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Jiang W, Chen S, Lv M, Zhang Z, Wang Z, Shao X, Hua S, Hao C, Wang Y. Are we ready to face the next wave of RSV surge after the COVID-19 Omicron pandemic in China? Front Cell Infect Microbiol 2023; 13:1216536. [PMID: 38152122 PMCID: PMC10751930 DOI: 10.3389/fcimb.2023.1216536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 11/14/2023] [Indexed: 12/29/2023] Open
Abstract
Background China had its first wave of COVID-19 in 2020 and second wave of COVID-19 Omicron in 2022. The number of RSV cases decreased sharply in 2020 and 2022. Investigation of the resurge of RSV infections after the first wave of COVID-19 will guide us to take preventive actions before the resurge of RSV infections after the second wave of COVID-19 Omicron. Methods We analysed epidemiological and clinical data of 59934 patients with lower respiratory tract infections (LRTI) from a prospective long-term cohort surveillance programme in Suzhou, China, collected from February 2016 to January 2022. The annual incidence of RSV infection in children aged<16 years in 2020 and 2021 was compared with the pre-pandemic years 2016 to 2019. We also compared the clinical characteristics, and RSV-related ICU admissions between pre-pandemic years and 2021. Results Among children with LRTI, the positive rate of RSV increased by 70.7% in 2021 compared to the average level in the pre-pandemic years. The RSV resurge in 2021 was most prominently in children aged 2-4 years (a significant rise compared with the expected value 149.1%; 95%CI, 67.7% to 378%, P<.01). The percentage of RSV-related ICU admissions decreased in 2021 (3.2% vs 6.7%, P<0.01). The death rate of RSV infections in 2021 was 0.2%, while that in pre-pandemic years was only 0.02%. RSV-associated death in immunocompetent children (complicated by necrotizing encephalitis) was firstly occurred in 2021. Conclusions Our findings raise concerns for RSV control in Southeast China after the COVID-19 pandemic especially for children aged 2-4 years. Although ICU admissions were significantly reduced in this resurgence, we could not ignore the increase of RSV-associated death.
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Affiliation(s)
- Wujun Jiang
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Sainan Chen
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Meng Lv
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Zhen Zhang
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Zhihui Wang
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Xuejun Shao
- Clinical Laboratory, Children’s Hospital of Soochow University, Suzhou, China
| | - Shenghao Hua
- Clinical Laboratory, Children’s Hospital of Soochow University, Suzhou, China
| | - Chuangli Hao
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Yuqing Wang
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
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Baishya ML, Collins BN, Lepore SJ. Antecedents of Self-Efficacy to Achieve Smoking-Behavior-Change Goals among Low-Income Parents Enrolled in an Evidence-Based Tobacco Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13573. [PMID: 36294153 PMCID: PMC9603224 DOI: 10.3390/ijerph192013573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/13/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Previous studies have shown that greater self-efficacy (SE) to modify smoking behaviors during treatment improves long-term post-treatment outcomes. Little is known about factors that might enhance SE for smoking abstinence and for reducing children's tobacco smoke exposure (TSE). The present study investigated hypothesized predictors of end-of-treatment SE to abstain from smoking and to protect children from TSE by conducting secondary multiple regression analyses of data (N = 327) from the Kids Safe and Smokefree (KiSS) behavioral intervention trial. KiSS aimed to reduce parental smoking and child TSE in urban, low-income, and minority communities. The results showed that partner support and initiating a planned quit attempt during treatment were positively related to SE to abstain from smoking and to reduce children's TSE (all p's < 0.001) at the end of treatment (EOT). Further, lower baseline nicotine dependence and the use of nicotine replacement were related to higher SE to abstain from smoking at EOT (p < 0.01), whereas more restrictive residential smoking rules and lower children's TSE at baseline was associated with higher SE to reduce children's TSE at EOT (all p's < 0.05). These findings inform theory and future intervention design, identifying individual and social-environmental factors that might enhance smoking-behavior-change SE.
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Sinaga HT, Achmad N, Manalu M, Perangin-Angin S, Doloksaribu LG. Length Attainment and Stunting Prevalence of Children aged 0–24 Months Living in the Area of Clay Brick Kilns in Pagar Merbau Sub District, Indonesia. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The association of air pollution with children’s health and growth has been proved.
AIM: This study aimed to assess the length attainment and stunting prevalence of children living in the areas of clay brick kiln and non-clay brick kilns.
