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Jana A, Dey D, Ghosh R. Contribution of low birth weight to childhood undernutrition in India: evidence from the national family health survey 2019-2021. BMC Public Health 2023; 23:1336. [PMID: 37438769 DOI: 10.1186/s12889-023-16160-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 06/20/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Infants born with low birth weight (LBW), i.e. less than 2500g, is considered an important factor of malnutrition in Asia. In India, research related to this issue is still neglected and limited. Evidence exists that a large number of child deaths occur in India due to maternal and child malnutrition-related complications. Moreover, it has been found that the cost of malnutrition in India results in a significant reduction of the country's Gross Domestic Product (GDP). Thus, in this current context, this study aims to explore the contribution of low birth weight to childhood undernutrition in India. METHODS The study used data from the 5th round of the National Family Health Survey (NFHS-5), a large-scale survey conducted in India. The survey collected information from 176,843 mothers and 232,920 children. The study used the last birth information (last children born 5 years preceding the survey) due to the detailed availability of maternal care information. Univariate and bivariate analyses were conducted to determine the percentage distribution of outcome variables. Multivariate logistic regression was employed to examine the association between LBW and undernutrition (stunting, wasting, and underweight). The study also used the Fairlie decomposition analysis to estimate the contribution of LBW to undernutrition among Indian children. RESULTS The results show that childhood undernutrition was higher in states like Uttar Pradesh, Bihar, Jharkhand, Gujarat, and Maharashtra. The results of the logistic regression analysis show that infants born with low birth weight were more likely to be stunted (OR = 1.46; 95% CI: 1.41-1.50), wasted (OR = 1.33; 95% CI: 1.27-1.37), and underweight (OR = 1.76; 95% CI: 1.70-1.82) in their childhood compared to infants born without low birth weight. The findings from the decomposition analysis explained that approximately 14.8% of the difference in stunting, 10.4% in wasting, and 9.6% in underweight among children born with low birth weight after controlling for the individuals' selected characteristics. CONCLUSION The findings suggest that LBW has a significant contribution to malnutrition. The study suggests that policymakers should prioritize strengthening maternal and child healthcare schemes, particularly focusing on antenatal and postnatal care, as well as kangaroo mother care at the grassroots level to reduce the burden of LBW and undernourished children.
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Affiliation(s)
- Arup Jana
- Research Scholar, International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Deepshikha Dey
- MPhil., International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Ranjita Ghosh
- PhD Scholar, Institute for Social and Economic Change, Karnataka, 560072, India.
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2
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Goth FEM, Green K, Hansen BM, Agertoft L, Jørgensen IM. From neonatal lung function to lung function and respiratory morbidity at 6-year follow-up. Pediatr Pulmonol 2023; 58:566-576. [PMID: 36349430 PMCID: PMC10098878 DOI: 10.1002/ppul.26240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 10/20/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Lung function is traceable from infancy to adulthood. Only a few studies have examined lung function from birth to childhood longitudinally in children born moderate to late preterm. We aimed to investigate how prematurity and lung function in the neonatal period are related to lung function and respiratory morbidity at age 6 in former moderate to late preterm children compared with children born at term. METHODS Lung function was measured in a cohort of moderately to late preterm (n = 48) and term-born (n = 53) infants in the neonatal period by FeNO, and tidal breathing flow-volume loops (TBFVL) and at age 6 (n = 52) by spirometry, whole-body plethysmograph and impulse oscillation combined with a respiratory symptom questionnaire. RESULTS Moderate to late preterm children had a higher TPEF /TE ratio neonatally (42.6% vs. 33.7%, p = 0.02) and a lower % predicted orced expiratory volume in the first second at age 6 (94.4% vs. 101.9%, p = 0.01) compared to term-born children. We found a significant association between the variability of neonatal tidal volume and effective airway resistance at age 6 (β = -0.34, p = 0.03). No association between neonatal FeNO or TBFVL and respiratory morbidity at 6-year follow-up was shown. CONCLUSION Children born moderate to late preterm had lower lung function at age 6 than term-born children. We did not find evidence for the use of neonatal tidal breathing parameters as a predictor for subsequent respiratory morbidity or lung function, however sample size was small.
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Affiliation(s)
- Fanny E M Goth
- Department of Pediatrics and Adolescence Medicine, Nordsjaellands Hospital, Hillerod, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kent Green
- Department of Pediatrics and Adolescence Medicine, Nordsjaellands Hospital, Hillerod, Denmark
| | - Bo M Hansen
- Department of Pediatrics and Adolescence Medicine, Nordsjaellands Hospital, Hillerod, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lone Agertoft
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Inger M Jørgensen
- Department of Pediatrics and Adolescence Medicine, Nordsjaellands Hospital, Hillerod, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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3
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Tocco Tussardi I, Tfaily A, Locatelli F, Antonicelli L, Battaglia S, Bono R, Corsico AG, Murgia N, Pirina P, Ferrari M, Tardivo S, Jarvis DL, Verlato G. The Association of Self-Reported Birthweight with Lung Function and Respiratory Diseases: Results from a Multi-Centre, Multi-Case Control Study in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15062. [PMID: 36429783 PMCID: PMC9690666 DOI: 10.3390/ijerph192215062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/10/2022] [Accepted: 11/12/2022] [Indexed: 06/16/2023]
Abstract
Early life conditions are associated with lung function and the development of respiratory and non-respiratory illnesses. The relationship with birthweight (BW), however, is conflicting. We examined associations of self-reported BW with lung function and the development of respiratory and also non-respiratory diseases within the GEIRD (Gene-Environment Interaction in Respiratory Diseases) project, an Italian multi-centre, multi-case control study involving cases of COPD, asthma, allergic rhinitis and controls. Multinomial logistic regression was performed with case/control status as response variable; BW as main determinant; and adjusting for sex, age and smoking status. Of the 2287 participants reporting BW, 6.4% (n = 147) had low BW (<2500 g), and this proportion was greater in women than men (7.8% vs. 5.1%; p = 0.006). Both men and women with low BW were shorter than those with normal BW (mean ± SD: 160.2 ± 5.5 vs. 162.6 ± 6.5 cm in women, p = 0.009; 172.4 ± 6.1 vs. 174.8 ± 7.2 cm in men, p < 0.001). Although FEV1 and FVC were reduced in individuals with low BW, this was explained by associations with sex and height. In multivariable analysis, BW was not associated with respiratory diseases in adulthood. However, those with low BW had a higher risk of self-reported hospitalisation for lung disease before the age of two (10.3% vs. 4.1%; p < 0.001), severe respiratory infection before the age of five (16.9% vs. 8.8%; p = 0.001) and hypertension in adulthood (29.9% vs. 23.7%; p = 0.001); however, they had a lower risk of arrhythmia (2.7% vs. 5.8%; p = 0.027).
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Affiliation(s)
- Ilaria Tocco Tussardi
- Department of Diagnostics and Public Health, Section of Hygiene, University of Verona, 37134 Verona, Italy
| | - Ahmad Tfaily
- Department of Diagnostics and Public Health, Section of Epidemiology and Medical Statistics, University of Verona, 37134 Verona, Italy
| | - Francesca Locatelli
- Department of Diagnostics and Public Health, Section of Epidemiology and Medical Statistics, University of Verona, 37134 Verona, Italy
| | - Leonardo Antonicelli
- Department of Internal Medicine, University Hospital of Ancona, 60131 Ancona, Italy
| | - Salvatore Battaglia
- ‘ProMISE’ (Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties) Department, University of Palermo, 90133 Palermo, Italy
| | - Roberto Bono
- Department of Public Health and Paediatrics, University of Torino, 10124 Torino, Italy
| | - Angelo G. Corsico
- Department of Internal Medicine and Medical Therapy, University of Pavia, 27100 Pavia, Italy
- Pneumology Unit, Foundation I.R.C.C.S. Policlinico San Matteo, 27100 Pavia, Italy
| | - Nicola Murgia
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, University of Perugia, 06123 Perugia, Italy
| | - Pietro Pirina
- Department of Clinical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
| | - Marcello Ferrari
- Department of Respiratory Medicine, University of Verona, 37129 Verona, Italy
| | - Stefano Tardivo
- Department of Diagnostics and Public Health, Section of Hygiene, University of Verona, 37134 Verona, Italy
| | - Deborah L. Jarvis
- National Heart and Lung Institute, Section of Genomic and Environmental Medicine, Imperial College London, London SW7 2BX, UK
| | - Giuseppe Verlato
- Department of Diagnostics and Public Health, Section of Epidemiology and Medical Statistics, University of Verona, 37134 Verona, Italy
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Lifelong Lung Sequelae of Prematurity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095273. [PMID: 35564667 PMCID: PMC9104309 DOI: 10.3390/ijerph19095273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 04/22/2022] [Accepted: 04/24/2022] [Indexed: 11/29/2022]
Abstract
The clinical, functional, and structural pattern of chronic lung disease of prematurity has changed enormously in last years, mirroring a better perinatal management and an increasing lung immaturity with the survival of increasingly premature infants. Respiratory symptoms and lung function impairment related to prematurity seem to improve over time, but premature birth increases the likelihood of lung function impairment in late childhood, predisposing to chronic obstructive pulmonary disease (COPD). It is mandatory to identify those individuals born premature who are at risk for developing long-term lung disease through a better awareness of physicians, the use of standardized CT imaging scores, and a more comprehensive periodic lung function evaluation. The aim of this narrative review was to provide a systematic approach to lifelong respiratory symptoms, lung function impairment, and lung structural anomalies in order to better understand the specific role of prematurity on lung health.
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Accorsi BF, Friedrich FO, Corso AL, Rosa JPD, Jones MH. Intra-breath oscillometry for the evaluation of lung function in children and adolescents with a history of preterm birth. J Bras Pneumol 2022; 48:e20210290. [PMID: 35137869 PMCID: PMC8836632 DOI: 10.36416/1806-3756/e20210290] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 11/01/2021] [Indexed: 12/04/2022] Open
Abstract
Objective: To assess respiratory system impedance (Zrs) and spirometric parameters in children and adolescents with and without a history of preterm birth. Methods: We evaluated a sample of 51 subjects between 11 and 14 years of age: 35 who had a history of preterm birth (preterm group) and 16 who had been born at term (full-term group). Lung function was measured by spirometry, spectral oscillometry, and intra-breath oscillometry. Results: Neither spirometry nor spectral oscillometry revealed any statistically significant differences between the preterm and full-term groups. However, intra-breath oscillometry demonstrated significant differences between the two groups in terms of the change in resistance, reactance at end-inspiration, and the change in reactance (p < 0.05 for all). Conclusions: Our findings suggest that abnormalities in Zrs persist in children and adolescents with a history of preterm birth and that intra-breath oscillometry is more sensitive than is spectral oscillometry. Larger studies are needed in order to validate these findings and to explore the impact that birth weight and gestational age at birth have on Zrs later in life.
