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Brew BK, Donnolley N, Henry A, Dahlen H, Jalaludin B, Chambers GM. Double jeopardy-pregnancy and birth during a catastrophic bushfire event followed by a pandemic lockdown, a natural experiment. ENVIRONMENTAL RESEARCH 2022; 214:113752. [PMID: 35777439 DOI: 10.1016/j.envres.2022.113752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/01/2022] [Accepted: 06/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND From November 2019 to January 2020, eastern Australia experienced the worst bushfires in recorded history. Two months later, Sydney and surrounds were placed into lockdown for six weeks due to the COVID-19 pandemic, followed by ongoing restrictions. Many pregnant women at this time were exposed to both the bushfires and COVID-19 restrictions. OBJECTIVE To assess the impact of exposure to bushfires and pandemic restrictions on perinatal outcomes. METHODS The study included 60 054 pregnant women who gave birth between November 2017 and December 2020 in South Sydney. Exposure cohorts were based on conception and birthing dates: 1) bushfire late pregnancy, born before lockdown; 2) bushfires in early-mid pregnancy, born during lockdown or soon after; 3) conceived during bushfires, lockdown in second trimester; 4) conceived after bushfires, pregnancy during restrictions. Exposure cohorts were compared with pregnancies in the matching periods in the two years prior. Associations between exposure cohorts and gestational diabetes, preeclampsia, hypertension, stillbirth, mode of birth, birthweight, preterm birth and small for gestational age were assessed using generalised estimating equations, adjusting for covariates. RESULTS A decrease in low birth weight was observed for cohort 1 (aOR 0.81, 95%CI 0.69, 0.95). Conversely, cohort 2 showed an increase in low birth weight, and increases in prelabour rupture of membranes, and caesarean sections (aOR 1.18, 95%CI 1.03, 1.37; aOR 1.21, 95%CI 1.07, 1.37; aOR 1.10 (1.02, 1.18) respectively). Cohort 3 showed an increase in unplanned caesarean sections and high birth weight babies (aOR 1.15, 95%CI 1.04, 1.27 and aOR 1.16, 95%CI 1.02, 1.31 respectively), and a decrease in gestational diabetes mellitus was observed for both cohorts 3 and 4. CONCLUSION Pregnancies exposed to both severe climate events and pandemic disruptions appear to have increased risk of adverse perinatal outcomes beyond only experiencing one event, but further research is needed.
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Affiliation(s)
- Bronwyn K Brew
- National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health & School of Clinical Medicine, UNSW, Australia.
| | - Natasha Donnolley
- National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health & School of Clinical Medicine, UNSW, Australia
| | - Amanda Henry
- Discipline of Women's Health, School of Clinical Medicine, UNSW, Australia; Department of Women's and Children's Health, St George Hospital, Kogarah, NSW, Australia
| | - Hannah Dahlen
- School of Nursing and Midwifery, Western Sydney University, Australia
| | - Bin Jalaludin
- Ingham Institute for Applied Medical Research, UNSW Sydney, Australia
| | - Georgina M Chambers
- National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health & School of Clinical Medicine, UNSW, Australia
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Time-Specific Factors Influencing the Development of Asthma in Children. Biomedicines 2022; 10:biomedicines10040758. [PMID: 35453508 PMCID: PMC9025817 DOI: 10.3390/biomedicines10040758] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/16/2022] [Accepted: 03/23/2022] [Indexed: 02/01/2023] Open
Abstract
Susceptibility to asthma is complex and heterogeneous, as it involves both genetic and environmental insults (pre- and post-birth) acting in a critical window of development in early life. According to the Developmental Origins of Health and Disease, several factors, both harmful and protective, such as nutrition, diseases, drugs, microbiome, and stressors, interact with genotypic variation to change the capacity of the organism to successfully adapt and grow in later life. In this review, we aim to provide the latest evidence about predictive risk and protective factors for developing asthma in different stages of life, from the fetal period to adolescence, in order to develop strategic preventive and therapeutic interventions to predict and improve health later in life. Our study shows that for some risk factors, such as exposure to cigarette smoke, environmental pollutants, and family history of asthma, the evidence in favor of a strong association of those factors with the development of asthma is solid and widely shared. Similarly, the clear benefits of some protective factors were shown, providing new insights into primary prevention. On the contrary, further longitudinal studies are required, as some points in the literature remain controversial and a source of debate.