METHODS: The study was a cross-sectional study conducted from February to December 2020. The location of the study was in Pagar Merbau Subdistrict, Deli Serdang District, North Sumatera Indonesia. Four villages were selected purposively to be the location of study. The total participants were 192 families who have children aged 0–24 years old. To assess the length attainment, the median WHO standard was determined as reference. The growth curve of children was presented in a bubble growth chart. To determine whether the groups were comparable, pair t-tests were applied.
RESULTS: Compared to the median WHO standard, the length attainment of boys aged 18–24 months shorter 1.1–1.9 cm and 0.8–1.9 cm (CBK vs. non-CBK, respectively), whereas for girls shorter 1.5–2.0 cm and 0.8–1.2 cm (CBK vs. non-CBK, respectively). The difference length between non-CBK and CBK children at age 18–24 months is 0.8–1.9 cm. Growth curves of children since born until aged 24 months were around −1SD–0SD. The prevalence of stunting is 18.6% versus 19.8%.
CONCLUSION: The presence of clay brick kilns in villages treated children’s growth. Government should manage the establishment of clay brick kilns in villages. Children cognitive and height of children at school age need to investigate.
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Islam S, Rana MJ, Mohanty SK. Cooking, smoking, and stunting: Effects of household air pollution sources on childhood growth in India. INDOOR AIR 2021; 31:229-249. [PMID: 32779283 DOI: 10.1111/ina.12730] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/22/2020] [Accepted: 07/29/2020] [Indexed: 05/14/2023]
Abstract
This paper investigates the effects of household air pollution (HAP) on child stunting in India using a sample of 206, 898 under-five children from the latest National Family Health Survey (2015-16). Descriptive statistics and multivariate analysis were used to understand the association of stunting by type of cooking fuel, separate kitchen, and indoor smoking in the household. Using clean cooking fuels (CCFs), having a separate kitchen, and being unexposed to smoking can reduce the prevalence of stunting by 4%, 1%, and 1%, respectively, from the current prevalence of stunting (38%). The probability of childhood stunting among children living in households using unclean cooking fuel (UCF) was significantly higher (OR-1.16; 95% CI: 1.13-1.19) than those living in households using CCF. Findings were similar results in the absence of separate kitchen (OR-1.08; 95% CI: 1.05-1.10) and exposure to environmental tobacco smoke (OR-1.06; 95% CI: 1.04-1.08). Households using UCF had a 16% higher likelihood of stunting, while there was a strong gradient of HAP with stunting after controlling socioeconomic and demographic factors. Therefore, the LPG programs, such as the Pradhan Mantri Ujjwala Yojana, may be crucial to reduce HAP and its adverse impact on stunting, and successively to achieve sustainable development goals.
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Affiliation(s)
- Samarul Islam
- International Institute for Population Sciences (IIPS), Mumbai, India
| | - Md Juel Rana
- International Institute for Population Sciences (IIPS), Mumbai, India
- Centre for the Study of Regional Development, School of Social Sciences, Jawaharlal Nehru University (JNU), New Delhi, India
| | - Sanjay K Mohanty
- International Institute for Population Sciences (IIPS), Mumbai, India
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Astuti DD, Handayani TW, Astuti DP. Cigarette smoke exposure and increased risks of stunting among under-five children. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.02.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Does use of solid fuels for cooking contribute to childhood stunting? A longitudinal data analysis from low- and middle-income countries. J Biosoc Sci 2020; 53:121-136. [DOI: 10.1017/s0021932020000097] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractUsing longitudinal data from the first and second waves of the Young Lives Study (YLS) in Ethiopia, India (Andhra Pradesh), Peru and Vietnam, conducted in 2002 and 2006–07, and a repeated measures mixed model, this study examined the effect of the use of solid fuels for cooking on childhood stunting among children aged 5–76 months. The analysis showed that in all four populations, the average height-for-age z-score (HAZ score) was much lower among children living in households using solid fuels than among children in households using cleaner fuels for cooking. The average HAZ score was lower among children living in households that used solid fuels in both waves of the YLS compared with those whose households used solid fuels in only one of the two waves. A significant reduction was noted in the average HAZ score between the two waves in all countries except Ethiopia. The results of the repeated measures mixed model suggest that household use of solid fuels was significantly associated with lower HAZ scores in all populations, except Ethiopia. The findings also indicate that the reduction in the HAZ scores between waves 1 and 2 was not statistically significant by the type of cooking fuel after controlling for potential confounding factors. The study provides further evidence of a strong association between household use of solid fuels and childhood stunting in low- and middle-income countries using longitudinal data. The findings highlight the need to reduce exposure to smoke from the combustion of solid fuels, by shifting households to cleaner cooking fuels, where feasible, by providing cooking stoves with improved combustion of solid fuels and improved venting, and by designing and implementing public information campaigns to inform people about the health risks of exposure to cooking smoke.
