Asthma in Children in Relation to Pre-term Birth and Fetal Growth Restriction

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• 作者：Gibby Koshy (1)
  Kafya A. S. Akrouf (2)
  Yvonne Kelly (3)
  Ali Delpisheh (4)
  Bernard J. Brabin (1) (5) (6)
  
• 关键词：Asthma ; Pre ; term birth ; Small for gestational age ; Maternal asthma ; Smoking ; Children
• 刊名：Maternal and Child Health Journal
• 出版年：2013
• 出版时间：August 2013
• 年：2013
• 卷：17
• 期：6
• 页码：1119-1129
• 全文大小：311KB
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• 作者单位：Gibby Koshy (1)
  Kafya A. S. Akrouf (2)
  Yvonne Kelly (3)
  Ali Delpisheh (4)
  Bernard J. Brabin (1) (5) (6)
  
  1. Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK
  2. Department of Infection Control, Amiri Hospital, Kuwait City, Kuwait
  3. Institute for Social and Economic Research, University of Essex, Colchester, Essex, UK
  4. Department of Epidemiology, Ilam University of Medical Sciences, Ilam, Iran
  5. Department of Community Child Health, Royal Liverpool Children’s Hospital, Alder Hey, NHS Trust, Liverpool, UK
  6. Global Child Health Group, Emma Kinderziekenhuis, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
  

文摘

To assess the impact of parental asthma on risk of pre-term birth (PTB) and intrauterine growth restriction, and their subsequent association with childhood asthma. Three sequential cross-sectional surveys were conducted in 1993 (3,746), 1998 (1,964) and 2006 (1,074) in the same 15 schools among 5-1?year old children in Merseyside using the same respiratory health questionnaire completed by parents (sample size in brackets). Between 1993 and 2006, prevalence of PTB varied between 12.4 and 15.2?%, and of small for gestational age (SGA or growth restricted) babies between 2.1 and 4.6?%, and maternal asthma prevalence between 8.1 and 13.4?%. For the combined surveys mothers with asthma were more likely to have a PTB than non-asthmatic mothers (OR 1.39, 95?% CI 1.10-.95, p?<?0.001), and in the 2006 survey were more likely to have an SGA baby. 40.9?% of PTBs of asthmatic mothers developed doctor diagnosed asthma compared to 34.3?% for term babies (adjusted OR 1.65, 1.34-.04, p?<?0.001). The corresponding estimates for the symptom triad of cough, wheeze and breathlessness were 19.4 and 17.6?% (adjusted OR 1.78, 0.79-.98). Conversely SGA babies were less likely to develop doctor diagnosed asthma (adjusted OR 0.49, 0.27-.90, p?<?0.021), or the symptom triad of cough, wheeze and breathlessness (adjusted OR 0.22, 0.05-.97, p?<?0.043), whether or not the mother was asthmatic. Maternal asthma is an independent risk factor for PTB which predisposes to childhood asthma. Intrauterine growth restriction was protective against childhood asthma.