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Serrano-Lomelin J, Hicks A, Kumar M, Johnson DW, Chari R, Osornio-Vargas A, Crawford S, Bakal J, Ospina MB. Patterns of respiratory health services utilization from birth to 5 years of children who experienced adverse birth outcomes. PLoS One 2021; 16:e0247527. [PMID: 33606848 PMCID: PMC7895380 DOI: 10.1371/journal.pone.0247527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 02/09/2021] [Indexed: 01/04/2023] Open
Abstract
Introduction Adverse birth outcomes have important consequences for future lung health. We evaluated patterns of respiratory health services utilization in early childhood among children born preterm (PTB), small and large for gestational age at term (SGA and LGA, respectively), and appropriate-for-gestational age at term. Materials and methods We conducted a population-based retrospective cohort study using administrative health data of all singleton live births in Alberta, Canada between 2005–2010. Data on hospitalizations and emergency department (ED) visits from birth to 5 years were collected for asthma, bronchitis, bronchiolitis, croup, influenza, pneumonia, and other acute upper and lower respiratory tract infections (other URTI and other LRTI, respectively). Adjusted rate ratios were estimated for respiratory ED visits and hospitalizations for adverse birth outcomes using the appropriate-for-gestational age at term group as reference. Age-specific trajectories of total respiratory health services utilization rates for each group were estimated in Poisson models. Results A total of 293,764 episodes of respiratory care from 206,994 children were analyzed. Very PTB children had the highest rates of health services use for all respiratory conditions, particularly for asthma, pneumonia, and bronchiolitis hospitalizations. Moderate/late PTB children also had elevated ED visits and hospitalizations for all respiratory conditions. Children born SGA showed high rates of ED visits for other LRTI, and of hospitalizations for bronchitis, bronchiolitis, and other URTI. Children born LGA had high rates of croup and other URTI ED visits, and of bronchiolitis and bronchiolitis hospitalizations. Age-specific trajectories showed a decreasing trend in the rates of total respiratory health service utilization from birth to five years of age for all groups studied. Children born PTB and LGA at term significantly required more respiratory health services over time compared to the reference group. Conclusion Patterns of paediatric respiratory health services utilization vary according to gestational age and fetal growth.
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Affiliation(s)
- Jesus Serrano-Lomelin
- Faculty of Medicine & Dentistry, Department of Obstetrics & Gynecology, University of Alberta, Edmonton, Alberta, Canada
| | - Anne Hicks
- Faculty of Medicine & Dentistry, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Manoj Kumar
- Faculty of Medicine & Dentistry, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - David W. Johnson
- Department of Pediatrics, Emergency Medicine, and Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Radha Chari
- Faculty of Medicine & Dentistry, Department of Obstetrics & Gynecology, University of Alberta, Edmonton, Alberta, Canada
| | - Alvaro Osornio-Vargas
- Faculty of Medicine & Dentistry, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | | | | | - Maria B. Ospina
- Faculty of Medicine & Dentistry, Department of Obstetrics & Gynecology, University of Alberta, Edmonton, Alberta, Canada
- * E-mail:
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Brew B, Gibberd A, Marks GB, Strobel N, Allen CW, Jorm L, Chambers G, Eades S, McNamara B. Identifying preventable risk factors for hospitalised asthma in young Aboriginal children: a whole-population cohort study. Thorax 2021; 76:539-546. [PMID: 33419952 DOI: 10.1136/thoraxjnl-2020-216189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 12/14/2020] [Accepted: 12/17/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Australia has one of the highest rates of asthma worldwide. Indigenous children have a particularly high burden of risk determinants for asthma, yet little is known about the asthma risk profile in this population. AIM To identify and quantify potentially preventable risk factors for hospitalised asthma in Australian Aboriginal children (1-4 years of age). METHODS Birth, hospital and emergency data for all Aboriginal children born 2003-2012 in Western Australia were linked (n=32 333). Asthma was identified from hospitalisation codes. ORs and population attributable fractions were calculated for maternal age at birth, remoteness, area-level disadvantage, prematurity, low birth weight, maternal smoking in pregnancy, mode of delivery, maternal trauma and hospitalisations for acute respiratory tract infection (ARTI) in the first year of life. RESULTS There were 705 (2.7%) children hospitalised at least once for asthma. Risk factors associated with asthma included: being hospitalised for an ARTI (OR 4.06, 95% CI 3.44 to 4.78), area-level disadvantage (OR 1.58, 95% CI 1.28 to 1.94), being born at <33 weeks' gestation (OR 3.30, 95% CI 2.52 to 4.32) or birth weight <1500 g (OR 2.35, 95% CI 1.39 to 3.99). The proportion of asthma attributable to an ARTI was 31%, area-level disadvantage 18%, maternal smoking 5%, and low gestational age and birth weight were 3%-7%. We did not observe a higher risk of asthma in those children who were from remote areas. CONCLUSION Improving care for pregnant Aboriginal women as well as for Aboriginal infants with ARTI may help reduce the burden of asthma in the Indigenous population.
