs in the property (OR: 1.29, 95 %, CI:0.99–1.70) mold in the property (OR: 1.75, 95 %, CI:1.12–2.76), pet(s) in the student's bedroom (OR: 1.75, 95 %, CI: 0.97–3.14), a family history of asthma and allergic diseases (OR: 2.20, 95 %, CI: 1.69–2.87), tobacco smoke exposures in the property (OR: 1.43, 95 %, CI:1.04–1.96), having allergic rhinitis (OR: 7.86, 95 % CI: 5.89–10.50) and eczema (OR: 3.85, 95 % CI: 2.10–7.08). Conclusions Families are suggested to adopt strategies to reduce exposure to outdoor air pollutants and contain indoor allergens. More studies are necessary to further explore the effects of modifying and changing these risk factors. 3.4 % in the 6–7 year age group and 4.8 % in the 13–14 year age group had current wheezing. In both age groups, current wheeze is more common in boys than girls. Mold in the home, pet in the bedroom and tobacco smoke exposures are the most important risk factors for current wheeze.
Collapse
|
11
|
Pijnenburg MW, Frey U, De Jongste JC, Saglani S. Childhood asthma- pathogenesis and phenotypes. Eur Respir J 2021; 59:13993003.00731-2021. [PMID: 34711541 DOI: 10.1183/13993003.00731-2021] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 10/15/2021] [Indexed: 11/05/2022]
Abstract
In the pathogenesis of asthma in children there is a pivotal role for a type 2 inflammatory response to early life exposures or events. Interactions between infections, atopy, genetic susceptibility, and environmental exposures (such as farmyard environment, air pollution, tobacco smoke exposure) influence the development of wheezing illness and the risk for progression to asthma. The immune system, lung function and the microbiome in gut and airways develop in parallel and dysbiosis of the microbiome may be a critical factor in asthma development. Increased infant weight gain and preterm birth are other risk factors for development of asthma and reduced lung function. The complex interplay between these factors explains the heterogeneity of asthma in children. Subgroups of patients can be identified as phenotypes based on clinical parameters, or endotypes, based on a specific pathophysiological mechanism. Paediatric asthma phenotypes and endotypes may ultimately help to improve diagnosis of asthma, prediction of asthma development and treatment of individual children, based on clinical, temporal, developmental or inflammatory characteristics. Unbiased, data-driven clustering, using a multidimensional or systems biology approach may be needed to better define phenotypes. The present knowledge on inflammatory phenotypes of childhood asthma has now been successfully applied in the treatment with biologicals of children with severe therapy resistant asthma, and it is to be expected that more personalized treatment options may become available.
Collapse
Affiliation(s)
- Mariëlle W Pijnenburg
- Department of Paediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Urs Frey
- University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Johan C De Jongste
- Department of Paediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Sejal Saglani
- National Heart and Lung Institute, Imperial College, London, UK
| |
Collapse
|
12
|
Mavoa S, Keevers D, Kane SC, Wake M, Tham R, Lycett K, Wong YT, Chong K. Parental Preconception Exposures to Outdoor Neighbourhood Environments and Adverse Birth Outcomes: A Protocol for a Scoping Review and Evidence Map. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178943. [PMID: 34501533 PMCID: PMC8431720 DOI: 10.3390/ijerph18178943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/22/2021] [Accepted: 08/23/2021] [Indexed: 11/19/2022]
Abstract
Parental preconception exposures to built and natural outdoor environments could influence pregnancy and birth outcomes either directly, or via a range of health-related behaviours and conditions. However, there is no existing review summarising the evidence linking natural and built characteristics, such as air and noise pollution, walkability, greenness with pregnancy and birth outcomes. Therefore, the planned scoping review aims to collate and map the published literature on parental preconception exposures to built and natural outdoor environments and adverse pregnancy and birth outcomes. We will search electronic databases (MEDLINE, EMBASE, Scopus) to identify studies for inclusion. Studies will be included if they empirically assess the relationship between maternal and paternal preconception exposures to physical natural and built environment features that occur outdoors in the residential neighbourhood and adverse pregnancy and birth outcomes. Two reviewers will independently screen titles and abstracts, and then the full text. Data extraction and assessment of study quality will be performed by one researcher and checked by a second researcher. Results will be summarised in a narrative synthesis, with additional summaries presented as tables and figures. The scoping review will be disseminated via a peer-reviewed publication, at academic conferences, and published on a website.
