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Vilcins D, Blake TL, Sly PD, Saffery R, Ponsonby AL, Burgner D, Tang MLK, Reid N. Effects of prenatal alcohol exposure on infant lung function, wheeze, and respiratory infections in Australian children. Alcohol Clin Exp Res (Hoboken) 2023; 47:2278-2287. [PMID: 38151787 DOI: 10.1111/acer.15205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 09/29/2023] [Accepted: 10/02/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Prenatal alcohol exposure (PAE) is a known risk factor for a range of adverse outcomes, such as facial dysmorphism, adverse birth outcomes, and neurodevelopmental changes. Preclinical research shows that PAE also inhibits lung development, lowers surfactant protein expression, has detrimental effects on alveolar macrophages, and decreases both T and B cell numbers. However, clinical evidence of respiratory impacts from PAE is limited. This study explored whether lung function, wheeze, and incidence of respiratory infections differ in children with PAE compared with unexposed children. METHODS Data from the Barwon Infant Study (n = 1074) were examined. PAE data were extracted from maternal questionnaires at trimesters 1 and 2 (combined), and trimester 3, and included as "total standard drinks" during each trimester and total pregnancy intake, a binary yes/no for PAE, and binge drinking (>5 standard drinks in one session). Respiratory outcomes were parent-reported wheeze, lung function (measured by multiple breath washout), and parent report and medical record indicators of health service attendances for respiratory conditions. Linear and logistic regressions were performed to quantify relationships between PAE and respiratory outcomes, controlling for socioeconomic status, birthweight, sex, gestational age, and maternal smoking. RESULTS Binge drinking was associated with increased health service attendance for respiratory condition(s) in the first 12 months of life (OR = 5.0, 95% CI (1.7, 20.7), p = 0.008). We did not find a relationship between binary PAE and binge drinking with lung function at 4 weeks of age or wheeze at 12 months. The number of standard drinks consumed in trimester two was associated with a lower lung clearance index (β = -0.011 turnovers, 95% CI (-0.0200, -0.0013), p = 0.03), and a small increase in functional residual capacity (β = 0.34 mL, 95% CI (0.02, 0.66), p = 0.04). CONCLUSIONS We found an association between binge drinking and health service utilization for respiratory conditions in infancy, but no evidence that low-level PAE was associated with adverse respiratory outcomes.
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Affiliation(s)
- Dwan Vilcins
- Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Tamara L Blake
- Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Peter D Sly
- Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute, Royal Children's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Anne-Louise Ponsonby
- The Florey Institute of Neuroscience and Mental Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - David Burgner
- Murdoch Children's Research Institute, Royal Children's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mimi L K Tang
- Murdoch Children's Research Institute, Royal Children's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Natasha Reid
- Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
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Vilcins D, Lee WR, Pham C, Tanner S, Knibbs LD, Burgner D, Blake TL, Mansell T, Ponsonby AL, Sly PD. Association of maternal air pollution exposure and infant lung function is modified by genetic propensity to oxidative stress. medRxiv 2023:2023.10.13.23296994. [PMID: 37873073 PMCID: PMC10592989 DOI: 10.1101/2023.10.13.23296994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Introduction The association between air pollution and poor respiratory health outcomes is well established, however less is known about the biological mechanisms, especially in early life. Children are particularly at risk from air pollution, especially during the prenatal period as their organs and systems are still undergoing crucial development. Therefore, our study aims to investigate if maternal exposure to air pollution during pregnancy is associated with oxidative stress (OS) and inflammation in pregnancy or infant lung function at 4 weeks of age, and the extent to which the association is modified by an infant's genetic risk of OS. Methods The Barwon Infant Study (BIS) is a longitudinal study of Australian children from the region of Geelong, Victoria. A total of 314 infants had available lung function and maternal OS markers. Exposure to annual air pollutants (NO 2 and PM 2.5 ) were estimated using validated, satellite-based, land-use regression models. Infant lung function was measured by multiple-breath washout, and the ratio of peak tidal expiratory flow over expiratory time was calculated at 4 weeks of age. An inflammation biomarker, glycoprotein acetyls (GlycA), was measured in maternal (36 weeks) and cord blood, and oxidative stress (OS) biomarkers, 8-hydroxyguanine (8-OHGua) and 8-hydroxy-2'-deoxyguanosine (8-OHdG) were measured in maternal urine at 28 weeks. A genetic pathway score for OS (gPFS ox ) was calculated for each infant participant in the BIS cohort, and high risk defined as score >8. Linear regression was used to explore the association of maternal air pollution exposure with infant lung function, and potential modification by OS genotype was tested through use of interaction terms and other methods. Results There was no evidence of a relationship between maternal exposure to air pollution and infant lung function in the whole population. We did not find an association between air pollution and GlycA or OS during pregnancy. We found evidence of an association between NO 2 and lower in functional residual capacity (FRC) for children with a high genetic risk of OS (β=-5.3 mls, 95% CI (-9.3, -1.3), p=0.01). We also found that when NO 2 was considered in tertiles, the highest tertile of NO 2 was associated with increase in lung clearance index (LCI) (β=0.46 turnovers, (95% CI 0.10, 0.82), p=0.01) in children with a genetic propensity to OS. Conclusion Our study found that high prenatal levels of exposure to ambient NO 2 levels is associated with lower FRC and higher LCI in infants with a genetic propensity to oxidative stress. There was no relationship between maternal exposure to air pollution with maternal and cord blood inflammation or OS biomarkers.