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Affiliation(s)
- Bruna Freire Accorsi
- . Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Frederico Orlando Friedrich
- . Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Andréa Lúcia Corso
- . Departamento de Neonatologia e Pediatria, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS) Brasil
| | - Juliana Pontes da Rosa
- . Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS), Brasil
| | - Marcus Herbert Jones
- . Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil.,. Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS), Brasil
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6
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de Souza LV, de Meneck F, Parizotto GP, Franco M. Low birth weight and its relation to physical fitness parameters in children: Its negative effect on muscle strength and cardiorespiratory endurance. Am J Hum Biol 2021; 34:e23595. [PMID: 33709521 DOI: 10.1002/ajhb.23595] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 02/16/2021] [Accepted: 02/26/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND There is increasing evidence that low birth weight has a negative effect on physical fitness, muscle strength, and cardiorespiratory endurance, although the findings are inconsistent. OBJECTIVES This study aimed to evaluate whether birth weight acts as a prenatal determinant of physical fitness parameters and to determine the role of environmental or biological variables on this effect. METHODS One hundred and sixty-seven children aged 6-14 years were included in this study. The anthropometric data, physical activity index, standing long jump, flexibility, handgrip strength, and cardiorespiratory fitness were evaluated. RESULTS A positive correlation was found between birth weight and cardiorespiratory fitness (r = .349; p < .001), right handgrip strength (r = .337; p < .001), and left handgrip strength (r = .320; p < .001), suggesting that children with low birth weight had the worst performance in both cardiorespiratory endurance and grip strength tests. These findings remained significant after adjustment for prematurity, sex, age, physical activity index, and body mass index (BMI). Stepwise multiple regression analyses revealed a significant interaction of high birth weight, older age, and low BMI in predicting better cardiorespiratory endurance (R2 = .308). When handgrip strength was tested as the dependent variable, we found that high birth weight, male sex, and older age emerged as important determinants for both sides. CONCLUSION Children aged 6-14 years born with a birth weight < 2.5 kg have low handgrip strength and cardiorespiratory fitness, which seems to be mediated partially by influences of both prenatal environment (e.g., birth weight) and biological variables (e.g., age, sex, BMI).
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Affiliation(s)
| | - Franciele de Meneck
- Division of Nephrology, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | | | - Maria Franco
- Division of Nephrology, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
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7
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Al Salmi I, Hannawi S. Birthweight and Lipids in Adult Life: Population-Based Cross Sectional Study. Lipids 2020; 55:365-374. [PMID: 32372421 DOI: 10.1002/lipd.12242] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/04/2020] [Accepted: 04/17/2020] [Indexed: 02/05/2023]
Abstract
The purpose of this study was to examine the association of birthweight with lipid profile in the general adult population. Participants in the second-wave of a nationally representative cross sectional AusDiab-study were asked to complete a birthweight questionnaire. Fasting total cholesterol (TC), LDL-C, HDL-C, and triacylglycerol levels were modeled against birthweight. Four thousand five hundred and two people reported their birthweights, mean (SD) of 3.4(0.7) kg. Females with low birthweight-LBW had higher levels of TC, LDL-C, and triacylglycerols, but no difference in HDL-C, than those with normal-birthweight-NBW;≥2.5 kg. People with LBW showed a trend toward increased risk for high TC (≥5.5 mmol/L) compared to NBW. Among females with LBW, the risk for high LDL-C (≥3.5 mmol/L) was increased compared to those of NBW. The risk for low HDL-C (<0.9 mmol/L) was increased among males with LBW compared to those with NBW. Examination of the relationship on the continuum showed no differences except for high triacylglycerol levels among females with the lowest birthweight quintile compared to the higher birthweight quintile. However, the risk for various abnormalities by birthweight quintiles was similar to that when we used the traditional definition of LBW vs. NBW. Females and males with low birthweight differ in their risk for lipids abnormalities. Females had higher risk for high LDL-C, whereas males had high risk for low HDL-C (<0.9 mmol/L). In addition, females with low birthweight had the highest triacylglycerol levels. High LDL-C, low HDL-C, and high triacylglycerols are well-recognized risk factors for cardiovascular disease.
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Affiliation(s)
- Issa Al Salmi
- The Medicine Department, The Royal Hospital, 23 July Street, P O Box 1331, code 111, Muscat, Oman
| | - Suad Hannawi
- The Medicine Department, MOHAP, PO Box 6552, Dubai, UAE
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8
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Stotts AL, Northrup TF, Green C, Suchting R, Hovell MF, Khan A, Villarreal YR, Schmitz JM, Velasquez MM, Hammond SK, Hoh E, Tyson J. Reducing Tobacco Smoke Exposure in High-Risk Infants: A Randomized, Controlled Trial. J Pediatr 2020; 218:35-41.e1. [PMID: 31870605 DOI: 10.1016/j.jpeds.2019.10.070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/24/2019] [Accepted: 10/28/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To evaluate a hospital-initiated intervention to reduce tobacco smoke exposure in infants in the neonatal intensive care unit. STUDY DESIGN A randomized, controlled trial compared motivational interviewing plus financial incentives with conventional care on infant urine cotinine at 1 and 4 months' follow-up. Mothers of infants in the neonatal intensive care unit (N = 360) who reported a smoker living in the home were enrolled. Motivational interviewing sessions were delivered in both the hospital and the home. Financial incentives followed session attendance and negative infant cotinine tests postdischarge. RESULTS The intervention effect on infant cotinine was not significant, except among mothers who reported high baseline readiness/ability to protect their infant (P ≤ .01) and mothers who completed the study within 6 months postdischarge (per protocol; P ≤ .05). Fewer mothers in the motivational interviewing plus financial incentives condition were smoking postdischarge (P ≤ .01). More mothers in the motivational interviewing plus financial incentives group reported a total home and car smoking ban at follow-up (P ≤ .05). CONCLUSIONS Motivational interviewing combined with financial incentives reduced infant tobacco smoke exposure in a subset of women who were ready/able to protect their infant. The intervention also resulted in less maternal smoking postpartum. More robust interventions that include maternal and partner/household smoking cessation are likely needed to reduce the costly effects of tobacco smoke exposure on children and their families. TRIAL REGISTRATION ClinicalTrials.gov: NCT01726062.
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Affiliation(s)
- Angela L Stotts
- Department of Family and Community Medicine, McGovern Medical School at UTHealth, Houston, TX
| | - Thomas F Northrup
- Department of Family and Community Medicine, McGovern Medical School at UTHealth, Houston, TX
| | - Charles Green
- Department of Pediatrics, McGovern Medical School at UTHealth, Houston, TX
| | - Robert Suchting
- Department of Psychiatry and Behavioral Science, McGovern Medical School at UTHealth, Houston, TX
| | - Melbourne F Hovell
- Center for Behavioral Epidemiology and Community Health, School of Public Health, San Diego State University, San Diego, CA
| | - Amir Khan
- Department of Pediatrics, McGovern Medical School at UTHealth, Houston, TX
| | - Yolanda R Villarreal
- Department of Family and Community Medicine, McGovern Medical School at UTHealth, Houston, TX
| | - Joy M Schmitz
- Department of Psychiatry and Behavioral Science, McGovern Medical School at UTHealth, Houston, TX
| | | | - S Katharine Hammond
- Division of Environmental Health, School of Public Health, University of California, Berkeley, CA
| | - Eunha Hoh
- Division of Environmental Health, School of Public Health, San Diego State University, San Diego, CA
| | - Jon Tyson
- Department of Pediatrics, McGovern Medical School at UTHealth, Houston, TX
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Easson K, Dahan-Oliel N, Rohlicek C, Sahakian S, Brossard-Racine M, Mazer B, Riley P, Maltais DB, Nadeau L, Hatzigeorgiou S, Schmitz N, Majnemer A. A Comparison of Developmental Outcomes of Adolescent Neonatal Intensive Care Unit Survivors Born with a Congenital Heart Defect or Born Preterm. J Pediatr 2019; 207:34-41.e2. [PMID: 30528759 DOI: 10.1016/j.jpeds.2018.11.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 10/31/2018] [Accepted: 11/01/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To compare cognitive, motor, behavioral, and functional outcomes of adolescents born with a congenital heart defect (CHD) and adolescents born preterm. STUDY DESIGN Adolescents (11-19 years old) born with a CHD requiring open-heart surgery during infancy (n = 80) or born preterm ≤29 weeks of gestational age (n = 128) between 1991 and 1999 underwent a cross-sectional evaluation of cognitive (Leiter International Performance Scale-Revised), motor (Movement Assessment Battery for Children-II), behavioral (Strengths and Difficulties Questionnaire), and functional (Vineland Adaptive Behavior Scale-II) outcomes. Independent samples t tests and Pearson χ2 or Fisher exact tests were used to compare mean scores and proportions of impairment, respectively, between groups. RESULTS Adolescents born with a CHD and adolescents born preterm had similar cognitive, motor, behavioral, and functional outcomes. Cognitive deficits were detected in 14.3% of adolescents born with a CHD and 11.8% of adolescents born preterm. Motor difficulties were detected in 43.5% of adolescents born with a CHD and 50% of adolescents born preterm. Behavioral problems were found in 23.7% of adolescents in the CHD group and 22.9% in the preterm group. Functional limitations were detected in 12% of adolescents born with a CHD and 7.3% of adolescents born preterm. CONCLUSIONS Adolescents born with a CHD or born preterm have similar profiles of developmental deficits. These findings highlight the importance of providing long-term surveillance to both populations and guide the provision of appropriate educational and rehabilitation services to better ameliorate long-term developmental difficulties.
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Affiliation(s)
- Kaitlyn Easson
- Research Institute of the McGill University Health Centre, Montreal, Québec, Canada; Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Québec, Canada
| | - Noémi Dahan-Oliel
- School of Physical and Occupational Therapy, McGill University, Montreal, Québec, Canada; Shriners Hospitals for Children, Montreal, Québec, Canada
| | - Charles Rohlicek
- Department of Cardiology, Montreal Children's Hospital, Montreal, Québec, Canada
| | - Sossy Sahakian
- Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
| | - Marie Brossard-Racine
- Research Institute of the McGill University Health Centre, Montreal, Québec, Canada; Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Québec, Canada; School of Physical and Occupational Therapy, McGill University, Montreal, Québec, Canada; Department of Pediatrics, Division of Child Neurology, McGill University, Montreal, Québec, Canada
| | - Barbara Mazer
- School of Physical and Occupational Therapy, McGill University, Montreal, Québec, Canada
| | - Patricia Riley
- Department of Pediatrics, Montreal Children's Hospital, Montreal, Québec, Canada
| | - Désirée B Maltais
- Department of Rehabilitation, Université Laval, Québec City, Québec, Canada
| | - Line Nadeau
- Department of Rehabilitation, Université Laval, Québec City, Québec, Canada
| | | | - Norbert Schmitz
- Department of Psychiatry, McGill University, Montreal, Québec, Canada
| | - Annette Majnemer
- Research Institute of the McGill University Health Centre, Montreal, Québec, Canada; School of Physical and Occupational Therapy, McGill University, Montreal, Québec, Canada; Department of Pediatrics, Division of Child Neurology, McGill University, Montreal, Québec, Canada.
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10
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Ioan I, Gemble A, Hamon I, Schweitzer C, Metche S, Bonabel C, Nguyen-Thi PL, Hascoet JM, Demoulin-Alexikova S, Marchal F. Expiratory Flow - Vital Capacity: Airway - Lung Dysanapsis in 7 Year Olds Born Very Preterm? Front Physiol 2018; 9:650. [PMID: 29896122 PMCID: PMC5987129 DOI: 10.3389/fphys.2018.00650] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 05/14/2018] [Indexed: 01/13/2023] Open
Abstract
An index normalizing airway dimension for lung size derived from spirometry was found inversely correlated to lung size in school children born very preterm, indicating larger alveolar volumes draining into comparatively smaller airways. In contrast in children born full term the index was independent of lung size.