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Affiliation(s)
- Bronwyn Brew
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia .,School of Women's and Children's Health, University of New South Wales, Sydney, 2033, New South Wales, Australia
| | - Alison Gibberd
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Guy B Marks
- Woolcock Institute of Medical Research, Sydney, New South Wales, Australia.,South West Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Natalie Strobel
- Kurongkurl Katitjin, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Clare Wendy Allen
- Children's Hospital Westmead, University of Sydney, Westmead, New South Wales, Australia
| | - Louisa Jorm
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Georgina Chambers
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, 2033, New South Wales, Australia
| | - Sandra Eades
- Curtin Medical School, Curtin University, Perth, Western Australia, Australia
| | - Bridgette McNamara
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Effect of Intrauterine Smoke Exposure on microRNA-15a Expression in Human Lung Development and Subsequent Asthma Risk. Healthcare (Basel) 2020; 8:healthcare8040536. [PMID: 33291534 PMCID: PMC7761806 DOI: 10.3390/healthcare8040536] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/28/2020] [Accepted: 11/30/2020] [Indexed: 11/16/2022] Open
Abstract
Background: In utero smoke (IUS) exposure is associated with asthma susceptibility. Objective: We sought to test the hypothesis that changes in miRNA expression by IUS exposure during human lung development is associated with asthma susceptibility. Methods: Gene expression was profiled from 53 IUS unexposed and 51 IUS exposed human fetal lung tissues. We tested for the differential expression of miRNAs across post-conception age and by IUS using linear models with covariate adjustment. We tested the IUS-associated miRNAs for association with their gene expression targets using pair-wise inverse correlation. Using our mouse model, we investigated the persistence of the IUS-associated miRNA signature using RT-PCR from the lungs of mouse pups with and without IUS at postnatal day 14. MiRNAs were then tested for association with asthma and exacerbations using whole blood gene expression profiles from Asthma BRIDGE. Results: Five miRNAs were differentially expressed across post-conception age (adjusted p < 0.0002) including two that were differentially expressed by IUS exposure in human fetal lung (p < 0.05). MiR-15a was differentially expressed by post-conception age (p = 0.00002), IUS exposure in human fetal lung (p = 0.005), and in the post-natal mouse lung (p = 0.01). MiR-15a was also associated with the in utero expression of GSDMB (adjusted p = 0.0002), a known childhood asthma gene and with asthma exacerbations (p = 0.0009) in Asthma BRIDGE. Thus, miR-15a is expressed during human lung development, is impacted by IUS exposure, regulates the intrauterine expression of asthma genes, and is associated with asthma severity. Conclusions: These results provide evidence for the role of miR-15a in the fetal origin of asthma.