Collapse
Affiliation(s)
- Suzanne Mavoa
- Melbourne School of Population & Global Health, University of Melbourne, Parkville, VIC 3010, Australia
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia; (M.W.); (K.L.)
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia;
- Correspondence: ; Tel.: +61-3-9035-9720
| | - Daniel Keevers
- Melbourne Medical School, University of Melbourne, Parkville, VIC 3010, Australia;
| | - Stefan C. Kane
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, VIC 3010, Australia;
- Department of Maternal Fetal Medicine, Royal Women’s Hospital, Parkville, VIC 3052, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia; (M.W.); (K.L.)
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3010, Australia
- Liggins Institute, University of Auckland, Grafton, Auckland 1023, New Zealand
| | - Rachel Tham
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia;
| | - Kate Lycett
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia; (M.W.); (K.L.)
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3010, Australia
- School of Psychology, Faculty of Health, Deakin University, Burwood, VIC 3125, Australia
| | - Yen Ting Wong
- IMPACT Institute, School of Medicine, Deakin University, Waurn Ponds, VIC 3216, Australia;
| | - Katherine Chong
- Ingram School of Nursing, McGill University, Montreal, QC H3A 2M7, Canada;
| |
Collapse
|
13
|
Conway JM. Mass Incarceration and Children's Health: A State-Level Analysis of Adverse Birth Outcomes and Infant, Child, and Teen Mortality. FAMILY & COMMUNITY HEALTH 2021; 44:194-205. [PMID: 33646979 DOI: 10.1097/fch.0000000000000295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Children's health indicators such as mortality and adverse birth outcomes are poorer in the United States than in comparable nations. These measures also show racial inequities within the United States, with Black children experiencing the highest levels. Mass incarceration may partially explain these findings. High incarceration rates can disrupt community functioning, influencing behavior and health. The purpose of the current study was to conduct a macro (state)-level analysis examining whether yearly state incarceration rates predict health outcomes including infant, child, and teen mortality as well as preterm birth and low birth weight. It was hypothesized that prior year incarceration rates would show positive relationships with all outcomes and that relationships would be stronger for Black than for white children. Yearly state-level panel data were gathered from 1990 to 2017. Weighted least squares regression used states' prior year incarceration rates to predict child health outcomes, using controls for overall state effects and year-to-year effects. Time-varying covariates such as state unemployment rate were also included to address the possibility of spurious relationships. Results indicated that as hypothesized, incarceration rates positively predicted infant mortality, child mortality (for Black children only), preterm births, and low-weight births. Relationships tended to be stronger for Black than for white children.