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Affiliation(s)
- Iulia Ioan
- Department of Pediatric Respiratory Function Testing, Children's Hospital, Vandoeuvre-lès-Nancy, France.,EA 3450 DevAH-Department of Physiology, Faculty of Medicine, University of Lorraine, Nancy, France
| | - Aurore Gemble
- Department of Pediatrics, Children's Hospital, Vandoeuvre-lès-Nancy, France
| | - Isabelle Hamon
- EA 3450 DevAH-Department of Physiology, Faculty of Medicine, University of Lorraine, Nancy, France.,Department of Neonatal Medicine, Regional Maternity Hospital, Nancy, France
| | - Cyril Schweitzer
- Department of Pediatric Respiratory Function Testing, Children's Hospital, Vandoeuvre-lès-Nancy, France.,EA 3450 DevAH-Department of Physiology, Faculty of Medicine, University of Lorraine, Nancy, France.,Department of Pediatrics, Children's Hospital, Vandoeuvre-lès-Nancy, France
| | - Stéphanie Metche
- Department of Pediatric Respiratory Function Testing, Children's Hospital, Vandoeuvre-lès-Nancy, France
| | - Claude Bonabel
- Department of Pediatric Respiratory Function Testing, Children's Hospital, Vandoeuvre-lès-Nancy, France.,EA 3450 DevAH-Department of Physiology, Faculty of Medicine, University of Lorraine, Nancy, France
| | - Phi L Nguyen-Thi
- Department of Epidemiology, Faculty of Medicine, University of Lorraine, Nancy, France
| | - Jean-Michel Hascoet
- EA 3450 DevAH-Department of Physiology, Faculty of Medicine, University of Lorraine, Nancy, France.,Department of Neonatal Medicine, Regional Maternity Hospital, Nancy, France
| | - Silvia Demoulin-Alexikova
- Department of Pediatric Respiratory Function Testing, Children's Hospital, Vandoeuvre-lès-Nancy, France.,EA 3450 DevAH-Department of Physiology, Faculty of Medicine, University of Lorraine, Nancy, France
| | - François Marchal
- Department of Pediatric Respiratory Function Testing, Children's Hospital, Vandoeuvre-lès-Nancy, France.,EA 3450 DevAH-Department of Physiology, Faculty of Medicine, University of Lorraine, Nancy, France
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11
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Thunqvist P, Tufvesson E, Bjermer L, Winberg A, Fellman V, Domellöf M, Melén E, Norman M, Hallberg J. Lung function after extremely preterm birth-A population-based cohort study (EXPRESS). Pediatr Pulmonol 2018; 53:64-72. [PMID: 29152899 DOI: 10.1002/ppul.23919] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 10/30/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Follow-up studies of children and young adults born very-to-moderately preterm show persistent and significant lung function deficits. The aim of the study was to determine lung function and airway mechanics in school-aged children born in 2004 to 2007 and extremely preterm (after 22-26 weeks of gestation). METHODS In a population-based cohort of children born extremely preterm and controls born at term (n = 350), follow-up at 6½-years-of-age was performed using spirometry and impulse oscillometry. Associations to gestational age, smallness for gestational age (SGA), and bronchopulmonary dysplasia (BPD) were assessed. RESULTS Children born extremely preterm had lower forced vital capacity (FVC, z-score: -0.7, 95%CI: -1.0;-0.4), forced expiratory volume (FEV1 , z-score: -1.1, 95%CI: -1.4; -0.8), higher frequency-dependence of resistance (R5-20 , 0.09, 95%CI: 0.05; 0.12 kPa · L-1 · s-1 ) and larger area under the reactance curve (AX, 0.78, 95%CI: 0.49; 1.07 kPa · L-1 ) than controls. In children born at 22-24 weeks of gestation, 24% had FVC and 44% had FEV1 below the lower limit of normal. SGA and severe BPD only marginally contributed to pulmonary outcomes. Asthma-like disease was reported in 40% of extremely preterm children and 15% of controls. CONCLUSION Many children born extremely preterm have altered airway mechanics and significant obstructive reduction in lung function. This warrants consideration for treatment and continued follow-up.
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Affiliation(s)
- Per Thunqvist
- Department of Pediatrics, Sachs' Children Youth Hospital Södersjukhuset, Stockholm, Sweden.,Department of Clinical Science and Education, Karolinska Institutet, Sodersjukhuset, Stockholm, Sweden
| | - Ellen Tufvesson
- Department of Clinical Sciences, Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Leif Bjermer
- Department of Clinical Sciences, Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Anna Winberg
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Vineta Fellman
- Department of Pediatrics, Clinical Sciences, Lund University, Lund, Sweden
| | - Magnus Domellöf
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Erik Melén
- Department of Pediatrics, Sachs' Children Youth Hospital Södersjukhuset, Stockholm, Sweden.,Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Mikael Norman
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Neonatal Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Jenny Hallberg
- Department of Pediatrics, Sachs' Children Youth Hospital Södersjukhuset, Stockholm, Sweden.,Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden
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12
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Yoon Y, Jung G, Ri S, Choung JT, Yoo Y. Clinical characteristics of lower respiratory tract infection in low birth weight children. ALLERGY ASTHMA & RESPIRATORY DISEASE 2018. [DOI: 10.4168/aard.2018.6.4.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Yoonsun Yoon
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Geehae Jung
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Soohyun Ri
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Ji Tae Choung
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
- Environmental Health Center, Korea University Anam Hospital, Seoul, Korea
| | - Young Yoo
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
- Environmental Health Center, Korea University Anam Hospital, Seoul, Korea
- Allergy Immunology Center, Korea University, Seoul, Korea
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13
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Balte P, Karmaus W, Roberts G, Kurukulaaratchy R, Mitchell F, Arshad H. Relationship between birth weight, maternal smoking during pregnancy and childhood and adolescent lung function: A path analysis. Respir Med 2016; 121:13-20. [PMID: 27888986 DOI: 10.1016/j.rmed.2016.10.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 10/04/2016] [Accepted: 10/17/2016] [Indexed: 01/23/2023]
Abstract
BACKGROUND Low birth weight and gestational maternal smoking have been linked with reduced lung function in children in many cross sectional studies. However, these associations have not yet been assessed with repeated measurements of lung function. Our aim was to investigate the effects of birth weight, gestational age, and gestational maternal smoking on lung function in children at age 10 and 18 years. METHODS In the Isle of Wight birth cohort spirometry was performed at age 10 and 18 years. Information on birth weight and gestational age were obtained from hospital records. Mothers were asked about smoking during pregnancy. We employed linear mixed models to estimate the effect of these risk factors on repeated measurements of lung function. We considered maternal asthma, sex, neonatal intensive care unit admission, height, socio-economic status, personal smoking in participants at age 18, body mass index and environmental tobacco smoke exposure as potential confounders. Finally, we used path analysis to determine links between birth weight, gestational age and gestational maternal smoking on lung function at age 10 and 18 years. RESULTS Linear mixed models showed that with every 1 kg increase in birth weight, Forced expiratory volume in one second (FEV1) increased by 42.6 ± 17.2 mL and Forced expiratory flow between 25% and 75% (FEF25-75) of Forced vital capacity (FVC) increased by 95.5 ± 41.2 mL at age 18 years after adjusting for potential confounders. Path analysis suggested that birth weight had positive direct effects on FEV1 and FEF25-75 and positive indirect effect on FVC at 10 years which were carried forward to 18 years. Additionally, results also suggested a positive association between gestational age and FEV1, FVC and FEF25-75 at ages 10 and 18 years and an inverse association between gestational smoke exposure and FEV1/FVC ratio and FEF25-75 at age 18 years. CONCLUSIONS Higher birth weight and gestational age were associated with higher FEV1, FVC and FEF25-75 and maternal smoking during pregnancy was associated with reduced FEV1/FVC ratio and FEF25-75. The use of path analysis can improve our understanding of underlying "causal" pathways among different prenatal and childhood factors that affect lung function in both pre-adolescent and adolescent periods.
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Affiliation(s)
- Pallavi Balte
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA.
| | - Wilfried Karmaus
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA.
| | - Graham Roberts
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK; The David Hide Asthma and Allergy Research Centre, Isle of Wight, UK; NIHR Southampton Respiratory Biomedical Research Unit, University Hospital Southampton, Southampton, UK.
| | - Ramesh Kurukulaaratchy
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK; The David Hide Asthma and Allergy Research Centre, Isle of Wight, UK; NIHR Southampton Respiratory Biomedical Research Unit, University Hospital Southampton, Southampton, UK.
| | - Frances Mitchell
- The David Hide Asthma and Allergy Research Centre, Isle of Wight, UK.
| | - Hasan Arshad
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK; The David Hide Asthma and Allergy Research Centre, Isle of Wight, UK; NIHR Southampton Respiratory Biomedical Research Unit, University Hospital Southampton, Southampton, UK.
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14
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Hood RD, Wu JM, Witorsch RJ, Witorsch P. Environmental Tobacco Smoke Exposure and Respiratory Health in Children: An Updated Critical Review and Analysis of the Epidemiological Literature. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/1420326x9200100105] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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15
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Zainal N, Rahardja A, Faris Irfan CY, Nasir A, Wan Pauzi WI, Mohamad Ikram I, Van Rostenberghe H. Prevalence of asthma-like symptoms and assessment of lung function in schoolchildren born with low birth weight. Singapore Med J 2016; 57:690-693. [PMID: 26805669 DOI: 10.11622/smedj.2016019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION This study aimed to determine the prevalence of asthma-like symptoms among schoolchildren with low birth weight (LBW), and to compare the lung function of these children with that of children with normal birth weight. METHODS This was a comparative cross-sectional study. We recruited children aged 8-11 years from eight primary schools in Kota Bharu, Kelantan, Malaysia. The children were divided into two groups: those with LBW (< 2,500 g) and those with normal birth weight (≥ 2,500 g). Parents of the enrolled children were asked to complete a translated version of the International Study of Asthma and Allergies in Childhood questionnaire. Lung function tests, done using a MicroLoop Spirometer, were performed for the children in both groups by a single investigator who was blinded to the children's birth weight. RESULTS The prevalence of 'ever wheezed' among the children with LBW was 12.9%. This value was significantly higher than that of the children with normal birth weight (7.8%). Forced vital capacity (FVC), forced expiratory volume in one second, and forced expiratory flow when 50% and 75% of the FVC had been exhaled were significantly lower among the children with LBW as compared to the children with normal birth weight. CONCLUSION LBW is associated with an increased prevalence of asthma-like symptoms and impaired lung function indices later in life. Children born with LBW may need additional follow-up so that future respiratory problems can be detected early.
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Affiliation(s)
- Nik Zainal
- Department of Paediatrics, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Andy Rahardja
- Department of Paediatrics, Faculty of Medical and Health Sciences, Universiti Malaysia Sarawak, Sarawak, Malaysia
| | | | - Ariffin Nasir
- Department of Paediatrics, Universiti Sains Malaysia, Kelantan, Malaysia
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16
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The radiology of diffuse interstitial pulmonary disease in children: pearls, pitfalls and new kids on the block in 2015. Radiol Med 2015; 121:352-61. [PMID: 26589422 DOI: 10.1007/s11547-015-0599-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 10/27/2015] [Indexed: 12/29/2022]
Abstract
Diffuse interstitial lung disease in children differs markedly from interstitial lung disease in adults and is a distinct entity. The childhood interstitial lung disease (ChILD) classification, devised in 2010 separates conditions into those occurring in infancy, and those not specific to infants, the later group containing many conditions related to systemic diseases (including connective tissue diseases and depositional/storage disorders), and conditions occurring in immunocompromised children. In this article, we briefly review normal lung growth and development. We discuss our preferred technique for imaging the lungs with computed tomography in children, and review the recent literature regarding the radiological appearance of various ChILD. We illustrate this with cases from our institution and emphasize the more recently recognised conditions including pleuroparenchymal fibroelastosis and filamin A deficiency-related lung disease.