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Garden FL, Toelle BG, Mihrshahi S, Webb KL, Almqvist C, Tovey ER, Brew BK, Ayer JG, Skilton MR, Jones G, Ferreira MAR, Cowie CT, Weber-Chrysochoou C, Britton WJ, Celermajer DS, Leeder SR, Peat JK, Marks GB. Cohort profile: The Childhood Asthma Prevention Study (CAPS). Int J Epidemiol 2019; 47:1736-1736k. [PMID: 29800224 DOI: 10.1093/ije/dyy078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2018] [Indexed: 12/22/2022] Open
Affiliation(s)
- Frances L Garden
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia.,Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.,Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
| | - Brett G Toelle
- Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia.,Sydney Local Health District, Sydney, NSW, Australia
| | - Seema Mihrshahi
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Karen L Webb
- Nutrition Policy Institute, University of California, Berkeley, CA, USA
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Euan R Tovey
- Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
| | - Bronwyn K Brew
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Julian G Ayer
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Heart Centre for Children, Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Michael R Skilton
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, NSW, Australia
| | - Graham Jones
- School of Science and Health, Western Sydney University, Sydney, NSW, Australia
| | | | - Christine T Cowie
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia.,Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.,Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
| | | | - Warwick J Britton
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Mycobacterial Research Program, Centenary Institute, Sydney, NSW, Australia
| | - David S Celermajer
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Stephen R Leeder
- Menzies Centre for Health Policy, University of Sydney, Sydney, NSW, Australia
| | - Jennifer K Peat
- Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
| | - Guy B Marks
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia.,Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.,Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
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7
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MacDonald KD, Vesco KK, Funk KL, Donovan J, Nguyen T, Chen Z, Lapidus JA, Stevens VJ, McEvoy CT. Maternal body mass index before pregnancy is associated with increased bronchodilator dispensing in early childhood: A cross-sectional study. Pediatr Pulmonol 2016; 51:803-11. [PMID: 26797879 PMCID: PMC4956540 DOI: 10.1002/ppul.23384] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 12/21/2015] [Accepted: 12/29/2015] [Indexed: 12/19/2022]
Abstract
RATIONALE Maternal prepregnancy obesity has been associated with early wheeze and childhood asthma in their offspring. Some of these studies have been in minority, urban, and disadvantaged populations using parental recall and questionnaires. The association of maternal prepregnancy obesity with bronchodilator dispensing to their offspring, in a primarily insured, non-urban, White population in the United States is unknown. OBJECTIVES AND METHODS We conducted a retrospective cohort study using pharmacy dispensing data from the electronic medical records of a large United States health maintenance organization to examine the relationship between maternal prepregnancy body mass index (BMI) and inhaled bronchodilator dispensing in the offspring to 4 years of age. We included infants ≥37 weeks' gestation with birth weight ≥2.5 kg which yielded 6,194 mother-baby pairs. Maternal prepregnancy BMI was categorized as underweight (<18.5 kg/m(2) ), normal (18.5-24.9 kg/m(2) ), overweight (25-29.9 kg/m(2) ), or obese (≥30 kg/m(2) ). RESULTS In the entire cohort, 27.6% of the offspring received a bronchodilator dispensing. This ranged from 19.2% in the offspring of underweight mothers to 31.3% of those born to obese mothers. In the fully adjusted model using normal BMI as the referent, children of obese mothers had a 22% higher rate of bronchodilator dispensing (adjusted OR = 1.22; 95%CI 1.05-1.41; P = 0.008). CONCLUSIONS In this insured, non-urban, White population, maternal prepregnancy obesity was associated with bronchodilator dispensing in the offspring in early life. These results extend previous data and reaffirm the potential widespread public health impact that prepregnancy obesity may have on subsequent childhood respiratory health. Pediatr Pulmonol. 2016;51:803-811. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Kelvin D MacDonald
- Oregon Health and Science University, 3181 SW Sam Jackson Road, Portland, Oregon
| | - Kimberly K Vesco
- Kasier Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, Oregon
| | - Kristine L Funk
- Kasier Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, Oregon
| | - Jerena Donovan
- Kasier Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, Oregon
| | - Thuan Nguyen
- Oregon Health and Science University, 3181 SW Sam Jackson Road, Portland, Oregon
| | - Zunqiu Chen
- Oregon Health and Science University, 3181 SW Sam Jackson Road, Portland, Oregon
| | - Jodi A Lapidus
- Oregon Health and Science University, 3181 SW Sam Jackson Road, Portland, Oregon
| | - Victor J Stevens
- Kasier Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, Oregon
| | - Cindy T McEvoy
- Oregon Health and Science University, 3181 SW Sam Jackson Road, Portland, Oregon
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Fishmeal supplementation during ovine pregnancy and lactation protects against maternal stress-induced programming of the offspring immune system. BMC Vet Res 2015; 11:266. [PMID: 26472344 PMCID: PMC4608120 DOI: 10.1186/s12917-015-0573-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 10/05/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Prenatally stressed offspring exhibit increased susceptibility to inflammatory disorders due to in utero programming. Research into the effects of n-3 PUFAs shows promising results for the treatment and prevention of these disorders. The purpose of this study was to investigate whether maternal fishmeal supplementation during pregnancy and lactation protects against programming of the offspring's immune response following simulated maternal infection. METHODS In order to accomplish this, 53 ewes were fed a diet supplemented with fishmeal (FM; rich in n-3 PUFA) or soybean meal (SM; rich in n-6 PUFAs) from day 100 of gestation (gd 100) through lactation. On gd135, half the ewes from each dietary group were challenged with either 1.2 μg/kg Escherichia coli lipopolysaccharide (LPS) endotoxin to simulate a bacterial infection, or saline as the control. At 4.5 months of age the offspring's dermal immune response was assessed by cutaneous hypersensitivity testing with ovalbumin (OVA) and candida albicans (CAA) 21 days after sensitization. Skinfold measurements were taken and serum blood samples were also collected to assess the primary and secondary antibody immune response. RESULTS Offspring born to SM + LPS mothers had a significantly greater change in skinfold thickness in response to both antigens as well as a greater secondary antibody response to OVA compared to all treatments. CONCLUSIONS Supplementation during pregnancy with FM appears to protect against adverse fetal programming that may occur during maternal infection and this may reduce the risk of atopic disease later in life.