Collapse
Affiliation(s)
- James M Conway
- Department of Psychological Science, Central Connecticut State University, New Britain
| |
Collapse
|
14
|
Grant T, Brigham EP, McCormack MC. Childhood Origins of Adult Lung Disease as Opportunities for Prevention. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 8:849-858. [PMID: 32147138 DOI: 10.1016/j.jaip.2020.01.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/26/2019] [Accepted: 01/16/2020] [Indexed: 02/06/2023]
Abstract
Prenatal and childhood exposures have been shown to impact lung development, lung function trajectory, and incidence and prevalence of respiratory disease. Early life may serve as a window of susceptibility to such exposures, with the potential to influence lifelong respiratory health. Risk factors encountered in early life with potentially durable impact on lung health include prematurity, respiratory viral illness, allergen sensitization and exposure, tobacco use and exposure, indoor and outdoor pollution, diet, and obesity. These exposures vary in the extent to which they are modifiable, and interventions aimed at reducing harmful exposures range from individual-level behavior modification to policy initiatives implemented to promote population health. For many exposures, including tobacco-related exposures, multilevel interventions are needed. Future research is needed to provide insight as to early-life interventions to promote optimal lung growth and prevent development of chronic respiratory disease. Clinicians should play an active role, assisting individual patients in avoiding known detrimental exposures including maternal smoking during pregnancy and initiation of active smoking. Clinicians can be empowered by evidence to support policies promoting reduction of population-level risk factors, such as restriction on electronic cigarette sales and legislation to uphold air quality standards, to encourage attainment of maximal lung function and reduce risk of chronic lung disease.
Collapse
Affiliation(s)
- Torie Grant
- Division of Pediatric Allergy/Immunology, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Emily P Brigham
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Meredith C McCormack
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Md.
| |
Collapse
|
15
|
Ghimire PR, Mooney J, Fox L, Dubois L. Smoking Cessation during the Second Half of Pregnancy Prevents Low Birth Weight among Australian Born Babies in Regional New South Wales. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073417. [PMID: 33806144 PMCID: PMC8036667 DOI: 10.3390/ijerph18073417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 01/14/2023]
Abstract
Smoking during pregnancy is a modifiable risk behavior of adverse health outcomes including low birth weight (LBW), and LBW is a key marker of newborns immediate and future health. This study aimed to examine the association between smoking cessation during the second half of pregnancy and LBW among babies born in Southern New South Wales Local Health District (SNSWLHD). Routinely collected perinatal data on singleton live births for the period 2011–2019 in five public hospitals of SNSWLHD were utilized. Multivariate logistic regression models were fitted to examine the association between smoking cessation during the second half of pregnancy and LBW. Analyses showed that mothers who ceased smoking during the second half of pregnancy were 44% less likely to have LBW babies (adjusted odds ratio (aOR) = 0.56; 95% confidence interval (CI): 0.34, 0.94) compared to those who continued smoking throughout pregnancy. Mothers who reported an average daily dose of 1–10 or >10 cigarettes during the second half of pregnancy were significantly more likely to have babies with LBW than those who ceased smoking during the second half of pregnancy. Early identification of smoking behavior and promotion of smoking-cessation intervention for risk populations including pregnant women within the older age bracket (35–49 years) is imperative to reduce LBW.
Collapse
Affiliation(s)
- Pramesh Raj Ghimire
- Population Health, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia;
- Correspondence: ; Tel.: +61-436-852-496
| | - Julie Mooney
- Nursing and Midwifery, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia;
| | - Louise Fox
- Integrated Care and Allied Health, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia;
| | - Lorraine Dubois
- Population Health, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia;
| |
Collapse
|
16
|
Al Yassen AQ, Al-Asadi JN, Khalaf SK. The role of Caesarean section in childhood asthma. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2019; 14:10-17. [PMID: 32175036 PMCID: PMC7067498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE As indicated by previous studies, children born via Caesarean section may have an increased risk of developing asthma compared with those born via vaginal delivery. The aim of this study is to assess the association between a Caesarean section and the risk of childhood asthma. Methods: This was a case-control study carried out in Basrah, Iraq including 952 children aged 3-12 years. Four hundred and seven asthmatic cases and a control group of 545 age-matched non-asthmatic children were enrolled. Binary logistic regression was used to assess the relationship between asthma and birth via Caesarean section. RESULTS The mean age of the children was 6.7±2.5 years. Two-hundred eighty-three children (29.7%) were delivered via Caesarean section. The binary logistic regression analysis showed that delivery via Caesarean section was found to be an independent significant risk factor for asthma (OR=3.37; 95% CI=1.76-6.46; p<0.001). In addition, many other risk factors were found to be significant predictors of asthma, including bottlefeeding (OR=27.29; 95% CI=13.54-54.99; p<0.001) and low birth weight (OR=16.7; 95% CI=6.97-37.49; p<0.001). CONCLUSION Caesarean section is significantly associated with an increased risk of childhood asthma.