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17
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Cristea AI, Ackerman VL, Swigonski NL, Yu Z, Slaven JE, Davis SD. Physiologic findings in children previously ventilator dependent at home due to bronchopulmonary dysplasia. Pediatr Pulmonol 2015; 50:1113-8. [PMID: 26479734 DOI: 10.1002/ppul.23129] [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: 03/19/2014] [Revised: 08/18/2014] [Accepted: 08/30/2014] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Bronchopulmonary dysplasia (BPD) is the primary respiratory complication of premature birth. Some preterm newborns develop chronic respiratory failure, requiring home ventilator support. While physiologic measures have been described for prematurely born children, little is known about spirometric indices in patients with severe BPD who were previously ventilator dependent at home. METHODS We retrospectively reviewed medical charts of patients with severe BPD who were ventilator dependent at home. We excluded patients with other comorbidities that could contribute to the severity of BPD. Spirometry was performed when the patient was able to follow commands. RESULTS Between 1984 and 2012, within our severe BPD cohort who previously required home ventilator support, 19 patients were able to perform reproducible spirometry meeting ATS/ERS acceptability criteria. Ten (52.6%) were females, 13 (68.4%) were Caucasians. Mean age at liberation from ventilation was 2.4 years (C.I. 2.0, 2.9) and at decannulation was 3.5 years (C.I. 2.9, 4.0); median age at first reproducible spirometry measurement was 6.6 years (IQR: 4.9, 8.3). Spirometry results revealed significant airway obstruction, as demonstrated by Z-scores values of -1.5 (C.I. -2.5, -0.4) for FVC, -2.7 (C.I. -3.3, -1.9) for FEV1 , and -3.6 (C.I. -4.3, -2.9) for FEF25-75 . More so, serial spirometric measurements' slopes revealed that the airway obstruction remained static over time (FEV1 slope: -0.07, P-value: 0.2624; FVC slope: -0.01, P-value: 0.9064; and FEF25-75 : 0.0, P-value: 0.8532). CONCLUSIONS Extreme prematurity associated with severe BPD requiring home ventilator support carries significant risks of morbidity. These patients had substantially diminished respiratory function reflecting airflow abnormalities that remained static over time.
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Affiliation(s)
- A Ioana Cristea
- Department of Pediatrics, Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana
| | - Veda L Ackerman
- Department of Pediatrics, Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana
| | - Nancy L Swigonski
- Department of Pediatrics, Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana
| | - Zhangsheng Yu
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana
| | - James E Slaven
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Stephanie D Davis
- Department of Pediatrics, Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana
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18
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Johnson CC, Peterson EL, Joseph CL, Ownby DR, Breslau N. Birth weight and asthma incidence by asthma phenotype pattern in a racially diverse cohort followed through adolescence. J Asthma 2015; 52:1006-12. [PMID: 26374620 PMCID: PMC4831062 DOI: 10.3109/02770903.2015.1054405] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Low birth weight (LBW) has been shown to be an independent risk factor for asthma. We hypothesized that LBW would have its greatest impact on early onset disease. METHODS A racially diverse cohort of children born from 1983 to 1985 at two hospitals, one urban and one suburban in the same metropolitan area, and oversampled for babies weighing ≤2500 g, was identified retrospectively when the children were 6 years of age and followed periodically. At the age 17 years study visit, cohort members and their parent/guardians were separately interviewed face-to-face regarding the subject's history of asthma using the standardized ISAAC questionnaire. We measured the cumulative incidence of asthma from birth through adolescence defined by age of diagnosis and persistence/remittance. RESULTS Six-hundred and eighty teens (82.6% of the original cohort) were included in the analyses, 387 with LBW and 293 of normal birth weight. The prevalence of physician-diagnosed "Current Asthma" was associated with LBW (p = 0.003 for trend), with patterns stronger in males and whites. LBW was associated most strongly with Late Onset Persistent asthma (current asthma that was diagnosed after 8 years); p for trend 0.032. This trend was again most evident in males and whites. None of the asthma categories classified as "remittent" were statistically associated with LBW. CONCLUSIONS LBW was not associated with diagnosed asthma that remitted before age 17 years. LBW was associated with asthma diagnosis in mid-childhood that persisted through adolescence, suggesting that the asthmagenic effects of LBW can become evident post the early years of childhood and persist into adulthood.
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Affiliation(s)
| | - Edward L. Peterson
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI
| | | | - Dennis R. Ownby
- Section of Allergy-Immunology, Georgia Regents University, Augusta, GA
| | - Naomi Breslau
- Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing, MI
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19
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Olivas-Calderón E, Recio-Vega R, Gandolfi AJ, Lantz RC, González-Cortes T, Gonzalez-De Alba C, Froines JR, Espinosa-Fematt JA. Lung inflammation biomarkers and lung function in children chronically exposed to arsenic. Toxicol Appl Pharmacol 2015; 287:161-167. [PMID: 26048584 PMCID: PMC4751871 DOI: 10.1016/j.taap.2015.06.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 05/28/2015] [Accepted: 06/01/2015] [Indexed: 01/11/2023]
Abstract
Evidence suggests that exposure to arsenic in drinking water during early childhood or in utero has been associated with an increase in respiratory symptoms or diseases in the adulthood, however only a few studies have been carried out during those sensitive windows of exposure. Recently our group demonstrated that the exposure to arsenic during early childhood or in utero in children was associated with impairment in the lung function and suggested that this adverse effect could be due to a chronic inflammation response to the metalloid. Therefore, we designed this cross-sectional study in a cohort of children associating lung inflammatory biomarkers and lung function with urinary As levels. A total of 275 healthy children were partitioned into four study groups according with their arsenic urinary levels. Inflammation biomarkers were measured in sputum by ELISA and the lung function was evaluated by spirometry. Fifty eight percent of the studied children were found to have a restrictive spirometric pattern. In the two highest exposed groups, the soluble receptor for advanced glycation end products' (sRAGE) sputum level was significantly lower and matrix metalloproteinase-9 (MMP-9) concentration was higher. When the biomarkers were correlated to the urinary arsenic species, negative associations were found between dimethylarsinic (DMA), monomethylarsonic percentage (%MMA) and dimethylarsinic percentage (%DMA) with sRAGE and positive associations between %DMA with MMP-9 and with the MMP-9/tissue inhibitor of metalloproteinase (TIMP-1) ratio. In conclusion, chronic arsenic exposure of children negatively correlates with sRAGE, and positively correlated with MMP-9 and MMP-9/TIMP-1 levels, and increases the frequency of an abnormal spirometric pattern. Arsenic-induced alterations in inflammatory biomarkers may contribute to the development of restrictive lung diseases.
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Affiliation(s)
- Edgar Olivas-Calderón
- Department of Environmental Health, Biomedical Research Center, School of Medicine, University of Coahuila, Torreon, Coahuila, Mexico; School of Medicine, University Juarez of Durango, Gomez Palacio, Durango, Mexico.
| | - Rogelio Recio-Vega
- Department of Environmental Health, Biomedical Research Center, School of Medicine, University of Coahuila, Torreon, Coahuila, Mexico.
| | - A Jay Gandolfi
- Southwest Environmental Health Science Center, University of Arizona, Tucson, AZ, USA; Department of Cellular and Molecular Medicine, University of Arizona, Tucson, AZ, USA.
| | - R Clark Lantz
- Department of Cellular and Molecular Medicine, University of Arizona, Tucson, AZ, USA; Department of Pharmacology and Toxicology, University of Arizona, Tucson, AZ, USA.
| | - Tania González-Cortes
- Department of Environmental Health, Biomedical Research Center, School of Medicine, University of Coahuila, Torreon, Coahuila, Mexico.
| | - Cesar Gonzalez-De Alba
- Department of Environmental Health, Biomedical Research Center, School of Medicine, University of Coahuila, Torreon, Coahuila, Mexico.
| | - John R Froines
- Center for Environmental and Occupational Health, School of Public Health, University of California at Los Angeles, Los Angeles, CA, USA.
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20
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Lanari M, Prinelli F, Adorni F, Di Santo S, Vandini S, Silvestri M, Musicco M. Risk factors for bronchiolitis hospitalization during the first year of life in a multicenter Italian birth cohort. Ital J Pediatr 2015; 41:40. [PMID: 26006025 PMCID: PMC4453833 DOI: 10.1186/s13052-015-0149-z] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 05/18/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Respiratory Syncytial Virus (RSV) is one of the main causes of respiratory infections during the first year of life. Very premature infants may contract more severe diseases and 'late preterm infants' may also be more susceptible to the infection. The aim of this study is to evaluate the risk factors for hospitalization during the first year of life in children born at different gestational ages in Italy. METHODS A cohort of 33-34 weeks gestational age (wGA) newborns matched by sex and age with two cohort of newborns born at 35-37 wGA and > 37 wGA were enrolled in this study for a three-year period (2009-2012). Hospitalization for bronchiolitis (ICD-9 code 466.1) during the first year of life was assessed through phone interview at the end of the RSV season (November-March) and at the completion of the first year of life. RESULTS The study enrolled 2314 newborns, of which 2210 (95.5 %) had a one year follow-up and were included in the analysis; 120 (5.4 %) were hospitalized during the first year of life for bronchiolitis. Children born at 33-34 wGA had a higher hospitalization rate compared to the two other groups. The multivariate analysis carried out on the entire population associated the following factors with higher rates for bronchiolitis hospitalization: male gender; prenatal treatment with corticosteroids; prenatal exposure to maternal smoking; singleton delivery; respiratory diseases in neonatal period; surfactant therapy; lack of breastfeeding; siblings <10 years old; living in crowded conditions and/or in unhealthy households and early exposure to the epidemic RSV season. When analysis was restricted to preterms born at 33-34 wGA the following variables were associated to higher rates of bronchiolitis hospitalization: male gender, prenatal exposure to maternal smoking, neonatal surfactant therapy, having siblings <10 years old, living in crowded conditions and being exposed to epidemic season during the first three months of life. CONCLUSION Our study identified some prenatal, perinatal and postnatal conditions proving to be relevant and independent risk factors for hospitalization for bronchiolitis during the first year of life. The combination of these factors may lead to consider palivizumab prophylaxis in Italy.
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Affiliation(s)
- Marcello Lanari
- Pediatrics and Neonatology Unit, Imola Hospital, Imola, Italy.
| | - Federica Prinelli
- Institute of Biomedical Technologies, National Research Council, Milan, Italy. .,Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy.
| | - Fulvio Adorni
- Institute of Biomedical Technologies, National Research Council, Milan, Italy.
| | | | - Silvia Vandini
- Neonatology Unit S.Orsola-Malpighi Hospital, Via Massarenti 11, Bologna, Italy.
| | - Michela Silvestri
- Pediatric Pulmonology and Allergy Unit, Istituto Giannina Gaslini, Genoa, Italy.
| | - Massimo Musicco
- Institute of Biomedical Technologies, National Research Council, Milan, Italy. .,Foundation IRCCS Santa Lucia, Rome, Italy.