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Hedman L, Andersson M, Bjerg A, Forsberg B, Lundbäck B, Rönmark E. Environmental risk factors related to the incidence of wheeze and asthma in adolescence. Clin Exp Allergy 2015; 45:184-91. [PMID: 24773259 DOI: 10.1111/cea.12335] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 03/04/2014] [Accepted: 03/15/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Asthma is common among adolescents, but there are few population-based studies on the risk factors for incident asthma and wheeze at this age group. OBJECTIVE To study risk factors for incident asthma and wheeze in adolescence. METHOD Within the Obstructive Lung Disease In Northern Sweden (OLIN) studies, a cohort of 3430 school children (age 7-8 year) was recruited in 1996. In the present study, this cohort was followed from age 12-19 year. At baseline (age 12 year), 3151 participated and skin prick tests (SPT) were performed. The cohort was resurveyed annually, and risk factors for the cumulative incidence of asthma and wheeze from age 12-19 year were analysed using multivariate Cox regression. RESULTS Female sex (wheeze: HR 1.4 95%CI 1.2-1.6; asthma: HR 1.8 95%CI 1.2-2.5) and a positive SPT to cat, dog or horse at baseline (wheeze: HR 1.6 95%CI 1.2-2.1; asthma: HR 2.3 95%CI 1.4-4.0) were significantly associated with the cumulative incidence of wheeze and asthma. Increasing numbers of siblings were inversely related to the incidence of wheeze (HR 0.9 95%CI 0.8-0.97) and asthma (HR 0.8 95%CI 0.7-0.97). Parental asthma was related to the incidence of asthma (HR 1.8 95%CI 1.2-2.6) while ever smoking (HR 2.0 95%CI 1.6-2.4) and house dampness (HR 1.3 95%CI 1.1-1.6) were risk factors for the incidence of wheeze. Maternal ETS exposure increased the risk of incident asthma in non-sensitized subjects (HR 1.9 95%CI 1.0-3.7). CONCLUSION AND CLINICAL RELEVANCE Several environmental risk factors related to the incidence of asthma and wheeze in adolescence were identified and may be possible targets for intervention and prevention.