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Brown RA, Dakkak H, Seabrook JA. Is Breast Best? Examining the effects of alcohol and cannabis use during lactation. J Neonatal Perinatal Med 2019; 11:345-356. [PMID: 29843260 DOI: 10.3233/npm-17125] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Maternal drug use during lactation may have adverse effects on the health of their children. Two common drugs used during this period are alcohol and cannabis. A literature search was conducted using PubMed, CINAHL, Nursing and Allied Health, and Google Scholar with the following search terms: marijuana, cannabis, THC, alcohol, ethanol, breastfeeding, lactation, and breastmilk. The search strategy was restricted to papers since the year 2000, and limited to English language journals. Reference lists were also used to capture any articles that were missed from the database searches. In total, 19 articles were found related to alcohol and breastfeeding (n = 17 original research papers; n = 2 systematic reviews), and 4 articles were specific to cannabis (n = 2 original papers; n = 2 systematic reviews). The most common outcomes associated with alcohol consumption and breastfeeding included changes in sleep patterns, reduced milk production and flow, lower milk intake, and impaired immune function. Maternal outcomes related to cannabis consumption included panic attacks, delayed response time, increased heart rate, reduced short-term memory, dizziness, and impaired motor performance; infant outcomes associated with maternal cannabis use and breastfeeding were reduced muscular tonus, poor sucking, and growth delay and restriction. Mothers should be advised to refrain from substance use during the lactation period for the health and safety of their children.
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Affiliation(s)
- R A Brown
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada
| | - H Dakkak
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada
| | - J A Seabrook
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada.,Department of Paediatrics, Western University, London, ON, Canada.,Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.,Children's Health Research Institute, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada.,Human Environments Analysis Laboratory, London, ON, Canada
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8
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Kristjansson AL, Thorisdottir IE, Steingrimsdottir T, Allegrante JP, Lilly CL, Sigfusdottir ID. Maternal smoking during pregnancy and scholastic achievement in childhood: evidence from the LIFECOURSE cohort study. Eur J Public Health 2018; 27:850-855. [PMID: 28957474 PMCID: PMC5881721 DOI: 10.1093/eurpub/ckx074] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Research on the impact of maternal smoking during pregnancy (MSDP) on scholastic achievement in the offspring has shown conflicting findings. The objective of this study was to assess the impact of MSDP on scholastic achievement in a birth cohort of children in 4th, 7th and 10th grades. Methods We analysed data from the LIFECOURSE study, a cohort study of risk and protective factors in all children born in Reykjavik, Iceland, in the year 2000 (N = 1151, girls = 49.3%). Retrospective registry data for 2014–2015 were merged with prospective survey data that were collected in April 2016. Data on MSDP were assessed during regular antenatal visits at the end of the first trimester. Standardized academic achievement scores were obtained from official school transcripts. Data were analysed using OLS regressions that were entered in three hierarchical blocks. Results Children of mothers who smoked tobacco during the first trimester consistently revealed between 5% and 7% lower scores on standardized academic achievement in 4th, 7th and 10th grade (∼6–8 points on a normally distributed 120 point scale) than those of mothers who had not smoked tobacco during this period (P < 0.05). These findings held after controlling for several factors associated with the time of birth (e.g. birth weight, maternal age at birth, birth order, parental cohabitation and household income), as well as the year of scholastic assessment (parental cohabitation, household income and parental education). Conclusions Maternal smoking during pregnancy was negatively related to scholastic achievement in the offspring during 4th, 7th and 10th grade.