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Nasanen-Gilmore SPK, Saha S, Rasul I, Rousham EK. Household environment and behavioral determinants of respiratory tract infection in infants and young children in northern Bangladesh. Am J Hum Biol 2015; 27:851-8. [PMID: 25994352 DOI: 10.1002/ajhb.22736] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 03/06/2015] [Accepted: 04/21/2015] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Respiratory tract infections (RTI) are one of the leading causes of under-five mortality in Bangladesh. Solid biomass fuels are the main source of domestic fuel used for cooking across Bangladesh, leading to smoke and pollution exposure in the home. This article aims to identify risk factors for RTI among children aged under five years in Bangladesh with a particular focus on the household environment, fuel use, and cooking practices. METHODS A cross-sectional household-health survey was carried out in 321 households in northern Bangladesh. The survey included care-giver interviews on cooking practices, child health, and household behaviors during cooking. Health status of the youngest child (under five years) from each household was recorded through maternal interviews, medical diagnosis, and assessment of biomarkers (C-reactive protein (CRP), hemoglobin) from finger-prick blood samples. Anthropometric status (weight, height) was recorded. RESULTS Children who spent ≥30 minutes/day within 5 feet of the stove during cooking had a significantly increased risk of moderate/severe RTI compared with children spending <30 minutes/day close to the stove (OR = 2.15, 95%CI: 1.20-3.86, P = 0.01), independent of socio-economic status (SES), biomass fuel type (wood, dung, plant-derived, compressed rice husks), child age, anthropometric status, CRP and hemoglobin. CONCLUSIONS In environments with a heavy reliance on solid biomass fuels, the amount of time a child spends near the stove during cooking may be an important risk for RTI. These novel findings from Bangladesh warrant further investigation of mother-infant behaviors during cooking in relation to child health, to ascertain whether the association is likely to be causal.
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Affiliation(s)
| | - Subir Saha
- Office of School Wellness Programs, New York City Department of Education, New York
| | - Izaz Rasul
- Concern Worldwide, Bangladesh, Gulshan 1, Dhaka, Bangladesh
| | - Emily K Rousham
- Centre for Global Health and Human Development, School of Sports, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, United Kingdom
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Misra R, Shah S, Fowell D, Wang H, Scheible K, Misra S, Huyck H, Wyman C, Ryan RM, Reynolds AM, Mariani T, Katzman PJ, Pryhuber GS. Preterm cord blood CD4⁺ T cells exhibit increased IL-6 production in chorioamnionitis and decreased CD4⁺ T cells in bronchopulmonary dysplasia. Hum Immunol 2015; 76:329-338. [PMID: 25797206 DOI: 10.1016/j.humimm.2015.03.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 02/09/2015] [Accepted: 03/11/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Chorioamnionitis (CA) is associated with premature delivery and bronchopulmonary dysplasia (BPD). We hypothesize that preterm infants exposed to CA have reduced suppressive regulatory T cells (Treg) and increased non-regulatory T cell pro-inflammatory cytokines, increasing risk for BPD. OBJECTIVE To evaluate cord blood CD4(+) T cell regulatory phenotype and pro-inflammatory cytokine production in CA and BPD groups. STUDY DESIGN Cord blood mononuclear cells from infants (GA ⩽32 weeks), with or without placental histological evidence of CA (hChorio), were analyzed by flow cytometry. Clinical information was collected by retrospective chart review. Numbers of putative Treg (CD4(+)FoxP3(+)CD25(+)CD127Dim), CD4(+) non-Tregs, and CD4(+) T cell intracellular cytokine content following in vitro stimulation were compared with CA status and oxygen requirement at 36weeks postmenstrual age. RESULT Absolute Treg numbers were not different in CA and non-CA exposed samples. However, the infants who developed BPD had a significant decrease in Treg and non-regulatory T cell numbers. Greater IL-6 production was observed in hCA group. CONCLUSION A pro-inflammatory CD4(+) T cell status is noted in CA and BPD but the later disease is also associated with decrease in Tregs, suggesting that the development of BPD is marked by distinct inflammatory changes from those of CA exposed infants.
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Affiliation(s)
- Ravi Misra
- Department of Pediatrics, Neonatology Division, Golisano Children's Hospital
| | - Syed Shah
- Department of Pediatrics, Neonatology Division, Golisano Children's Hospital
| | - Deborah Fowell
- Department of Microbiology and Immunology, Center for Vaccine Biology and Immunology
| | - Hongyue Wang
- Department of Biostatistics and Computational Biology
| | - Kristin Scheible
- Department of Pediatrics, Neonatology Division, Golisano Children's Hospital
| | - Sara Misra
- Department of Pediatrics, Neonatology Division, Golisano Children's Hospital
| | - Heidie Huyck
- Department of Pediatrics, Neonatology Division, Golisano Children's Hospital
| | - Claire Wyman
- Department of Pediatrics, Neonatology Division, Golisano Children's Hospital
| | - Rita M Ryan
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC29425
| | - Anne Marie Reynolds
- Department of Pediatrics, University at Buffalo, Buffalo, NY, 14222, United States
| | - Tom Mariani
- Department of Pediatrics, Neonatology Division, Golisano Children's Hospital.,Pediatric Molecular and Personalized Medicine Program
| | - Philip J Katzman
- Department of Pathology and Laboratory Medicine University of Rochester Medical Center (URMC), Rochester, NY 14642
| | - Gloria S Pryhuber
- Department of Pediatrics, Neonatology Division, Golisano Children's Hospital
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23
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Abstract
Chronic obstructive pulmonary disease is mainly a smoking-related disorder and affects millions of people worldwide, with a large effect on individual patients and society as a whole. Although the disease becomes clinically apparent around the age of 40-50 years, its origins can begin very early in life. Different risk factors in very early life--ie, in utero and during early childhood--drive the development of clinically apparent chronic obstructive pulmonary disease in later life. In discussions of which risk factors drive chronic obstructive pulmonary disease, it is important to realise that the disease is very heterogeneous and at present is largely diagnosed by lung function only. In this Review, we will discuss the evidence for risk factors for the various phenotypes of chronic obstructive pulmonary disease during different stages of life.
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Affiliation(s)
- Dirkje S Postma
- Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, Netherlands; Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
| | - Andrew Bush
- National Heart and Lung Institute, Imperial College, London, UK
| | - Maarten van den Berge
- Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, Netherlands; Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Waidyatillake NT, Allen KJ, Lodge CJ, Dharmage SC, Abramson MJ, Simpson JA, Lowe AJ. The impact of breastfeeding on lung development and function: a systematic review. Expert Rev Clin Immunol 2014; 9:1253-65. [PMID: 24215413 DOI: 10.1586/1744666x.2013.851005] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
With the global trend of increasing asthma and allergic disorders there is strong interest regarding early life nutrition as a potentially modifiable risk factor for lung disease. This systematic review includes 10 studies that assessed the effect of breastfeeding on lung growth and function. The review found breastfeeding to be beneficial for lung function, with the most consistent effect on increased forced vital capacity. There was no clear evidence that the relationship between breastfeeding and lung function was mediated through other factors. Furthermore, the findings from the few studies that investigated if maternal asthma modified the effect of breastfeeding on lung function were inconsistent. Further research is needed to determine the specific details such as duration and type (exclusive vs partial) of breastfeeding that leads to improved lung function.
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Affiliation(s)
- Nilakshi T Waidyatillake
- Centre for Molecular, Environmental, Genetic and Analytic (MEGA) Epidemiology, Melbourne School of Population and Global Health, The University of Melbourne, 207, Bouverie Street, Carlton, Vic 3052, Australia
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25
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Ramsey KA, Foong RE, Sly PD, Larcombe AN, Zosky GR. Early life arsenic exposure and acute and long-term responses to influenza A infection in mice. ENVIRONMENTAL HEALTH PERSPECTIVES 2013; 121:1187-93. [PMID: 23968752 PMCID: PMC3801203 DOI: 10.1289/ehp.1306748] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 07/23/2013] [Indexed: 05/04/2023]
Abstract
BACKGROUND Arsenic is a significant global environmental health problem. Exposure to arsenic in early life has been shown to increase the rate of respiratory infections during infancy, reduce childhood lung function, and increase the rates of bronchiectasis in early adulthood. OBJECTIVE We aimed to determine if early life exposure to arsenic exacerbates the response to early life influenza infection in mice. METHODS C57BL/6 mice were exposed to arsenic in utero and throughout postnatal life. At 1 week of age, a subgroup of mice were infected with influenza A. We then assessed the acute and long-term effects of arsenic exposure on viral clearance, inflammation, lung structure, and lung function. RESULTS Early life arsenic exposure reduced the clearance of and exacerbated the inflammatory response to influenza A, and resulted in acute and long-term changes in lung mechanics and airway structure. CONCLUSIONS Increased susceptibility to respiratory infections combined with exaggerated inflammatory responses throughout early life may contribute to the development of bronchiectasis in arsenic-exposed populations.
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Affiliation(s)
- Kathryn A Ramsey
- Division of Clinical Sciences, Telethon Institute for Child Health Research, Subiaco, Western Australia, Australia
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26
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27
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28
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Vollsæter M, Røksund OD, Eide GE, Markestad T, Halvorsen T. Lung function after preterm birth: development from mid-childhood to adulthood. Thorax 2013; 68:767-76. [PMID: 23749815 DOI: 10.1136/thoraxjnl-2012-202980] [Citation(s) in RCA: 146] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND As a result of advances in perinatal care, more small preterm infants survive. There are concerns that preterm birth and its treatments may harm pulmonary development and thereby lead to chronic airway obstruction in adulthood. OBJECTIVE To assess the development of spirometric lung function variables from mid-childhood to adulthood after extreme preterm birth. METHODS Two population-based cohorts born at gestational age ≤28 weeks or with birth weight ≤1000 g performed lung function tests at 10 and 18 and at 18 and 25 years of age, respectively, together with matched term-born controls. The results are presented as z scores, normalised for age, sex and height. Longitudinal development was compared for groups born at term and preterm, split by a history of absence (n=20), mild (n=38) or moderate/severe (n=25) neonatal bronchopulmonary dysplasia (BPD). RESULTS The preterm-born cohorts, particularly those with neonatal BPD, had significantly lower forced expiratory volume in 1 s and mid-expiratory flow than those born at term at all assessments (z scores in the range -0.40 to -1.84). Within each of the subgroups the mean z scores obtained over the study period were largely similar, coefficients of determination ranging from 0.64 to 0.82. The pattern of development for the BPD subgroups did not differ from each other or from the groups born at term (tests of interaction). CONCLUSIONS Airway obstruction was present from mid-childhood to adulthood after extreme preterm birth, most evident after neonatal BPD. Lung function indices were tracking similarly in the preterm and term-born groups.
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Affiliation(s)
- Maria Vollsæter
- Department of Clinical Science, Section for Pediatrics, University of Bergen, Bergen, Norway.