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Mahar RK, Carlin JB, Ranganathan S, Ponsonby AL, Vuillermin P, Vukcevic D. Bayesian modelling of lung function data from multiple-breath washout tests. Stat Med 2018; 37:2016-2033. [PMID: 29582453 DOI: 10.1002/sim.7650] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 10/30/2017] [Accepted: 02/09/2018] [Indexed: 11/10/2022]
Abstract
Paediatric respiratory researchers have widely adopted the multiple-breath washout (MBW) test because it allows assessment of lung function in unsedated infants and is well suited to longitudinal studies of lung development and disease. However, a substantial proportion of MBW tests in infants fail current acceptability criteria. We hypothesised that a model-based approach to analysing the data, in place of traditional simple empirical summaries, would enable more efficient use of these tests. We therefore developed a novel statistical model for infant MBW data and applied it to 1197 tests from 432 individuals from a large birth cohort study. We focus on Bayesian estimation of the lung clearance index, the most commonly used summary of lung function from MBW tests. Our results show that the model provides an excellent fit to the data and shed further light on statistical properties of the standard empirical approach. Furthermore, the modelling approach enables the lung clearance index to be estimated by using tests with different degrees of completeness, something not possible with the standard approach. Our model therefore allows previously unused data to be used rather than discarded, as well as routine use of shorter tests without significant loss of precision. Beyond our specific application, our work illustrates a number of important aspects of Bayesian modelling in practice, such as the importance of hierarchical specifications to account for repeated measurements and the value of model checking via posterior predictive distributions.
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Affiliation(s)
- Robert K Mahar
- Data Science, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Services, University of Melbourne, Parkville, Victoria, Australia
| | - John B Carlin
- Data Science, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Services, University of Melbourne, Parkville, Victoria, Australia.,Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Services, University of Melbourne, Parkville, Victoria, Australia
| | - Sarath Ranganathan
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Services, University of Melbourne, Parkville, Victoria, Australia.,Infection and Immunity, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Anne-Louise Ponsonby
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Services, University of Melbourne, Parkville, Victoria, Australia.,Population Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Peter Vuillermin
- Population Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,School of Medicine, Faculty of Health, Deakin University, Geelong, Victoria, Australia.,Department of Paediatrics, Barwon Health, Geelong, Victoria, Australia
| | - Damjan Vukcevic
- Data Science, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,School of Mathematics and Statistics, Faculty of Science, University of Melbourne, Parkville, Victoria, Australia
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Affiliation(s)
- Gwyneth Davies
- Respiratory Critical Care and Anaesthesia Section, Infection, Immunity and Inflammation Programme, UCL Great Ormond Street Institute of Child Health, London, UK
- Respiratory Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Paul Aurora
- Respiratory Critical Care and Anaesthesia Section, Infection, Immunity and Inflammation Programme, UCL Great Ormond Street Institute of Child Health, London, UK
- Respiratory Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Anagnostopoulou P, Egger B, Lurà M, Usemann J, Schmidt A, Gorlanova O, Korten I, Roos M, Frey U, Latzin P. Multiple breath washout analysis in infants: quality assessment and recommendations for improvement. Physiol Meas 2016; 37:L1-L15. [DOI: 10.1088/0967-3334/37/3/l1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Pittman JE. Assessment and Detection of Early Lung Disease in Cystic Fibrosis. Pediatric Allergy, Immunology, and Pulmonology 2015; 28:212-219. [DOI: 10.1089/ped.2015.0568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Jessica E. Pittman
- Division of Pediatric Allergy, Immunology, and Pulmonary Medicine, Washington University School of Medicine, Saint Louis, Missouri
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