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Affiliation(s)
- Alfgeir L Kristjansson
- Department of Social and Behavioural Sciences, School of Public Health, West Virginia University, Morgantown, WV, USA.,Icelandic Centre for Social Research and Analysis, Reykjavik University, Reykjavik, Iceland
| | - Ingibjorg E Thorisdottir
- Icelandic Centre for Social Research and Analysis, Reykjavik University, Reykjavik, Iceland.,Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | - Thora Steingrimsdottir
- Department of Obstetrics and Gynecology, Landspitali University Hospital and University of Iceland, Reykjavik, Iceland
| | - John P Allegrante
- Icelandic Centre for Social Research and Analysis, Reykjavik University, Reykjavik, Iceland.,Department of Health and Behaviour Studies, Teachers College, Columbia University, New York, NY, USA.,Department of Sociomedical sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Christa L Lilly
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Inga D Sigfusdottir
- Icelandic Centre for Social Research and Analysis, Reykjavik University, Reykjavik, Iceland.,Department of Psychology, Reykjavik University, Reykjavik, Iceland.,Department of Health and Behaviour Studies, Teachers College, Columbia University, New York, NY, USA
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9
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Fonseca PCDA, Carvalho CAD, Carvalho VAD, Ribeiro AQ, Priore SE, Franceschini SDCC, Vieira SA. Maternal smoking during pregnancy and early development of overweight and growth deficit in children: an analysis of survival. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2018. [DOI: 10.1590/1806-93042018000200007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to evaluate the association between smoking during pregnancy and nutritional status. Methods: cohort study with a sample of 460 children in the baseline. The children were assessed four times, being measured for weight and length to be converted in indexes length forage (L/A) and body mass index forage (BMI/A) in Z-score. The time until occurrence of growth deficit and overweight was calculated in days and compared to maternal smoking during pregnancy. To assess the association between smoking during pregnancy and the outcomes, a Hazard Ratio by Cox regression was obtained, adjusting by confounding variables selected from Directed Acyclic Graphs (DAG). Results: the time until occurrence of growth deficit and overweight was lower in children whose mothers smoked during pregnancy. Smoking during pregnancy was a risk factor for length deficit (HR = 2.84; CI95% = 1.42 to 5.70) and for overweight (HR = 1.96; CI95% = 1, 09 to 3.53), even after the adjustment. Conclusions: maternal smoking was a changeable factor associated with anthropometric outcomes, which demonstrates the need for actions to combat smoking during pregnancy in order to prevent early nutritional deviations.
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Diet and anthropometry at 2 years of age following an oral health promotion programme for Australian Aboriginal children and their carers: a randomised controlled trial. Br J Nutr 2017; 118:1061-1069. [PMID: 29198191 DOI: 10.1017/s000711451700318x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
There are marked disparities between indigenous and non-indigenous children's diets and oral health. Both diet and oral health are linked to longer-term health problems. We aimed to investigate whether a culturally appropriate multi-faceted oral health promotion intervention reduced Aboriginal children's intake of sugars from discretionary foods at 2 years of age. We conducted a single-blind, parallel-arm randomised controlled trial involving women who were pregnant or had given birth to an Aboriginal child in the previous 6 weeks. The treatment group received anticipatory guidance, Motivational Interviewing, health and dental care for mothers during pregnancy and children at 6, 12 and 18 months. The control group received usual care. The key dietary outcome was the percent energy intake from sugars in discretionary foods (%EI), collected from up to three 24-h dietary recalls by trained research officers who were blind to intervention group. Secondary outcomes included intake of macronutrients, food groups, anthropometric z scores (weight, height, BMI and mid-upper arm circumference) and blood pressure. We enrolled 224 children to the treatment group and 230 to the control group. Intention-to-treat analyses showed that the %EI of sugars in discretionary foods was 1·6 % lower in the treatment group compared with control (95 % CI -3·4, 0·2). This culturally appropriate intervention at four time-points from pregnancy to 18 months resulted in small changes to 2-year-old Aboriginal children's diets, which was insufficient to warrant broader implementation of the intervention. Further consultation with Aboriginal communities is necessary for understanding how to improve the diet and diet-related health outcomes of young Aboriginal children.