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29
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Hacking DF, Gibson AM, Robertson C, Doyle LW. Respiratory function at age 8-9 after extremely low birthweight or preterm birth in Victoria in 1997. Pediatr Pulmonol 2013; 48:449-55. [PMID: 22826206 DOI: 10.1002/ppul.22619] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2011] [Accepted: 05/07/2012] [Indexed: 11/11/2022]
Abstract
To determine if respiratory function at 8 years of age in extremely low birth weight (ELBW; birth weight <1,000 g) or extremely preterm (EPT, <28 weeks' gestation) children born in 1997 remains worse than normal birth weight (NBW; birth weight, >2,499 g) and term (37-42 weeks) controls, particularly in those ELBW/EPT children who had bronchopulmonary dysplasia (BPD). This was a cohort study of 201 consecutive ELBW/EPT survivors born in the state of Victoria during 1997, and 199 contemporaneous randomly selected NBW/term controls. Respiratory function was measured at 8 years of age according to standard guidelines, and compared with previous cohorts born in 1991-1992. Respiratory function data were available for almost 75% of both cohorts. ELBW/EPT subjects had substantial reductions in airflow compared with controls (e.g., mean difference in forced expiratory volume in 1 sec [FEV1 ] -0.91 SD, 95% confidence interval [CI] -1.19 to -0.63 SD, and in maximum expiratory flow between 25% and 75% of vital capacity [FEF25-75% ] -0.96 SD, 95% CI -1.22 to -0.71). These differences were similar to those observed between ELBW/EPT and controls subjects born in 1991-1992. Within the ELBW/EPT cohort, children who had BPD in the newborn period had significant reductions in both the FEV1 (-0.76 SD) and FEF25-75% (-0.58 SD) compared with those who did not have BPD, which were not statistically significant from those in the 1991-92 cohort. ELBW/EPT children born in 1997 still have significantly abnormal lung function compared with NBW/term controls, but results were similar to an earlier era when survival rates were lower. Pediatr Pulmonol. 2013; 48:449-455. © 2012 Wiley Periodicals, Inc.
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Affiliation(s)
- Douglas F Hacking
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
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30
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Abstract
BACKGROUND There is conflicting evidence regarding the associations between anthropometric birth measures and asthma and lung function in children, particularly for apparently healthy infants born at term. OBJECTIVE Our objective was to elucidate these relationships paying particular attention to features of study design and analysis that may threaten the validity of previous studies in this field. METHODS We analysed data from a cohort of children with a family history of asthma who were recruited antenatally. Anthropometric birth measures and potential confounders were recorded at birth and within the first year of life. Lung function and asthma outcomes were measured at 8 years of age. Airway hyperresponsiveness (AHR) was measured by methacholine challenge. The potential for a reversal paradox, due to inclusion of covariates on the causal pathway, was investigated. RESULTS Four hundred and fifty (73% of the initial cohort) children were tested at age 8 years. Birth weight in the lowest tertile was associated with current asthma (OR 1.95, 95% CI 1.08, 3.54) and recent wheeze (OR 1.87, 95%CI 1.08, 3.24), but not with AHR (OR 1.37, 95% CI 0.68, 2.78). Birth weight was positively associated with lung function. Current height modified the relationship between birth length and lung function suggesting that post-natal growth has an effect on this relationship. CONCLUSIONS Low birth weight is associated with a greater risk of current asthma and lower lung function at 8 years in children with a family history of asthma. Current height should be treated as an effect modifier when investigating the fetal origins hypothesis.
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Affiliation(s)
- B K Brew
- Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia.
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31
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Stotts AL, Northrup TF, Schmitz JM, Green C, Tyson J, Velasquez MM, Khan A, Hovell MF. Baby's Breath II protocol development and design: a secondhand smoke exposure prevention program targeting infants discharged from a neonatal intensive care unit. Contemp Clin Trials 2013; 35:97-105. [PMID: 23466754 DOI: 10.1016/j.cct.2013.02.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 02/07/2013] [Accepted: 02/22/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Over one-third of all children live with at least one parent who smokes cigarettes, which is associated with compromised child health. The impact of secondhand smoke exposure (SHSe) in medically fragile infants born prematurely is likely to be much higher. The Baby's Breath II study tests whether a hospital-initiated, motivational-enhancement program will result in less SHSe relative to conventional care in high-risk, low birthweight (LBW) infants discharged from a neonatal intensive care unit (NICU). The design and protocol for the ongoing BBII trial is described. METHODS/DESIGN Eligible participants are: (1) primary caregivers (typically mothers) of NICU infants who were born at LBW (<2500g) or ventilated for more than 12h; and (2) who smoke or live with at least one smoker. This randomized controlled trial has two conditions: Motivational interviewing plus incentives (MI+) and conventional care (CC). MI+ participants receive two hospital-based and two home-based counseling sessions, as well as incentives (i.e., prize-based draws) for (a) intervention attendance and (b) biochemical validation (i.e., urine cotinine dipstick) indicative of low or no infant SHSe. Participants in the control group receive conventional education-based care. Assessments are completed at baseline, mid-point, and 1- and 4-months post-intervention. DISCUSSION This study is the first to determine the efficacy of a brief intervention for reducing SHSe among high-risk, LBW infants discharged from a NICU, with the potential for saving lives and healthcare costs. Strengths, limitations and challenges to the conduct of this trial are discussed.
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Affiliation(s)
- Angela L Stotts
- Department of Family and Community Medicine, University of Texas Medical School at Houston, 6431 Fannin, Houston, TX 77030, USA.
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Ramsey KA, Larcombe AN, Sly PD, Zosky GR. In utero exposure to low dose arsenic via drinking water impairs early life lung mechanics in mice. BMC Pharmacol Toxicol 2013; 14:13. [PMID: 23419080 PMCID: PMC3584853 DOI: 10.1186/2050-6511-14-13] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 01/31/2013] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Exposure to arsenic via drinking water is a significant environmental issue affecting millions of people around the world. Exposure to arsenic during foetal development has been shown to impair somatic growth and increase the risk of developing chronic respiratory diseases. The aim of this study was to determine if in utero exposure to low dose arsenic via drinking water is capable of altering lung growth and postnatal lung mechanics. METHODS Pregnant C57BL/6 mice were given drinking water containing 0, 10 (current World Health Organisation (WHO) maximum contaminant level) or 100 μg/L arsenic from gestational day 8 to birth. Birth outcomes and somatic growth were monitored. Plethysmography and the forced oscillation technique were used to collect measurements of lung volume, lung mechanics, pressure-volume curves and the volume dependence of lung mechanics in male and female offspring at two, four, six and eight weeks of age. RESULTS In utero exposure to low dose arsenic via drinking water resulted in low birth weight and impaired parenchymal lung mechanics during infancy. Male offspring were more susceptible to the effects of arsenic on growth and lung mechanics than females. All alterations to lung mechanics following in utero arsenic exposure were recovered by adulthood. CONCLUSIONS Exposure to arsenic at the current WHO maximum contaminant level in utero impaired somatic growth and the development of the lungs resulting in alterations to lung mechanics during infancy. Deficits in growth and lung development in early life may contribute to the increased susceptibility of developing chronic respiratory disease in arsenic exposed human populations.
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Affiliation(s)
- Kathryn A Ramsey
- Division of Clinical Sciences, Telethon Institute for Child Health Research, 100 Roberts Road, Subiaco, WA, 6008, Australia.
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33
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Ramsey KA, Bosco A, McKenna KL, Carter KW, Elliot JG, Berry LJ, Sly PD, Larcombe AN, Zosky GR. In utero exposure to arsenic alters lung development and genes related to immune and mucociliary function in mice. ENVIRONMENTAL HEALTH PERSPECTIVES 2013; 121:244-50. [PMID: 23221970 PMCID: PMC3569690 DOI: 10.1289/ehp.1205590] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Accepted: 11/29/2012] [Indexed: 05/03/2023]
Abstract
BACKGROUND Exposure to arsenic via drinking water is a global environmental health problem. In utero exposure to arsenic via drinking water increases the risk of lower respiratory tract infections during infancy and mortality from bronchiectasis in early adulthood. OBJECTIVES We aimed to investigate how arsenic exposure in early life alters lung development and pathways involved in innate immunity. METHODS Pregnant BALB/c, C57BL/6, and C3H/HeARC mice were exposed to 0 (control) or 100 μg/L arsenic via drinking water from gestation day 8 until the birth of their offspring. We measured somatic growth, lung volume, and lung mechanics of mice at 2 weeks of age. We used fixed lungs for structural analysis and collected lung tissue for gene expression analysis by microarray. RESULTS The response to arsenic was genetically determined, and C57BL/6 mice were the most susceptible. Arsenic-exposed C57BL/6 mice were smaller in size, had smaller lungs, and had impaired lung mechanics compared with controls. Exposure to arsenic in utero up-regulated the expression of genes in the lung involved in mucus production (Clca3, Muc5b, Scgb3a1), innate immunity (Reg3γ, Tff2, Dynlrb2, Lplunc1), and lung morphogenesis (Sox2). Arsenic exposure also induced mucous cell metaplasia and increased expression of CLCA3 protein in the large airways. CONCLUSIONS Alterations in somatic growth, lung development, and the expression of genes involved in mucociliary clearance and innate immunity in the lung are potential mechanisms through which early life arsenic exposure impacts respiratory health.
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Affiliation(s)
- Kathryn A Ramsey
- Division of Clinical Sciences, Telethon Institute for Child Health Research, Perth, Western Australia, Australia.
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Matías V, San Feliciano L, Fernández JE, Lapeña S, Garrido E, Ardura J, Soga MJ, Aragón MP, Remesal A, Benito F, Andrés J, Centeno F, Marugán V, Bachiller R, Bermejo-Martin JF. Host and environmental factors influencing respiratory secretion of pro-wheezing biomarkers in preterm children. Pediatr Allergy Immunol 2012; 23:441-7. [PMID: 22554061 DOI: 10.1111/j.1399-3038.2012.01269.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cytokines are actively secreted by the respiratory mucosa of preterm children and participate in the pathogenesis of wheezing. This study aimed to identify the factors that could potentially influence respiratory secretion of cytokines in these children. A nasopharyngeal aspirate (NPA) was collected from 77 preterm children 1 yr after birth. NPAs from 14 healthy, 1-yr-old term children were collected in parallel. 27 cytokines were measured in the NPAs using a multiplex assay. Multivariate stepwise regression analysis with Bonferroni correction evidenced that the variable [daycare attendance] was associated with higher levels of [monocyte chemoattractant protein-1 (MCP-1), IL-6, vascular endothelial growth factor (VEGF), IL-1β, IL-10, tumor necrosis factor (TNF)-α]; [male sex] with higher levels of (MCP-1, VEGF, and IL-1β); [smokers at home] was associated with higher levels of MCP-1 (p < 0.0013). In turn, [prophylaxis with palivizumab] was associated with lower levels of (IL-6, IL-7) (p < 0.0013). All these mediators participate in the pathogenesis of asthma and recurrent wheezing. Preterm children secreted higher levels of chemokines (interferon-gamma inducible protein-10, macrophage inflammatory protein-1α, Eotaxin, MCP-1), growth factors (platelet-derived growth factor-bb, VEGF, fibroblast growth factor-basic, granulocyte macrophage colony-stimulating factor), Th1 (IL12, interferon-γ), Th2 (IL-9, IL-13), Th17 (IL-6, IL-17) cytokines, and immunomodulatory mediators (IL1RA and granulocyte colony-stimulating factor) than term children. In conclusion, we have identified for the first time a group of individual and environmental factors influencing respiratory secretion of cytokines in preterm children at the long term after birth. To know these factors could help to prevent the instauration of conditions linked to the appearance of chronic respiratory diseases such as wheezing or asthma.
