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1.
Pediatr Allergy Immunol ; 23(1): 40-9, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22017462

RESUMO

BACKGROUND: The CHRNA 3 and 5 genes on chromosome 15 encode the alpha subunits of the nicotinic acetylcholine receptor, mediating airway cholinergic activity. Polymorphisms are associated with cigarette smoking, chronic obstructive pulmonary disease, and lung cancer. AIMS: To determine possible associations between CHRNA 3/5 SNP rs8034191 and asthma or lung function in children in one local and one replicate multinational population, and assess if tobacco smoke modified the associations. MATERIALS AND METHODS: The rs8034191 SNP genotyped in 551 children from the environment and childhood asthma (ECA) birth cohort study in Oslo, Norway, and in 516 families from six European centers [the Genetics of Asthma International Network (GAIN) study] was tested for genotypic or allelic associations to current or history of asthma, allergic sensitization (≥ one positive skin prick tests), bronchial hyperresponsiveness (BHR), and lung function (FEV(1%) of predicted and FEV(1) /FVC ratio over/ below the 5th percentile). RESULTS: Although the TT and CT genotypes at SNP rs 8034191 were overall significantly associated with BHR (OR = 3.9, 95% CI 1.5-10.0, p = 0.005), stratified analyses according to exposure to maternal smoking in-utero or indoor smoking at 10 yrs of age showed significant association (OR = 4.4, 95% CI 1.5-12.6, p = 0.006 and OR 5.6, 95% CI 1.7-18.5, p = 0.004, respectively) only in the non-exposed and not in exposed children. The SNP-BHR association was replicated in the non-tobacco-smoke-exposed subjects in one of the GAIN centers (BHR associated with the T allele (p = 0.034)), but not in the collated GAIN populations. Asthma, allergic sensitization, and lung function were not associated with the rs8034191 alleles. CONCLUSION: An interaction between tobacco smoke exposure and a CHRNA3/5 polymorphism was found for BHR in children, but CHRNA3/5 was not associated with asthma or lung function.


Assuntos
Hiper-Reatividade Brônquica/genética , Proteínas do Tecido Nervoso/genética , Polimorfismo de Nucleotídeo Único/genética , Receptores Nicotínicos/genética , Fumar/genética , Adolescente , Adulto , Asma/etiologia , Asma/genética , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes de Função Respiratória , Capacidade Vital/genética , Adulto Jovem
3.
Am J Respir Crit Care Med ; 180(6): 491-8, 2009 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-19542478

RESUMO

RATIONALE: Daycare exposes young children to more infections early in life and may thereby prevent the development of asthma and allergy. OBJECTIVES: To prospectively study the effect of daycare on the development of asthma and allergic sensitization during the first 8 years of life. METHODS: In the Prevention and Incidence of Asthma and Mite Allergy birth cohort 3,963 newborn children were followed prospectively for 8 years. Daycare use and respiratory health were assessed yearly by questionnaires. At 8 years, sensitization to airborne allergens and airway responsiveness were measured. Daycare was defined as early (aged 0-2 yr), late (aged 2-4 yr), or none (no daycare before age 4 yr). Associations of daycare and/or older siblings with asthma symptoms (wheezing, shortness of breath, and inhaled steroids taken in the last year), airway responsiveness, and allergic sensitization were assessed in a longitudinal repeated-event analysis. MEASUREMENTS AND MAIN RESULTS: Children with early daycare had more wheezing in the first years of life, but less wheezing and steroid use between 4 and 8 years of age. At the age of 8 years, early daycare was not protective for asthma symptoms (adjusted odds ratio [aOR], 0.99; 95% confidence interval [CI], 0.74-1.32), allergic sensitization (aOR 0.86; 95% CI, 0.63-1.18), or airway hyperresponsiveness (aOR, 0.80; 95% CI, 0.57-1.14). The transient reduction in airway symptoms between age 4 and 8 years was only observed in children without older siblings. CONCLUSION: Early daycare is associated with an increase in airway symptoms until the age of 4 years, and fewer symptoms between the ages of 4 and 8 years. We found no protection against asthma symptoms, hyperresponsiveness, or allergic sensitization at the age of 8 years.