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Clemente DBP, Casas M, Janssen BG, Lertxundi A, Santa-Marina L, Iñiguez C, Llop S, Sunyer J, Guxens M, Nawrot TS, Vrijheid M. Prenatal ambient air pollution exposure, infant growth and placental mitochondrial DNA content in the INMA birth cohort. ENVIRONMENTAL RESEARCH 2017; 157:96-102. [PMID: 28535425 DOI: 10.1016/j.envres.2017.05.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 05/12/2017] [Accepted: 05/14/2017] [Indexed: 05/06/2023]
Abstract
BACKGROUND The association between prenatal air pollution exposure and postnatal growth has hardly been explored. Mitochondrial DNA (mtDNA), as a marker of oxidative stress, and growth at birth can play an intermediate role in this association. OBJECTIVE In a subset of the Spanish birth cohort INMA we assessed first whether prenatal nitrogen dioxide (NO2) exposure is associated with infant growth. Secondly, we evaluated whether growth at birth (length and weight) could play a mediating role in this association. Finally, the mediation role of placental mitochondrial DNA content in this association was assessed. METHODS In 336 INMA children, relative placental mtDNA content was measured. Land-use regression models were used to estimate prenatal NO2 exposure. Infant growth (height and weight) was assessed at birth, at 6 months of age, and at 1 year of age. We used multiple linear regression models and performed mediation analyses. The proportion of mediation was calculated as the ratio of indirect effect to total effect. RESULTS Prenatal NO2 exposure was inversely associated with all infant growth parameters. A 10µg/m³ increment in prenatal NO2 exposure during trimester 1 of pregnancy was significantly inversely associated with height at 6 months of age (-6.6%; 95%CI: -11.4, -1.9) and weight at 1 year of age (-4.2%; 95%CI: -8.3, -0.1). These associations were mediated by birth length (31.7%; 95%CI: 34.5, 14.3) and weight (53.7%; 95%CI: 65.3, -0.3), respectively. Furthermore, 5.5% (95%CI: 10.0, -0.2) of the association between trimester 1 NO2 exposure and length at 6 months of age could be mediated by placental mtDNA content. CONCLUSIONS Our results suggest that impaired fetal growth caused by prenatal air pollution exposure can lead to impaired infant growth during the first year of life. Furthermore, molecular adaptations in placental mtDNA are associated with postnatal consequences of air pollution induced alterations in growth.
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Affiliation(s)
- Diana B P Clemente
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium; Universitat Pompeu Fabra, Barcelona, Spain; CIBER de Epidemiologia y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain.
| | - Maribel Casas
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER de Epidemiologia y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Bram G Janssen
- Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Aitana Lertxundi
- Universidad del País Vasco UPV-EUH, Spain; Health Research Institute, Biodonostia, San Sebastián, Spain
| | - Loreto Santa-Marina
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain; Health Research Institute, Biodonostia, San Sebastián, Spain; Public Health Division of Gipuzkoa, Basque Government, Spain
| | - Carmen Iñiguez
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain; Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain; University of Valencia, Valencia, Spain
| | - Sabrina Llop
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain; University of Valencia, Valencia, Spain
| | - Jordi Sunyer
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER de Epidemiologia y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Mònica Guxens
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER de Epidemiologia y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Tim S Nawrot
- Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium; Department of Public Health & Primary Care, Unit Environment & Health, Leuven University, Leuven, Belgium
| | - Martine Vrijheid
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER de Epidemiologia y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
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Muraro AP, Souza RAGD, Rodrigues PRM, Ferreira MG, Sichieri R. Effects of socioeconomic position and social mobility on linear growth from early childhood until adolescence. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2017; 20:514-525. [PMID: 29160442 DOI: 10.1590/1980-5497201700030013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 11/28/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To assess the effect of socioeconomic position (SEP) in childhood and social mobility on linear growth through adolescence in a population-based cohort. METHODS Children born in Cuiabá-MT, central-western Brazil, were evaluated during 1994 - 1999. They were first assessed during 1999 - 2000 (0 - 5 years) and again during 2009 - 2011 (10 - 17 years), and their height-for-age was evaluated during these two periods.Awealth index was used to classify the SEP of each child's family as low, medium, or high. Social mobility was categorized as upward mobility or no upward mobility. Linear mixed models were used. RESULTS We evaluated 1,716 children (71.4% of baseline) after 10 years, and 60.6% of the families showed upward mobility, with a higher percentage among the lowest economic classes. A higher height-for-age was also observed among those from families with a high SEP both in childhood (low SEP= -0.35 z-score; high SEP= 0.15 z-score, p < 0.01) and adolescence (low SEP= -0.01 z-score; high SEP= 0.45 z-score, p < 0.01), whereas upward mobility did not affect their linear growth. CONCLUSION Expressive social mobility was observed, but SEP in childhood and social mobility did not greatly influence linear growth through childhood in this central-western Brazilian cohort.