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Affiliation(s)
- Vanesa Matías
- Servicio de Pediatría, Hospital Clínico Universitario, SACYL, Valladolid, Spain
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Abstract
BACKGROUND Bronchopulmonary dysplasia (BPD) and the longterm respiratory consequences of prematurity are unfamiliar to adult respirologists and remain under-recognized entities to adult caregivers. In Canada, the incidence of preterm births and its main chronic respiratory complication, BPD, have increased over the past 25 years. OBJECTIVE To describe the posthospitalization morbidity, medication use, health care use and pulmonary function tests of a large cohort of individuals with preterm birth complicated by BPD. METHODS A retrospective review of the hospital records of 322 preterm infants with BPD was conducted. Outcome variables were compared across levels of disease severity. Differences between groups were tested with one-way ANOVA for continuous variables and the Mantel-Haenszel chi-squared test for ordinal variables. RESULTS Outcomes after the initial hospitalization that were associated with the initial severity of BPD were as follows: hospital readmissions in the first two years of life, the presence of developmental delay, forced expiratory volume in 1 s and forced vital capacity on pulmonary function tests in patients between eight and 15 years of age. CONCLUSION Initial BPD severity was an important predictor of pulmonary function abnormality and health care use during childhood.
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36
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Stotts AL, Evans PW, Green CE, Northrup TF, Dodrill CL, Fox JM, Tyson JE, Hovell MF. Secondhand smoke risk in infants discharged from an NICU: potential for significant health disparities? Nicotine Tob Res 2011; 13:1015-22. [PMID: 21669959 PMCID: PMC3430443 DOI: 10.1093/ntr/ntr116] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Accepted: 04/29/2011] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Secondhand smoke exposure (SHSe) threatens fragile infants discharged from a neonatal intensive care unit (NICU). Smoking practices were examined in families with a high respiratory risk infant (born at very low birth weight; ventilated > 12 hr) in a Houston, Texas, NICU. Socioeconomic status, race, and mental health status were hypothesized to be related to SHSe and household smoking bans. METHODS Data were collected as part of The Baby's Breath Project, a hospital-based SHSe intervention trial targeting parents with a high-risk infant in the NICU who reported a smoker in the household (N = 99). Measures of sociodemographics, smoking, home and car smoking bans, and depression were collected. RESULTS Overall, 26% of all families with a high-risk infant in the NICU reported a household smoker. Almost half of the families with a smoker reported an annual income of less than $25,000. 46.2% of families reported having a total smoking ban in place in both their homes and cars. Only 27.8% families earning less than $25,000 reported having a total smoking ban in place relative to almost 60% of families earning more (p < .01). African American and Caucasian families were less likely to have a smoking ban compared with Hispanics (p < .05). Mothers who reported no smoking ban were more depressed than those who had a household smoking ban (p < .02). CONCLUSIONS The most disadvantaged families were least likely to have protective health behaviors in place to reduce SHSe and, consequently, are most at-risk for tobacco exposure and subsequent tobacco-related health disparities. Innovative SHSe interventions for this vulnerable population are sorely needed.
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Affiliation(s)
- Angela L Stotts
- Family and Community Medicine, University of Texas Medical School at Houston, 6431 Fannin, JJL 324, Houston, TX 77030, USA.
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Smith LJ, van Asperen PP, McKay KO, Selvadurai H, Fitzgerald DA. Post-natal corticosteroids are associated with reduced expiratory flows in children born very preterm. J Paediatr Child Health 2011; 47:448-54. [PMID: 21707820 DOI: 10.1111/j.1440-1754.2010.01992.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM Infants born very prematurely often received corticosteroids to minimise the risk of developing bronchopulmonary dysplasia (BPD) but their long term impact on lung function at school age is unclear. METHODS A cross-sectional study of 105 children [mean gestation of 27 weeks] was undertaken. Lung function assessments were conducted at a mean age of 10 years according to standard criteria. Corticosteroid dose was obtained from the medical record. RESULTS Spirometry in the BPD group was not significantly different to the non-BPD group, mean per-cent predicted (95% confidence interval) forced expiratory volume in 1 s (FEV1) 83% (79, 87) versus 86% (83, 90), FEF25%-75% 67% (60, 73) versus 75% (69, 81). Antenatal steroid treatment alone did not adversely affect airflow FEV1, 88% (84.92) versus 90% (82.97), and forced expiratory flow (FEF)25%-75%, 75% (69.81) versus 87% (70.104). Children who received post-natal corticosteroids had significantly lower flows than those who did not (FEV1 82% (78.85) vs. 88% (85.92), P = 0.006; FEF25%-75% 65% (59.71) vs. 78% (72.84), P = 0.003). Regression analysis revealed days on oxygen and days ventilated were statistically significant but weak predictors of airflow at 10 years of age. CONCLUSIONS A diagnosis of BPD did not predict reduced spirometry in middle childhood. Children who received post-natal corticosteroids as preterm infants had reduced expiratory flows compared with those who did not. While post-natal corticosteroids may be a marker of severity of lung disease, the potential of post-natal corticosteroids to influence lung development requires further investigation.
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Affiliation(s)
- Lucia J Smith
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
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Lum S, Bush A, Stocks J. Clinical Pulmonary Function Testing for Children with Bronchopulmonary Dysplasia. PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY 2011; 24:77-88. [DOI: 10.1089/ped.2010.0059] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Sooky Lum
- Portex Respiratory Unit, UCL, Institute of Child Health, London, United Kingdom
| | - Andrew Bush
- Department of Paediatrics, Royal Brompton Hospital, London, United Kingdom
| | - Janet Stocks
- Portex Respiratory Unit, UCL, Institute of Child Health, London, United Kingdom
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Narang I. Review Series: What goes around, comes around: childhood influences on later lung health?: Long-term follow-up of infants with lung disease of prematurity. Chron Respir Dis 2010; 7:259-69. [DOI: 10.1177/1479972310375454] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The incidence of live preterm birth is increasing and concomitantly the survival of preterm babies has increased over the last 30 years due to advances in neonatal care. Bronchopulmonary dysplasia (BPD) is a chronic respiratory disease that develops as a consequence of perinatal and/or neonatal lung injury following preterm birth and the pathology has also changed with changes in neonatal care. There are data suggesting that there is increased respiratory morbidity of ex-preterm subjects in childhood. It is only now that large populations of preterm subjects are reaching adulthood and may be at risk of persistent respiratory morbidity. This review will summarize the current knowledge in adulthood of respiratory sequelae following preterm birth; specifically it will review respiratory symptoms, pulmonary function, exercise capacity and structural lung disease as determined by high resolution computed tomography scans in ex-preterm survivors with and without BPD. Whether prematurity-related lung disease is associated with chronic obstructive airways disease will be discussed.
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Affiliation(s)
- Indra Narang
- Division of Respiratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada,
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Jedrychowski WA, Perera FP, Maugeri U, Mrozek-Budzyn D, Mroz E, Klimaszewska-Rembiasz M, Flak E, Edwards S, Spengler J, Jacek R, Sowa A. Intrauterine exposure to polycyclic aromatic hydrocarbons, fine particulate matter and early wheeze. Prospective birth cohort study in 4-year olds. Pediatr Allergy Immunol 2010; 21:e723-32. [PMID: 20444151 PMCID: PMC3683604 DOI: 10.1111/j.1399-3038.2010.01034.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The main goal of the study was to determine the relationship between prenatal exposure to polycyclic aromatic hydrocarbons (PAHs) measured by PAH-DNA adducts in umbilical cord blood and early wheeze. The level of PAH-DNA adducts in the cord blood is assumed to reflect the cumulative dose of PAHs absorbed by the foetus over the prenatal period. The effect of prenatal PAH exposure on respiratory health measured by the incidence rate ratio (IRR) for the number of wheezing days in the subsequent 4 yr follow-up was adjusted for potential confounding factors such as personal prenatal exposure to fine particulate matter (PM(2.5)), environmental tobacco smoke (ETS), gender of child, maternal characteristics (age, education and atopy), parity and mould/dampness in the home. The study sample includes 339 newborns of non-smoking mothers 18-35 yr of age and free from chronic diseases, who were recruited from ambulatory prenatal clinics in the first or second trimester of pregnancy. The number of wheezing days during the first 2 yr of life was positively associated with prenatal level of PAH-DNA adducts (IRR = 1.69, 95%CI = 1.52-1.88), prenatal particulate matter (PM(2.5)) level dichotomized by the median (IRR = 1.38; 95%CI: 1.25-1.51), maternal atopy (IRR = 1.43; 95%CI: 1.29-1.58), mouldy/damp house (IRR = 1.43; 95%CI: 1.27-1.61). The level of maternal education and maternal age at delivery was inversely associated with the IRRs for wheeze. The significant association between frequency of wheeze and the level of prenatal environmental hazards (PAHs and PM(2.5)) was not observed at ages 3 or 4 yrs. Although the frequency of wheezing at ages 3 or 4 was no longer associated with prenatal exposure to PAHs and PM(2.5), its occurrence depended on the presence of wheezing in the first 2 yr of life, which nearly tripled the risk of wheezing in later life. In conclusion, the findings may suggest that driving force for early wheezing (<24 months of age) is different to those leading to later onset of wheeze. As we reported no synergistic effects between prenatal PAH (measured by PAH-DNA adducts) and PM(2.5) exposures on early wheeze, this suggests the two exposures may exert independent effects via different biological mechanism on wheeze.
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Affiliation(s)
- Wieslaw A Jedrychowski
- Chair of Epidemiology and Preventive Medicine, Jagiellonian University, Medical College, Krakow, Poland.
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41
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Pei L, Chen G, Mi J, Zhang T, Song X, Chen J, Ji Y, Li C, Zheng X. Low birth weight and lung function in adulthood: retrospective cohort study in China, 1948-1996. Pediatrics 2010; 125:e899-905. [PMID: 20211946 DOI: 10.1542/peds.2008-3086] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The goal was to determine whether the components of low lung function in adulthood were associated with low birth weight in a Chinese population. METHODS A retrospective cohort study was conducted from December 1995 to August 1996. A total of 627 men and women who were born between 1948 and 1954 were recruited; lung function indices were tested and respiratory diseases were examined in the Peking Union Medical College Hospital. Information on variables was recorded, and multivariate analysis of variance was performed to evaluate associations. RESULTS Significant associations were observed between birth weight and forced expiratory volume in 1 second (FEV(1)), forced vital capacity (FVC), and peak expiratory flow (PEF) in adulthood, after adjustment for maternal age, gestational week, offspring's gender, birth height, history of dyspnea and asthma, lung diseases before 16 years of age, lung diseases after measles and pneumonia before 16 years of age, cough with sputum within 2 years, current asthma, taking medicine for asthma, adult BMI, male alcohol consumption, and male smoking (P < .001). Linear trends between birth weight and FEV(1), FVC, and PEF were noted (P < .001, 1-way analysis of variance); FEV(1), FVC, and PEF values increased with increasing birth weight. Low birth weight was associated with the FEV(1)/FVC predictive value (P < .05), but there was no linear trend (P > .05). CONCLUSIONS Low birth weight may increase the prevalence of and risk for low lung function in adulthood in the Chinese population. The development of lung function may be affected by hypogenesis in utero.