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Affiliation(s)
- L Hedman
- Department of Public Health and Clinical Medicine, Division for Occupational and Environmental Medicine, The OLIN Unit, Umeå University, Umeå, Sweden
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10
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Boudewijn IM, Savenije OEM, Koppelman GH, Wijga AH, Smit HA, de Jongste JC, Gehring U, Postma DS, Kerkhof M. Nocturnal dry cough in the first 7 years of life is associated with asthma at school age. Pediatr Pulmonol 2015; 50:848-55. [PMID: 25158300 DOI: 10.1002/ppul.23092] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 05/14/2014] [Accepted: 06/17/2014] [Indexed: 11/11/2022]
Abstract
BACKGROUND Childhood wheeze is an important, well-known risk factor for asthma, yet little is known about the contribution of nocturnal dry cough. We investigated the association of nocturnal dry cough at ages 1-7 years with doctor-diagnosed asthma at 8 years of age, both in the presence and absence of wheeze. METHODS Data of 3,252 children from the PIAMA birth cohort were studied. Parents reported the presence of nocturnal dry cough, wheeze, and doctor-diagnosed asthma in the past 12 months yearly, from birth up to the age of 8 years. RESULTS Nocturnal dry cough without wheeze was significantly associated with doctor-diagnosed asthma at age 8, except for age 1 (range of Relative Risks (RR) at ages 2-7: 1.8 (age 5) - 7.1 (age 7), all P-values <0.048). As expected, wheeze without nocturnal dry cough was strongly associated with doctor-diagnosed asthma at age 8 (range of RR: 2.0 (age 1) - 22.2 (age 7), all P-values <0.003). Of interest, nocturnal dry cough with wheeze showed the strongest association with doctor-diagnosed asthma at age 8 (range of RR: 3.7 (age 1) - 26.0 (age 7), all P-values <0.001). The relative excess risk of asthma at age 8 due to interaction of nocturnal dry cough with wheeze at age 1 year was 1.8 (0.1-3.6, P < 0.01). CONCLUSION Nocturnal dry cough and wheeze in early childhood are both independently associated with asthma at school age. The presence of both nocturnal dry cough and wheeze at age 1 almost doubles the risk of asthma at age 8 compared to wheeze alone.
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Affiliation(s)
- Ilse M Boudewijn
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, GRIAC Research Institute, Groningen, The Netherlands.,University of Groningen, University Medical Center Groningen, Department of Pulmonary Medicine, GRIAC Research Institute, Groningen, The Netherlands
| | - Olga E M Savenije
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, GRIAC Research Institute, Groningen, The Netherlands
| | - Gerard H Koppelman
- University of Groningen, University Medical Center Groningen, Department of Pediatric Pulmonology and Pediatric Allergology, GRIAC Research Institute, Groningen, The Netherlands
| | - Alet H Wijga
- Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Henriëtte A Smit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Johan C de Jongste
- Department of Pediatrics, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Dirkje S Postma
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Medicine, GRIAC Research Institute, Groningen, The Netherlands
| | - Marjan Kerkhof
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, GRIAC Research Institute, Groningen, The Netherlands
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Kotecha SJ, Watkins WJ, Henderson AJ, Kotecha S. The effect of birth weight on lung spirometry in white, school-aged children and adolescents born at term: a longitudinal population based observational cohort study. J Pediatr 2015; 166:1163-7. [PMID: 25681202 DOI: 10.1016/j.jpeds.2015.01.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 12/09/2014] [Accepted: 01/05/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate how birth weight affects lung function measurements in childhood and adolescence in term-born children. STUDY DESIGN We used data for white, term-born, singletons, from the Avon Longitudinal Study of Parents and Children to determine the association between birth weight and lung function at age 8-9 (n=4086) and 14-17 (n=2582) years. z-scores for lung function measures, adjusted for sex, height, and age, were modeled in terms of birth weight z-score adjusted for sex. In addition, gestation and head circumference then confounders (maternal smoking during pregnancy and social class) were added to the model. RESULTS At age 8-9 years, birth weight z-scores were significantly associated with lung function z-scores (forced expiratory volume in 1 second, forced vital capacity [FVC], and forced mid-expiratory flow between 25% and 75% of FVC). These relationships essentially were unchanged when birth weight z-scores were further adjusted for gestation, head circumference, and confounders, except for forced mid-expiratory flow between 25% and 75% of FVC, which was no longer significant after we adjusted for head circumference and confounders. At age 14-17 years, the associations between adjusted birth-weight z-scores and spirometry z-scores were in general not significant. Estimated differences for forced expiratory volume in 1 second were 30 mL at ages 8-9 years and 33 mL at 14-17 years for 1 kg change in birth-weight standardized for gestation and sex. CONCLUSIONS Birth weight is associated with lung function in term-born children at 8-9 years, but less so at 14-17 years, suggesting that birth weight influences lung function in early childhood but has lesser effect later in life.
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Affiliation(s)
- Sarah J Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - W John Watkins
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - A John Henderson
- Department of Community-based Medicine, University of Bristol, Bristol, United Kingdom
| | - Sailesh Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom.