Assuntos
Antígenos de Dermatophagoides/imunologia , Asma/imunologia , Creches , Hipersensibilidade/imunologia , Administração por Inalação , Fatores Etários , Alérgenos/imunologia , Asma/epidemiologia , Asma/prevenção & controle , Hiper-Reatividade Brônquica/imunologia , Criança , Pré-Escolar , Exposição Ambiental , Feminino , Humanos , Hipersensibilidade/epidemiologia , Hipersensibilidade/prevenção & controle , Imunoglobulina E/sangue , Lactente , Recém-Nascido , Masculino , Países Baixos/epidemiologia , Estudos Prospectivos , Sons Respiratórios/imunologia , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/imunologia , Irmãos , Espirometria , Esteroides/administração & dosagem
4.
BMC Public Health ; 10: 184, 2010 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-20380692

RESUMO

BACKGROUND: There is ample evidence that childhood overweight is associated with increased risk of chronic disease in adulthood. The aim of this study was to investigate associations between childhood overweight and common childhood health problems. METHODS: Data were used from a general population sample of 3960 8-year-old children, participating in the Dutch PIAMA birth cohort study. Weight and height, measured by the investigators, were used to define BMI status (thinness, normal weight, moderate overweight, obesity). BMI status was studied cross-sectionally in relation to the following parental reported outcomes: a general health index, GP visits, school absenteeism due to illness, health-related functional limitations, doctor diagnosed respiratory infections and use of antibiotics. RESULTS: Obesity was significantly associated with a lower general health score, more GP visits, more school absenteeism and more health-related limitations, (adjusted odds ratios around 2.0 for most outcomes). Obesity was also significantly associated with bronchitis (adjusted odds ratio (aOR) and 95% confidence intervals (95%CI): 5.29 (2.58;10.85) and with the use of antibiotics (aOR (95%CI): 1.79 (1.09;2.93)). Associations with flu/serious cold, ear infection and throat infection were positive, but not statistically significant. Moderate overweight was not significantly associated with the health outcomes studied. CONCLUSION: Childhood obesity is not merely a risk factor for disease in adulthood, but obese children may experience more illness and health related problems already in childhood. The high prevalence of the outcomes studied implies a high burden of disease in terms of absolute numbers of sick children.


Assuntos
Indicadores Básicos de Saúde , Obesidade/epidemiologia , Avaliação de Resultados em Cuidados de Saúde , Peso ao Nascer , Criança , Estudos de Coortes , Comorbidade , Estudos Transversais , Feminino , Seguimentos , Inquéritos Epidemiológicos , Humanos , Masculino , Centros de Saúde Materno-Infantil/estatística & dados numéricos , Mães , Países Baixos/epidemiologia , Razão de Chances , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Fatores de Risco
5.
Lancet ; 372(9643): 1100-6, 2008 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-18805338

RESUMO

The long-term solution to the asthma epidemic is thought to be prevention, and not treatment of established disease. Atopic asthma arises from gene-environment interactions, which mainly take place during a short period in prenatal and postnatal development. These interactions are not completely understood, and hence primary prevention remains an elusive goal. We argue that primary-care physicians, paediatricians, and specialists lack knowledge of the role of atopy in early life in the development of persistent asthma in children. In this review, we discuss how early identification of children at high risk is feasible on the basis of available technology and important for potential benefits to the children. Identification of an asthmatic child's atopic status in early life has practical clinical and prognostic implications, and sets the basis for future preventative strategies.


Assuntos
Alérgenos/efeitos adversos , Asma/etiologia , Exposição Ambiental/efeitos adversos , Sons Respiratórios/etiologia , Infecções Respiratórias/complicações , Alérgenos/classificação , Asma/genética , Asma/prevenção & controle , Criança , Pré-Escolar , Humanos , Hipersensibilidade/complicações , Hipersensibilidade/diagnóstico , Fenótipo , Infecções Respiratórias/virologia
6.
Br J Nutr ; 101(1): 116-21, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18492299

RESUMO

The long-chain PUFA (LCPUFA) content of an infant's diet might affect early weight gain. In early trials on supplementation of formula feeding n-3 LCPUFA affected weight gain adversely. n-6 LCPUFA are thought to promote adipose tissue development and might be associated with higher weight gain. We studied the association between the natural n-3 and n-6 LCPUFA content of breast milk of Dutch women and weight and BMI gain of their breast-fed infants in the first year of life. The children in this study were enrolled in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study and were born in 1996-1997 in The Netherlands. Parents reported their child's weight and length in a questionnaire. Of a subgroup of the total population breast-milk samples were collected (n 244). The fatty acid composition of breast milk was determined by GLC and expressed as weight percentages. Linear regression was used for data analysis. Mean gain in weight, length and BMI per week from birth to 1 year of age was 119.5 (SD 16.1) g, 0.48 (SD 0.05) cm and 0.06 (SD 0.03) kg/m2, respectively. The associations between n-6 and n-3 LCPUFA in breast milk, and infant weight, length and BMI gain were weak and inconsistent. The n-3 and n-6 LCPUFA content in breast milk did not affect weight or BMI gain in the first year of life in breast-fed term infants.