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Affiliation(s)
- Ana Paula Muraro
- Public Health Institute, Universidade Federal do Mato Grosso - Cuiabá (MT), Brazil
| | | | - Paulo Rogério Melo Rodrigues
- School of Nutrition, Department of Food and Nutrition, Universidade Federal do Mato Grosso - Cuiabá (MT), Brazil
| | - Márcia Gonçalves Ferreira
- Institute of Social Medicine, Universidade do Estado do Rio de Janeiro - Rio de Janeiro (RJ), Brazil
| | - Rosely Sichieri
- Institute of Social Medicine, Universidade do Estado do Rio de Janeiro - Rio de Janeiro (RJ), Brazil
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13
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Durante AS, Massa B, Pucci B, Gudayol N, Gameiro M, Lopes C. Effect of passive smoking on auditory temporal resolution in children. Int J Pediatr Otorhinolaryngol 2017; 97:18-23. [PMID: 28483231 DOI: 10.1016/j.ijporl.2017.03.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 03/15/2017] [Accepted: 03/16/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To determine the effect of passive smoking on auditory temporal resolution in primary school children, based on the hypothesis that individuals who are exposed to smoking exhibit impaired performance. DESIGN Auditory temporal resolution was evaluated using the Gaps In Noise (GIN) test. Exposure to passive smoking was assessed by measuring nicotine metabolite (cotinine) excreted in the first urine of the day. STUDY SAMPLE The study included 90 children with mean age of 10.2 ± 0.1 years old from a public school in São Paulo. Participants were divided into two groups: a study group, comprising 45 children exposed to passive smoking (cotinine > 5 ng/mL); and a control group, constituting 45 children who were not exposed to passive smoking. All participants had normal audiometry and immittance test results. RESULTS Statistically significant differences (p < 0.005) in performance on the GIN test were found between the two groups, with mean thresholds of 5.3 ms and 68.9% correct responses in the study group versus 4.6 ms and 74.0% in the control group. CONCLUSION The children exposed to passive smoking had poorer performance both in terms of thresholds and correct responses percentage on auditory temporal resolution assessment.
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Affiliation(s)
- Alessandra Spada Durante
- School of Speech-Language Pathology and Audiology - Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, SP, Brazil.
| | - Beatriz Massa
- School of Speech-Language Pathology and Audiology - Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, SP, Brazil
| | - Beatriz Pucci
- School of Speech-Language Pathology and Audiology - Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, SP, Brazil
| | - Nicolly Gudayol
- School of Speech-Language Pathology and Audiology - Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, SP, Brazil
| | - Marcella Gameiro
- School of Speech-Language Pathology and Audiology - Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, SP, Brazil
| | - Cristiane Lopes
- School of Speech-Language Pathology and Audiology - Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, SP, Brazil
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Roberts C, Wagler G, Carr MM. Environmental Tobacco Smoke: Public Perception of Risks of Exposing Children to Second- and Third-Hand Tobacco Smoke. J Pediatr Health Care 2017; 31:e7-e13. [PMID: 27692507 DOI: 10.1016/j.pedhc.2016.08.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 08/19/2016] [Accepted: 08/20/2016] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Extensive evidence exists regarding health risks posed by children's exposure to second-hand smoke, and there is increasing evidence concerning the risks of third-hand smoke. This evidence is most meaningful if the public is aware of these risks and can help curb childhood exposure. METHODS Participants were selected at an academic medical center and asked to complete a survey. Responses were compared based on respondents' smoking status and the presence or absence of children in their homes. RESULTS A total of 310 adults responded. Nonsmokers and respondents living with children were more likely to see smoking in the home as affecting all the queried health problems (p < .05). Knowledge of the risks of second-hand smoke exposure is limited, and very few respondents perceived risk from third-hand smoke exposure. DISCUSSION The widespread lack of awareness of the risks associated with environmental tobacco smoke must be addressed to curb childhood exposure.