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12
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Mebrahtu TF, Feltbower RG, Greenwood DC, Parslow RC. Birth weight and childhood wheezing disorders: a systematic review and meta-analysis. J Epidemiol Community Health 2014; 69:500-8. [PMID: 25534771 DOI: 10.1136/jech-2014-204783] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 12/07/2014] [Indexed: 01/19/2023]
Abstract
BACKGROUND Previous observational studies have claimed that birth weight and childhood wheezing disorders are associated although the results remained inconsistent. One systematic review and two systematic reviews that included meta-analyses reported inconsistent results. We aimed to conduct a systematic review and meta-analysis to investigate this. METHODS An online search of published papers linking childhood asthma and wheezing disorders with birth weight up to February 2014 was carried out using EMBASE and Medline medical research databases. Summary ORs were estimated using random-effects models. Subgroup meta-analyses were performed to assess the robustness of risk associations and between-study heterogeneity. RESULTS A total of 37 studies comprising 1,71, 737 participants were included in our meta-analysis. The unadjusted summary ORs for risk of childhood wheezing disorders associated with low birth weight (<2.5 kg) were 1.60 (95% CI 1.39 to 1.85, p<0.001) and 1.37 (95% CI 1.05 to 1.79, p=0.02) when compared with ≥2.5 and 2.5-4.0 kg birthweight groups, respectively. The overall summary OR for high birth weight (>4 kg) as compared to the 2.5-4.0 kg birthweight group was 1.02 (95% CI 0.99 to 1.04, p=0.13). There was substantial heterogeneity in the unadjusted low birth weight risk estimates which was not accounted for by predefined study characteristics. There was no significant heterogeneity in the high birth weight risk estimates. There was some evidence of funnel plot asymmetry and small study effects in the low birth weight (2.5 vs ≥2.5 kg and <2.5 vs 2.5-4 kg) OR estimates. CONCLUSIONS Our results suggest that low birth (<2.5 kg) is an independent risk factor for wheezing disorders during childhood and adolescence although there was substantial heterogeneity among the risk estimates. However, we found no significant association of high birth weight with wheezing disorders.
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Affiliation(s)
- Teumzghi F Mebrahtu
- Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, Leeds, UK
| | - Richard G Feltbower
- Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, Leeds, UK
| | - Darren C Greenwood
- Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, Leeds, UK
| | - Roger C Parslow
- Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, Leeds, UK
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13
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Mari A, Antonietta Ciardiello M, Passalacqua G, Vliagoftis H, Wardlaw AJ, Wickman M. Developments in the field of allergy in 2012 through the eyes of Clinical & Experimental Allergy. Clin Exp Allergy 2014; 43:1309-32. [PMID: 24118214 DOI: 10.1111/cea.12212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In 2012, we received 683 submissions and published 20 editorials, 38 reviews, 11 letters and 128 original articles. This represents an acceptance rate for original papers in the range of 20%. About 30% of original papers were triaged not to go out to review, either because the editors did not feel they had sufficient priority for publication or because the topic did not feel right for the readers of the journal. We place great emphasis on obtaining sufficient high-quality reviews to make our decisions on publication fair and consistent. Inevitably, however, there is a degree of luck about what gets published and which papers miss out, and we are always happy to receive an appeal on our decisions either at the triage stage or after review. This gives us the opportunity to revisit the decision and revise it or explain in more detail to the authors the basis for the decision. Once again in 2012, we were delighted by the quality of the papers submitted and the breadth and depth of research into allergic disease that it revealed. The pattern of papers submitted was similar in previous years with considerable emphasis on all aspects of asthma and rhinitis. We were particularly pleased with our special issue on severe asthma. Elucidating mechanisms using either animal models or patients has always been a major theme of the journal, and the excellent work in these areas has been summarized by Harissios Vliagoftis with a particularly interesting section on early-life events guiding the development of allergic disease, which understandably continue to be a major theme of research. Magnus Wickman summarized the papers looking at the epidemiology of allergic disease including work from birth cohorts, which are an increasingly rich source of data on risk factors for allergic disease, and two papers on the epidemiology of anaphylaxis. Giovanni Passalacqua discussed the papers in the clinical allergy section of the journal, and Adriano Mari who runs the excellent Allergome website discussed the papers looking at allergens including characterization and the relative usefulness of allergen arrays versus single extracts in diagnosis and management.