Collapse
Affiliation(s)
- AQ Al Yassen
- FRACGP College of Medicine, Basrah University, Iraq E-mail:
| | - JN Al-Asadi
- M.Sc. College of Medicine, Basrah University, Iraq E-mail:
| | - SK Khalaf
- Ph. D. College of Medicine, Basrah University, Iraq
| |
Collapse
|
17
|
Yu B, Dai L, Chen J, Sun W, Chen J, Du L, Deng N, Chen D. Prenatal and neonatal factors involved in the development of childhood allergic diseases in Guangzhou primary and middle school students. BMC Pediatr 2019; 19:479. [PMID: 31810445 PMCID: PMC6898923 DOI: 10.1186/s12887-019-1865-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 11/29/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Allergic diseases, such as asthma, dermatitis, rhinitis, and eczema, are highly prevalent in Chinese school children. Environmental factors, including air pollution and automobile exhaust, play an important role in the etiology of these diseases. However, prenatal and neonatal factors, such as gender, maternal diseases during pregnancy, and premature birth, may also be associated with allergic disease occurrence. The objective of this study was to explore prenatal and neonatal factors that are involved in the development of allergic diseases among primary and middle school students in Guangzhou, China. METHODS A cross-sectional survey was launched by the Health Promotion Centre for Primary and Secondary Schools of the Guangzhou Municipality in October 2017. All primary and middle school students in Guangzhou were notified to participate in the questionnaire online under the direction of their parents. The results of the physical examination were reported by the schools' medical department. The results of the questionnaire were collected and analyzed by the researchers. The prevalence of asthma, allergic rhinitis, allergic dermatitis, and eczema was identified. RESULTS Based on reported 183,449 questionnaires and medical records, the data indicate that the sex, birth weight, neonatal feeding type, delivery mode, and students' father smoking status were significantly associated with the prevalence of all four allergic diseases in primary and middle school children. In further stratified analyses of the children with normal birth weight (2500-4000 g) and without any maternal diseases during pregnancy, the factors of male sex, high birth weight, cesarean delivery, and father smoking status all increased the risk of asthma, dermatitis, rhinitis, and eczema. Also, unlike exclusive breastfeeding, breast plus formula feeding increased these risks, but pure formula feeding had the opposite effect. CONCLUSION Prenatal and neonatal factors, including male sex, high birth weight, cesarean delivery, only child, and father smoking status are associated with the risks of allergic diseases in school children.
Collapse
Affiliation(s)
- Bolan Yu
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, No.63 Duobao Rd, Guangzhou, 510150, China. .,Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, No.63 Duobao Rd, Guangzhou, 510150, China.
| | - Lijuan Dai
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, No.63 Duobao Rd, Guangzhou, 510150, China.,Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, No.63 Duobao Rd, Guangzhou, 510150, China
| | - Juanjuan Chen
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, No.63 Duobao Rd, Guangzhou, 510150, China.,Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, No.63 Duobao Rd, Guangzhou, 510150, China
| | - Wen Sun
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, No.63 Duobao Rd, Guangzhou, 510150, China.,Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, No.63 Duobao Rd, Guangzhou, 510150, China
| | - Jingsi Chen
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, No.63 Duobao Rd, Guangzhou, 510150, China.,Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, No.63 Duobao Rd, Guangzhou, 510150, China
| | - Lili Du
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, No.63 Duobao Rd, Guangzhou, 510150, China.,Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, No.63 Duobao Rd, Guangzhou, 510150, China
| | - Nali Deng
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, China
| | - Dunjin Chen
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, No.63 Duobao Rd, Guangzhou, 510150, China. .,Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, No.63 Duobao Rd, Guangzhou, 510150, China.