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Liu R, Xu X, Zhang Y, Zheng X, Kim SS, Dietrich KN, Ho SM, Reponen T, Chen A, Huo X. Thyroid Hormone Status in Umbilical Cord Serum Is Positively Associated with Male Anogenital Distance. J Clin Endocrinol Metab 2016; 101:3378-85. [PMID: 27383112 PMCID: PMC5010576 DOI: 10.1210/jc.2015-3872] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 06/28/2016] [Indexed: 02/05/2023]
Abstract
CONTEXT In human adults and adolescents, thyroid function affects sex hormones and male reproductive functions. Little is known about the thyroid function effects on the gonadal development in human infants. OBJECTIVE The aim was to examine the association between thyroid hormones (THs) and sexually dimorphic genital development or fetal growth. DESIGN This is a birth cohort study. PARTICIPANTS A total of 616 mothers and newborns were analyzed from two local hospitals. MAIN OUTCOME MEASURES TSH, free T3 (FT3), and free T4 (FT4) levels in cord blood serum, anogenital distance (AGD), birth weight, birth length, birth body mass index, and head circumference in neonates. RESULTS Longer AGD in male newborns was observed with higher cord serum FT3 (β, 1.36 mm [95% confidence interval (CI), 0.58-2.13] for 1 pmol/L FT3), FT4 (β, 0.12 mm [95% CI, 0.00-0.25] for 1 pmol/L FT4), and TSH (β, 3.14 mm [95% CI, 0.65-5.63] for a 10-fold TSH increase), and with a lower FT4/FT3 ratio (β, -0.11 mm [95% CI, -0.20 to -0.02] for doubling FT4/FT3 ratio). The relationships between TSH, birth weight, and birth length were different by secondhand smoke exposure. Secondhand smoke exposure had an effect modification, with interaction P value .039 and .010, respectively. Secondhand smoke exposure also had an effect modification on the relation between FT4 and head circumference with interaction P value .020. CONCLUSIONS In the absence of overt thyroid dysfunction, THs are positively associated with AGD in male newborns. TH effects on body size and head circumference may be modified by maternal secondhand smoke exposure.
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Affiliation(s)
- Rongju Liu
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Xijin Xu
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Yuling Zhang
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Xiangbin Zheng
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Stephani S Kim
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Kim N Dietrich
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Shuk-Mei Ho
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Tiina Reponen
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Aimin Chen
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
| | - Xia Huo
- Laboratory of Environmental Medicine and Developmental Toxicology (R.L., X.X., Y.Z., X.Z., X.H.), and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Obstetrics and Gynecology (R.L.), The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics (X.X.), Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Environmental Health (S.S.K., K.N.D., S.-M.H., T.R., A.C.), College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267; and School of Environment (X.H.), Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China
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Guidelines for the Management of Pregnant Women With Substance Use Disorders. PSYCHOSOMATICS 2016; 57:115-30. [DOI: 10.1016/j.psym.2015.12.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 11/29/2015] [Accepted: 11/30/2015] [Indexed: 11/21/2022]
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Lanari M, Vandini S, Adorni F, Prinelli F, Di Santo S, Silvestri M, Musicco M. Prenatal tobacco smoke exposure increases hospitalizations for bronchiolitis in infants. Respir Res 2015; 16:152. [PMID: 26695759 PMCID: PMC4699376 DOI: 10.1186/s12931-015-0312-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 12/09/2015] [Indexed: 11/29/2022] Open
Abstract
Background Tobacco smoke exposure (TSE) is a worldwide health problem and it is considered a risk factor for pregnant women’s and children’s health, particularly for respiratory morbidity during the first year of life. Few significant birth cohort studies on the effect of prenatal TSE via passive and active maternal smoking on the development of severe bronchiolitis in early childhood have been carried out worldwide. Methods From November 2009 to December 2012, newborns born at ≥33 weeks of gestational age (wGA) were recruited in a longitudinal multi-center cohort study in Italy to investigate the effects of prenatal and postnatal TSE, among other risk factors, on bronchiolitis hospitalization and/or death during the first year of life. Results Two thousand two hundred ten newborns enrolled at birth were followed-up during their first year of life. Of these, 120 (5.4 %) were hospitalized for bronchiolitis. No enrolled infants died during the study period. Prenatal passive TSE and maternal active smoking of more than 15 cigarettes/daily are associated to a significant increase of the risk of offspring children hospitalization for bronchiolitis, with an adjHR of 3.5 (CI 1.5–8.1) and of 1.7 (CI 1.1–2.6) respectively. Conclusions These results confirm the detrimental effects of passive TSE and active heavy smoke during pregnancy for infants’ respiratory health, since the exposure significantly increases the risk of hospitalization for bronchiolitis in the first year of life. Electronic supplementary material The online version of this article (doi:10.1186/s12931-015-0312-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marcello Lanari
- Pediatrics and Neonatology Unit, Imola Hospital, Via Montericco, 4, Imola, Italy.
| | - Silvia Vandini
- Neonatology Unit, S.Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 11 40138, Bologna, Italy.