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Affiliation(s)
- A Mari
- Allergome, Allergy Data Laboratories s.c., Latina, Italy
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14
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Byrjalsen A, Frøslev T, Telén Andersen AB, Olsen M, Sørensen HT. Use of corticosteroids during pregnancy and risk of asthma in offspring: a nationwide Danish cohort study. BMJ Open 2014; 4:e005053. [PMID: 24902733 PMCID: PMC4054622 DOI: 10.1136/bmjopen-2014-005053] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To examine whether in utero exposure to local and systemic corticosteroids is associated with asthma development in offspring. DESIGN Cohort study. SETTING Denmark. PARTICIPANTS We included all singletons born alive in Denmark between 1996 and 2009. Data on maternal corticosteroid use, asthma in offspring and covariates were obtained from medical registries. MAIN OUTCOME MEASURES We compared asthma risks of children prenatally exposed to corticosteroids and of children of former corticosteroid users with that of unexposed children. We computed absolute risks and used proportional-hazards regression to compute adjusted HRs (aHRs). Using logistic regression we compared exposed children with unexposed siblings in a 'within-mother-between-pregnancy' analysis. Adjustment addressed varying length of follow-up. RESULTS We identified 877 778 children, 3.6% of whom were prenatally exposed to systemic (n=5327) or local (n=24 436) corticosteroids. A total of 105 677 children developed asthma during follow-up with a 10-year risk of 18.4% among the exposed and 13.5% among the unexposed. The aHR was 1.54 (95% CI 1.45 to 1.65) for systemic use, 1.45 (95% CI 1.40 to 1.50) for local use and 1.32 (95% CI 1.30 to 1.34) for former use. The adjusted OR of the 'within-mother-between-pregnancy' analysis was 1.11 (95% CI 0.98 to 1.25). CONCLUSIONS These population-based data do not support a strong causal association between maternal corticosteroid use during pregnancy and increased asthma risk in offspring.
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Affiliation(s)
- Anna Byrjalsen
- Department of Clinical Epidemiology, Aarhus University, Aarhus N, Denmark
| | - Trine Frøslev
- Department of Clinical Epidemiology, Aarhus University, Aarhus N, Denmark
| | | | - Morten Olsen
- Department of Clinical Epidemiology, Aarhus University, Aarhus N, Denmark
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15
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Guibas GV, Moschonis G, Xepapadaki P, Roumpedaki E, Androutsos O, Manios Y, Papadopoulos NG. Conception via in vitro fertilization and delivery by Caesarean section are associated with paediatric asthma incidence. Clin Exp Allergy 2014; 43:1058-66. [PMID: 23957341 DOI: 10.1111/cea.12152] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 04/27/2013] [Accepted: 06/02/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND The association between perinatal factors and asthma inception is under rigorous investigation. Nevertheless, evidence of a correlation between asthma, conception via in vitro fertilization (IVF) and delivery through Caesarean section (C-section) is inconclusive. OBJECTIVE We aimed to assess the relation of asthma incidence with IVF and C-section, after controlling for several potential confounding factors. METHODS Parent-reported wheeze in the last 12 months (current), wheeze ever, physician-diagnosed asthma, method of conception, and type of delivery were recorded from questionnaires filled in by the parents of 2016 Greek children aged 9-13, (the Healthy Growth Study population). Some perinatal data were recorded from children's medical records and others were reported by parents; anthropometric measurements were also conducted in children. RESULTS IVF was correlated with physician-diagnosed asthma (OR = 2.25; 95% CI = 1.11-4.56), but not with current/ever wheeze after adjustment for potential confounding factors. After adjustment, C-section was also associated with asthma (OR = 1.39; 95% CI = 1.04-1.87), but not with current/ever wheeze. When the association of both IVF and C-section with asthma was examined in the same multivariate logistic regression model, it was weakened to borderline significance (OR = 2.04; 95% CI = 1-4.15 and OR = 1.34; 95% CI = 1-1.81 respectively). CONCLUSIONS AND CLINICAL RELEVANCE Conception via IVF and delivery by C-section may predispose children to future asthma development. Either variable could also exert a confounding effect on the link of the other to asthma; this may partially be accountable for inconsistencies in the findings of pertinent studies.
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Affiliation(s)
- G V Guibas
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
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Kolčić I. Double burden of malnutrition: A silent driver of double burden of disease in low- and middle-income countries. J Glob Health 2013; 2:020303. [PMID: 23289074 PMCID: PMC3529312 DOI: 10.7189/jogh.02.020303] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Affiliation(s)
- Ivana Kolčić
- Croatian Centre for Global Health, University of Split School of Medicine, Split, Croatia
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