| |
Collapse
|
18
|
Takata N, Tanaka K, Nagata C, Arakawa M, Miyake Y. Preterm birth is associated with higher prevalence of wheeze and asthma in a selected population of Japanese children aged three years. Allergol Immunopathol (Madr) 2019; 47:425-430. [PMID: 30573321 DOI: 10.1016/j.aller.2018.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 10/04/2018] [Accepted: 10/22/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND The present cross-sectional study investigated the associations between low birthweight (LBW), high birthweight, preterm birth (PTB), postterm birth, small for gestational age (SGA), and large for gestational age (LGA) and the prevalence of wheeze and asthma in Japanese children aged three years (age range, 33-54 months; mean age, 38.7 months). METHODS Study subjects were 6364 children. A questionnaire was used to collect all data. Wheeze and asthma were defined according to the criteria of the International Study of Asthma and Allergies in Childhood. RESULTS The prevalence values of wheeze and asthma were 19.5% and 7.7%, respectively. Of the 6364 subjects, 8.8% were classified as LBW (<2500g), 90.4% as normal birthweight, 0.8% as high birthweight (≥4000g), 4.8% as PTB (<37 weeks), 94.8% as term birth, 0.4% as postterm birth (≥42 weeks), 7.8% as SGA (<10th percentile), 82.5% as appropriate for gestational age, and 9.7% as LGA (>90th percentile). Compared with term birth, PTB was independently positively associated with wheeze and asthma: the adjusted ORs (95% CI) were 1.47 (1.11-1.92) and 1.52 (1.02-2.20), respectively. An independent positive association was shown between PTB and wheeze only in boys; the interaction between PTB and sex was significant. Such an interaction between PTB and sex was not seen for asthma. No evident associations were observed between LBW, high birthweight, postterm birth, SGA, or LGA and wheeze or asthma. CONCLUSIONS This is the first study in Japan to show that PTB, but not LBW or SGA, was significantly positively associated with childhood wheeze and asthma.
Collapse
|
19
|
Johansson K, McSorley HJ. Interleukin-33 in the developing lung-Roles in asthma and infection. Pediatr Allergy Immunol 2019; 30:503-510. [PMID: 30734382 DOI: 10.1111/pai.13040] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 01/06/2019] [Accepted: 01/08/2019] [Indexed: 02/07/2023]
Abstract
It has become increasingly clear that interleukin-33 (IL-33) plays a crucial role in initiation of type 2 immunity. The last decade of intense research has uncovered multiple mechanisms through which IL-33 targets key effector cells of the allergic immune response. Recently, IL-33 has been implicated in shaping the immune system of the lungs early in life, at a time which is crucial in the subsequent development of allergic asthma. In this review, we will address the current literature describing the role of IL-33 in the healthy and diseased lung. In particular, we will focus on the evidence for IL-33 in the development of immune responses in the lung, including the role of IL-33-responsive immune cells that may explain susceptibility to allergic sensitization at a young age and the association between genetic variants of IL-33 and asthma in humans. Finally, we will indicate areas for potential therapeutic modulation of the IL-33 pathway.