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Affiliation(s)
- Lijun Pei
- Institute of Population Research, Peking University, Beijing 100871, PR China
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Stevens TP, Dylag A, Panthagani I, Pryhuber G, Halterman J. Effect of cumulative oxygen exposure on respiratory symptoms during infancy among VLBW infants without bronchopulmonary dysplasia. Pediatr Pulmonol 2010; 45:371-9. [PMID: 20232470 DOI: 10.1002/ppul.21199] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
UNLABELLED Very low birth weight (VLBW) infants, even those without bronchopulmonary dysplasia (BPD) are at risk for pulmonary morbidity during infancy. Although some studies have found an association between the level of neonatal oxygen exposure and later morbidity, others have not. A possible explanation for these inconsistent findings is that the cumulative dosage of neonatal supplemental oxygen to which infants are exposure is difficult to accurately quantify. METHODS A prospective cohort study of VLBW infants without BPD was performed to test the hypothesis that cumulative oxygen exposure in the neonatal period summarized using an area under the curve analysis (Oxygen(AUC)) is predictive of later pulmonary symptoms. Risk factors tested in the analysis included both neonatal and outpatient respiratory exposures. Outcome measures included respiratory symptoms and use of medications and health services to treat those symptoms. RESULTS The prevalence of pulmonary symptoms after NICU discharge was 48% (36 of 75 patients). Oxygen(AUC) as early as 72 hr of age predicts respiratory symptoms and respiratory-related health service and medication use during infancy in a dose dependent manner. Oxygen(AUC) is a stronger predictor of later respiratory symptoms than is the number of days of supplemental oxygen or positive pressure respiratory therapy or integrated mean airway pressure (MAP(AUC)). CONCLUSIONS Oxygen(AUC) as early as 72 hr of age is predictive of later respiratory symptoms and use of health services and medications to treat those symptoms. Supplemental oxygen therapy should be monitored carefully to minimize oxygen exposure and risk of later respiratory symptoms in VLBW infants.
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Affiliation(s)
- Timothy P Stevens
- Division of Neonatology, Department of Pediatrics, University of Rochester, Rochester, New York, USA.
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43
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Hoy WE, Nicol JL. Birthweight and natural deaths in a remote Australian Aboriginal community. Med J Aust 2010; 192:14-9. [DOI: 10.5694/j.1326-5377.2010.tb03394.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2009] [Accepted: 08/18/2009] [Indexed: 11/17/2022]
Affiliation(s)
- Wendy E Hoy
- Centre for Chronic Disease, School of Medicine, University of Queensland, Brisbane, QLD
| | - Jennifer L Nicol
- Centre for Chronic Disease, School of Medicine, University of Queensland, Brisbane, QLD
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Patelarou E, Chochlidaki M, Vivilaki V, Brokalaki H. Is there a link between wheezing in early childhood and adverse birth outcomes? A systematic review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2009; 6:2752-61. [PMID: 20049220 PMCID: PMC2800059 DOI: 10.3390/ijerph6112752] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2009] [Accepted: 10/29/2009] [Indexed: 11/29/2022]
Abstract
We aimed to provide a summary of the existing published knowledge on the association between adverse birth outcomes and the development of wheezing during the first two years of life. We carried out a systematic review of epidemiological studies within the MEDLINE database. Epidemiological studies on human subjects, published in English, were included in the review. A comprehensive literature search yielded 72 studies for further consideration. Following the application of the eligibility criteria we identified nine studies. A positive association and an excess risk of wheezing during the first two years of life were revealed for adverse birth outcomes.
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Affiliation(s)
- Evridiki Patelarou
- University Hospital of Heraklion, Crete, 71414 Greece
- Author to whom correspondence should be addressed; E-Mail:
; Tel.: +30-2810-392366; Fax: +30-2810-394671
| | | | - Victoria Vivilaki
- Department of Midwifery, Technological Educational Institution, Athens, 12210 Greece; E-Mail:
| | - Hero Brokalaki
- Faculty of Nursing, University of Athens, 11527 Greece; E-Mail:
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Jedrychowski W, Perera FP, Maugeri U, Mrozek-Budzyn D, Mroz E, Flak E, Edwards S, Spengler JD, Jacek R, Sowa A, Musiał A. Early wheezing phenotypes and severity of respiratory illness in very early childhood: study on intrauterine exposure to fine particle matter. ENVIRONMENT INTERNATIONAL 2009; 35:877-84. [PMID: 19394697 PMCID: PMC2709737 DOI: 10.1016/j.envint.2009.03.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2008] [Revised: 03/16/2009] [Accepted: 03/16/2009] [Indexed: 05/19/2023]
Abstract
The main goal of the paper was to assess the pattern of risk factors having an impact on the onset of early wheezing phenotypes in the birth cohort of 468 two-year olds and to investigate the severity of respiratory illness in the two-year olds in relation to both wheezing phenotypes, environmental tobacco smoke (ETS) and personal PM(2.5) exposure over pregnancy period (fine particulate matter). The secondary goal of the paper was to assess possible association of early persistent wheezing with the length of the baby at birth. Pregnant women were recruited from ambulatory prenatal clinics in the first and second trimester of pregnancy. Only women 18-35 years of age, who claimed to be non-smokers, with singleton pregnancies, without illicit drug use and HIV infection, free from chronic diseases were eligible for the study. In the statistical analysis of respiratory health of children multinomial logistic regression and zero-inflated Poisson regression models were used. Approximately one third of the children in the study sample experienced wheezing in the first 2 years of life and in about two third of cases (67%) the symptom developed already in the first year of life. The early wheezing was easily reversible and in about 70% of infants with wheezing the symptom receded in the second year of life. The adjusted relative risk ratio (RRR) of persistent wheezing increased with maternal atopy (RRR=3.05; 95%CI: 1.30-7.15), older siblings (RRR=3.05; 95%CI: 1.67-5.58) and prenatal ETS exposure (RRR=1.13; 95%CI: 1.04-1.23), but was inversely associated with the length of baby at birth (RRR=0.88; 95%CI: 0.76-1.01). The adjusted incidence risk ratios (IRR) of coughing, difficult breathing, runny/stuffy nose and pharyngitis/tonsillitis in wheezers were much higher than that observed among non-wheezers and significantly depended on prenatal PM(2.5) exposure, older siblings and maternal atopy. The study shows a clear inverse association between maternal age or maternal education and respiratory illnesses and calls for more research efforts aiming at the explanation of factors hidden behind proxy measures of quality of maternal care of babies. The data support the hypothesis that burden of respiratory symptoms in early childhood and possibly in later life may be programmed already in prenatal period when the respiratory system is completing its growth and maturation.
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Affiliation(s)
- Wieslaw Jedrychowski
- Epidemiology and Preventive Medicine, Coll. Med. Jagiellonian University in Krakow, Poland.
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46
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Tennant PWG, Gibson GJ, Parker L, Pearce MS. Childhood respiratory illness and lung function at ages 14 and 50 years: childhood respiratory illness and lung function. Chest 2009; 137:146-55. [PMID: 19581355 DOI: 10.1378/chest.09-0352] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Although childhood respiratory tract infections and low birth weight have both been associated with reduced adult lung function, little is known about the timing of these associations during life. We used data from the Newcastle Thousand Families Study to examine how these and other factors influenced FEV(1) at age 14 years and between 14 and 49 to 51 years. METHODS Detailed information was collected prospectively during childhood. At age 14 years, 252 members of the cohort were recruited into a case-control study of respiratory health, which included measurement of FEV(1). One hundred twenty-two of these were measured again at age 49 to 51 years. Linear regression models were used to examine cross-sectional and longitudinal influences on FEV(1). RESULTS Lower height (P < .001), lower BMI (P < .001), being breast fed for less than 4 weeks (P = .028), childhood history of severe respiratory illness (P = .014), childhood history of asthma (P = .004), childhood history of TB (P = .023), and birth into a lower social class (P = .049) were all significant independent predictors of lower FEV(1) at 14 years of age. Correspondingly, being a women (P < .001), and having a higher FEV(1) at age 14 years (P < .001), a lower standardized birth weight (P = .025), a greater lifetime number of cigarettes smoked (P = .007), and a childhood history of severe respiratory illness (P = .047) were all independently associated with a greater decline (or a smaller increase) in FEV(1) between age 14 and 49 to 51 years. CONCLUSIONS This study suggests that the change in FEV(1) between youth and middle age depends on several factors acting throughout life, including FEV(1) in adolescence, sex, cigarette smoking, birth weight, and childhood respiratory health.
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Affiliation(s)
- Peter W G Tennant
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, NE1 4LP, United Kingdom
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Klusmann M, Owens C. HRCT in paediatric diffuse interstitial lung disease--a review for 2009. Pediatr Radiol 2009; 39 Suppl 3:471-81. [PMID: 19440768 DOI: 10.1007/s00247-009-1200-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Maria Klusmann
- Radiology Department, Great Ormond Street Hospital for Children, Great Ormond Street, London, UK.
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Al Salmi I, Hoy WE, Kondalsamy-Chennakes S, Wang Z, Healy H, Shaw JE. Birth weight and stages of CKD: a case-control study in an Australian population. Am J Kidney Dis 2008; 52:1070-8. [PMID: 18640755 DOI: 10.1053/j.ajkd.2008.04.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2007] [Accepted: 04/23/2008] [Indexed: 02/08/2023]
Abstract
BACKGROUND In view of recent reports of the relationship of kidney disease to birth weight, we evaluate the relationship between birth weight and chronic kidney disease (CKD), including end-stage kidney disease, in Australian adults. STUDY DESIGN A case-control study. SETTING & PARTICIPANTS Patients attending the nephrology department at a major metropolitan hospital in Australia were asked to recall their birth weight, excluding those with structural kidney abnormalities. Two controls for each patient, matched for sex and within 5 years of age, were selected from participants from the Australian Diabetes, Obesity and Lifestyle (AusDiab) Study, who had also been asked to report their birth weight. PREDICTOR Birth weight in kilograms. OUTCOMES & MEASUREMENTS CKD and stages were defined using the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative classification, proteinuria as a marker of kidney damage, and glomerular filtration rate estimates, by using the Modification of Diet in Renal Disease Study equation. RESULTS Of 189 patients with CKD who reported their birth weights for whom controls were identified, 106 were men. Mean age was 60.3 +/- 15 (SD) years. Mean birth weight overall was 3.27 +/- 0.6 versus 3.46 +/- 0.6 kg for their controls (P < 0.001), and proportions with birth weights less than 2.5 kg were 12.2% and 4.4% (P < 0.001). In patients with CKD, 22.8%, 21.7%, 18%, and 37.6% were in CKD stages 2 (n = 43), 3 (n = 41), 4 (n = 34), and 5 (n = 71), respectively. Birth weights by CKD stage and their AusDiab controls were as follows: stage 2, 3.38 +/- 0.52 versus 3.49 +/- 0.52 kg; P = 0.2; stage 3, 3.28 +/- 0.54 versus 3.44 +/- 0.54 kg; P = 0.1; stage 4, 3.19 +/- 0.72 versus 3.43 +/- 0.56 kg; P = 0.1; and stage 5, 3.09 +/- 0.65 versus 3.47 +/- 0.67 kg; P < 0.001. Differences in birth weights applied to women and men and people younger than 60 and 60 years and older and were present in the major "causal" categories of renal disease. LIMITATIONS Birth weight is by self-recall with a significant nonresponse rate to the questionnaire in both cases and controls. CONCLUSIONS Urban Australian patients with CKD had lower birth weights than their matched Australian controls. In addition, the more advanced the CKD stage, the lower the birth weight. Thus, lower birth weights appear to predispose to CKD and to its progression. Among possible explanations is the documented association between birth weight and nephron number.
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Affiliation(s)
- Isa Al Salmi
- Centre for Chronic Disease, The University of Queensland, Brisbane, QLD, Australia.
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