| | - Fulvio Adorni
- Epidemiology and Biostatistics Unit, Institute of Biomedical Technologies, National Research Council Milan, Via Fratelli Cervi 93, Segrate, MI, Italy.
| | - Federica Prinelli
- Epidemiology and Biostatistics Unit, Institute of Biomedical Technologies, National Research Council Milan, Via Fratelli Cervi 93, Segrate, MI, Italy.
| | - Simona Di Santo
- Epidemiology and Biostatistics Unit, Institute of Biomedical Technologies, National Research Council Milan, Via Fratelli Cervi 93, Segrate, MI, Italy. .,Department of Neuroscience, Foundation IRCCS Santa Lucia, Via Ardeatina 306, Rome, Italy.
| | - Michela Silvestri
- Pediatric Pulmonology and Allergy Unit, Istituto Giannina Gaslini, Genoa, Italy.
| | - Massimo Musicco
- Epidemiology and Biostatistics Unit, Institute of Biomedical Technologies, National Research Council Milan, Via Fratelli Cervi 93, Segrate, MI, Italy. .,Department of Neuroscience, Foundation IRCCS Santa Lucia, Via Ardeatina 306, Rome, Italy.
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Muraro AP, Gonçalves-Silva RMV, Ferreira MG, Silva GAE, Sichieri R. Effect of the exposure to maternal smoking during pregnancy and childhood on the body mass index until adolescence. Rev Saude Publica 2015; 49:41. [PMID: 26247384 PMCID: PMC4544362 DOI: 10.1590/s0034-8910.2015049005423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 10/27/2014] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Investigate the effect of exposure to smoking during pregnancy and early childhood on changes in the body mass index (BMI) from birth to adolescence. METHODS A population-based cohort of children (0-5 years old) from Cuiabá, Midwest Brazil, was assessed in 1999-2000 (n = 2,405). Between 2009 and 2011, the cohort was re-evaluated. Information about birth weight was obtained from medical records, and exposure to smoking during pregnancy and childhood was assessed at the first interview. Linear mixed effects models were used to estimate the association between exposure to maternal smoking during pregnancy and preschool age, and the body mass index of children at birth, childhood and adolescence. RESULTS Only 11.3% of the mothers reported smoking during pregnancy, but most of them (78.2%) also smoked during early childhood. Among mothers who smoked only during pregnancy (n = 59), 97.7% had smoked only in the first trimester. The changes in body mass index at birth and in childhood were similar for children exposed and those not exposed to maternal smoking. However, from childhood to adolescence the rate of change in the body mass index was higher among those exposed only during pregnancy than among those who were not exposed. CONCLUSIONS Exposure to smoking only during pregnancy, especially in the first trimester, seems to affect changes in the body mass index until adolescence, supporting guidelines that recommend women of childbearing age to stop smoking.
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Affiliation(s)
- Ana Paula Muraro
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso, Cuiabá, MT, Brasil
| | | | | | - Gulnar Azevedo E Silva
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Rosely Sichieri
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Abstract
OBJECTIVE Little is known about the contribution of childhood socio-economic position (SEP) and social mobility to weight change. The present study evaluated the effect of family SEP during the pre-school years and social mobility on BMI between birth and adolescence. DESIGN Longitudinal. The SEP of each child's family was classified according to an asset-based wealth index as low, medium or high. Four different categories of childhood-adolescence SEP groups were created in order to examine social mobility: low-medium/high, medium-medium, medium-high and high-high/medium. For each of these categories, BMI was tracked from birth to adolescence. Linear mixed-effects models were used to analyse the data. SETTING Cuiabá-MT, Brazil. SUBJECTS A population-based cohort of children born between 1994 and 1999 was assessed between 1999 and 2000, and again between 2009 and 2011. RESULTS A total of 1716 adolescents were followed from childhood to adolescence (71·4 % of baseline). The prevalence of overweight/obesity was 20·4 % in childhood and 27·7 % in adolescence. A higher SEP in childhood was associated with a greater prevalence of overweight in adolescence. Expressive upward social mobility occurred, mainly in the lowest SEP group. There was a greater rate of change in BMI between birth and adolescence among children with a higher SEP in childhood and children who remained in the higher SEP from childhood to adolescence. CONCLUSION Individuals from a higher SEP in childhood and those who remained in the higher social classes showed greater rate of change in BMI. Thus, initial SEP was the major determinant of changes in BMI.
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