Collapse
Affiliation(s)
- Kristina Johansson
- Department of Microbiology and Immunology, Sandler Asthma Basic Research Center, University of California, San Francisco, California.,Department of Medicine, University of California, San Francisco, California
| | - Henry J McSorley
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
20
|
Abstract
Asthma in inner-city children is often severe and difficult to control. Residence in poor and urban areas confers increased asthma morbidity even after adjusting for ethnicity, age, and gender. Higher exposure to household pests, such as cockroaches and mice, pollutants and tobacco smoke exposure, poverty, material hardship, poor-quality housing, differences in health care quality, medication compliance, and heath care access also contribute to increased asthma morbidity in this population. Since 1991, the National Institutes of Allergy and Infectious Diseases established research networks: the National Cooperative Inner-City Asthma Study (NCICAS), the Inner-City Asthma Study (ICAS), and the Inner-City Asthma Consortium (ICAC), to improve care for this at risk population. The most striking finding of the NCICAS is the link between asthma morbidity and the high incidence of allergen sensitization and exposure, particularly cockroach. The follow-up ICAS confirmed that reductions in household cockroach and dust mite were associated with reduction in the inner-city asthma morbidity. The ICAC studies have identified that omalizumab lowered fall inner-city asthma exacerbation rate; however, the relationship between inner-city asthma vs immune system dysfunction, respiratory tract infections, prenatal environment, and inner-city environment is still being investigated. Although challenging, certain interventions for inner-city asthma children have shown promising results. These interventions include family-based interventions such as partnering families with asthma-trained social workers, providing guidelines driven asthma care as well as assured access to controller medication, home-based interventions aim at elimination of indoor allergens and tobacco smoke exposure, school-based asthma programs, and computer/web-based asthma programs.
Collapse
|
21
|
Dharmage SC, Bui DS, Perret JL, Lodge CJ. Lung function deficits of adults born very preterm and with very low birthweight. THE LANCET RESPIRATORY MEDICINE 2019; 7:643-645. [PMID: 31078499 DOI: 10.1016/s2213-2600(19)30042-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 01/22/2019] [Indexed: 11/16/2022]
Affiliation(s)
- Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3052, Australia.
| | - Dinh S Bui
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3052, Australia; Department of Toxicology, Hanoi University of Pharmacy, Hanoi, Vietnam
| | - Jennifer L Perret
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3052, Australia; Institute for Breathing & Sleep, Melbourne, VIC, Australia
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3052, Australia
| |
Collapse
|
22
|
Early-life undernutrition reprograms CD4 + T-cell glycolysis and epigenetics to facilitate asthma. J Allergy Clin Immunol 2019; 143:2038-2051.e12. [PMID: 30654047 DOI: 10.1016/j.jaci.2018.12.999] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 11/28/2018] [Accepted: 12/24/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Exposure to early-life undernutrition is closely related to higher risks of adverse immunologic outcomes in adulthood. Although it has been suggested that asthma has its origins in early life, its underlying mechanisms remain largely unknown. OBJECTIVE We characterized the effects of early-life undernutrition on T lymphocytes, which play a pivotal role in immune diseases, and we investigated whether this contributes to susceptibility to asthma in adulthood. METHODS Pregnant mice were fed a protein restriction diet (PRD) to establish an early-life undernutrition model. Naive CD4+ T cells (CD4+CD62LhiCD44-) from offspring were used throughout the study. TH2 differentiation was examined by using fluorescence-activated cell sorting and ELISA under TH2-polarized conditions in vitro and through ovalbumin-induced experimental asthma in vivo. T-cell metabolism was measured with a Seahorse XF96 Analyzer. DNA methylation levels were measured by using bisulfite sequencing. RESULTS PRD CD4+ T cells displayed increased activation and proliferation and were prone to differentiate into TH2 cells both in vitro and in vivo, leading to susceptibility to experimental asthma. Mechanistically, early-life undernutrition upregulated mechanistic target of rapamycin 1-dependent glycolysis and induced conserved noncoding DNA sequence 1 DNA hypomethylation in the TH2 cytokine locus of CD4+ T cells. Glycolysis blockades undermined increased TH2 skewing and alleviated experimental asthma in PRD mice. CONCLUSION Early-life undernutrition induced mechanistic target of rapamycin 1-dependent glycolysis upregulation and TH2 cytokine locus hypomethylation in CD4+ T cells, resulting in increased T-cell activation, proliferation, and TH2 skewing and further susceptibility to experimental asthma.
Collapse
|
23
|
Matheson MC, Bowatte G, Perret JL, Lowe AJ, Senaratna CV, Hall GL, de Klerk N, Keogh LA, McDonald CF, Waidyatillake NT, Sly PD, Jarvis D, Abramson MJ, Lodge CJ, Dharmage SC. Prediction models for the development of COPD: a systematic review. Int J Chron Obstruct Pulmon Dis 2018; 13:1927-1935. [PMID: 29942125 PMCID: PMC6005295 DOI: 10.2147/copd.s155675] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Early identification of people at risk of developing COPD is crucial for implementing preventive strategies. We aimed to systematically review and assess the performance of all published models that predicted development of COPD. A search was conducted to identify studies that developed a prediction model for COPD development. The Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies was followed when extracting data and appraising the selected studies. Of the 4,481 records identified, 30 articles were selected for full-text review, and only four of these were eligible to be included in the review. The only consistent predictor across all four models was a measure of smoking. Sex and age were used in most models; however, other factors varied widely. Two of the models had good ability to discriminate between people who were correctly or incorrectly classified as at risk of developing COPD. Overall none of the models were particularly useful in accurately predicting future risk of COPD, nor were they good at ruling out future risk of COPD. Further studies are needed to develop new prediction models and robustly validate them in external cohorts.
Collapse
Affiliation(s)
- Melanie C Matheson
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Gayan Bowatte
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,National Institute of Fundamental Studies, Kandy, Sri Lanka
| | - Jennifer L Perret
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Department of Respiratory and Sleep Medicine, Institute for Breathing and Sleep, Austin Health, University of Melbourne, Melbourne, VIC, Australia
| | - Adrian J Lowe
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Chamara V Senaratna
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Department of Community Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Graham L Hall
- Telethon Kids Institute, Perth, WA, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia.,Centre of Child Health Research, University of Western Australia, Perth, WA, Australia
| | - Nick de Klerk
- Telethon Kids Institute, Perth, WA, Australia.,Centre of Child Health Research, University of Western Australia, Perth, WA, Australia
| | - Louise A Keogh
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Christine F McDonald
- Department of Respiratory and Sleep Medicine, Institute for Breathing and Sleep, Austin Health, University of Melbourne, Melbourne, VIC, Australia
| | - Nilakshi T Waidyatillake
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Peter D Sly
- Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - Deborah Jarvis
- MRC-PHE Centre for Environment and Health, Imperial College London, London, UK.,Population Health and Occupational Diseases, National Heart and Lung Institute, Imperial College London, London, UK
| | - Michael J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia
| |
Collapse
|
24
|
Gudmundsdottir J, Söderling J, Berggren H, Óskarsdóttir S, Neovius M, Stephansson O, Ekwall O. Long-term clinical effects of early thymectomy: Associations with autoimmune diseases, cancer, infections, and atopic diseases. J Allergy Clin Immunol 2018; 141:2294-2297.e8. [PMID: 29454003 DOI: 10.1016/j.jaci.2018.01.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 01/23/2018] [Accepted: 01/29/2018] [Indexed: 02/02/2023]
Affiliation(s)
- Judith Gudmundsdottir
- Department of Rheumatology and Inflammation Research, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Children's Medical Center, University Hospital of Iceland, Reykjavík, Iceland.
| | - Jonas Söderling
- Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institute, Stockholm, Sweden
| | - Håkan Berggren
- Department of Molecular and Clinical Medicine, Institute of Clinical Sciences, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sólveig Óskarsdóttir
- Department of Pediatrics, Institute of Clinical Sciences, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Martin Neovius
- Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institute, Stockholm, Sweden
| | - Olof Stephansson
- Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institute, Stockholm, Sweden; School of Public Health, University of California, Berkeley, Calif
| | - Olov Ekwall
- Department of Rheumatology and Inflammation Research, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Pediatrics, Institute of Clinical Sciences, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|