Assuntos
Ácidos Graxos Insaturados/farmacologia , Fenômenos Fisiológicos da Nutrição do Lactente/fisiologia , Leite Humano/química , Aumento de Peso/efeitos dos fármacos , Antropometria/métodos , Peso ao Nascer , Índice de Massa Corporal , Estudos de Coortes , Ácidos Graxos Insaturados/análise , Feminino , Crescimento/efeitos dos fármacos , Crescimento/fisiologia , Humanos , Recém-Nascido , Masculino , Aumento de Peso/fisiologia
7.
Am J Respir Crit Care Med ; 178(2): 124-31, 2008 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-18403722

RESUMO

RATIONALE: Maternal diet during pregnancy has the potential to affect airway development and to promote T-helper-2-cell responses during fetal life. This might increase the risk of developing childhood asthma or allergy. OBJECTIVES: We investigated the influence of maternal food consumption during pregnancy on childhood asthma outcomes from 1 to 8 years of age. METHODS: A birth cohort study consisting of a baseline of 4,146 pregnant women (1,327 atopic and 2,819 nonatopic). These women were asked about their frequency of consumption of fruit, vegetables, fish, egg, milk, milk products, nuts, and nut products during the last month. Their children were followed until 8 years of age. Longitudinal analyses were conducted to assess associations between maternal diet during pregnancy and childhood asthma outcomes over 8 years. MEASUREMENTS AND MAIN RESULTS: Complete data were obtained for 2,832 children. There were no associations between maternal vegetable, fish, egg, milk or milk products, and nut consumption and longitudinal childhood outcomes. Daily consumption of nut products increased the risk of childhood wheeze (odds ratio [OR] daily versus rare consumption, 1.42; 95% confidence interval [95% CI], 1.06-1.89), dyspnea (OR, 1.58; 95% CI, 1.16-2.15), steroid use (OR, 1.62; 95% CI, 1.06-2.46), and asthma symptoms (OR, 1.47; 95% CI, 1.08-1.99). CONCLUSIONS: Results of this study indicate an increased risk of daily versus rare consumption of nut products during pregnancy on childhood asthma outcomes. These findings need to be replicated by other studies before dietary advice can be given to pregnant women.


Assuntos
Asma/epidemiologia , Dieta , Gravidez , Adulto , Asma/imunologia , Asma/prevenção & controle , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Hipersensibilidade Imediata/epidemiologia , Hipersensibilidade Imediata/imunologia , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Análise Multivariada , Países Baixos/epidemiologia , Nozes/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/imunologia , Efeitos Tardios da Exposição Pré-Natal/prevenção & controle , Fenômenos Fisiológicos da Nutrição Pré-Natal/imunologia , Prevalência
9.
Eur J Hum Genet ; 14(3): 307-16, 2006 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-16391567

RESUMO

Asthma is a complex disease and the intricate interplay between genetic and environmental factors underlies the overall phenotype of the disease. Families with at least two siblings with asthma were collected from Europe, Australia and the US. A genome scan using a set of 364 families with a panel of 396 microsatellite markers was conducted. Nonparametric linkage analyses were conducted for asthma and three asthma-related phenotypes: bronchial hyper-reactivity (BHR), strict definition of asthma and atopic asthma. Nine chromosomal regions with LOD scores greater than 1.5 were identified (chromosomes 1q, 2p, 3q, 4p, 4q, 6q, 12q, 20p and 21). Linkage refinement analysis was performed for three BHR loci by genotyping single nucleotide polymorphisms at an average marker density of 1 cM. The LOD scores increased to 3.07 at chromosome 4p and 4.58 at chromosome 2p, while the chromosome 6p locus did not refine. The LOD score at the chromosome 2p locus is highly significant on a genome-wide basis. The refined locus covers a region with a physical size of 12.2 Mb. Taken together, these results provide evidence for a major asthma susceptibility locus on chromosome 2p.


Assuntos
Asma/genética , Cromossomos Humanos Par 2 , Ligação Genética , Genoma , Adolescente , Adulto , Criança , Mapeamento Cromossômico , Saúde da Família , Feminino , Predisposição Genética para Doença , Humanos , Escore Lod , Masculino , Repetições de Microssatélites , Pessoa de Meia-Idade , Modelos Genéticos , Modelos Estatísticos , Fenótipo , Polimorfismo de Nucleotídeo Único , Controle de Qualidade
10.
Environ Health Perspect ; 114(9): 1414-8, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16966098

RESUMO

BACKGROUND: Otitis media is one of the most common infections in young children. Although exposure to environmental tobacco smoke is a known risk factor associated with otitis media, little information is available regarding the potential association with air pollution. OBJECTIVE: We set out to study the relationship between exposure to traffic-related air pollution and otitis media in two birth cohorts. METHODS: Individual estimates of outdoor concentrations of traffic-related air pollutants-nitrogen dioxide, fine particles [particulate matter with aerodynamic diameters

Assuntos
Poluentes Atmosféricos/toxicidade , Exposição por Inalação , Otite Média/etiologia , Emissões de Veículos/toxicidade , Poluentes Atmosféricos/análise , Pré-Escolar , Estudos de Coortes , Feminino , Alemanha , Humanos , Lactente , Masculino , Países Baixos , Dióxido de Nitrogênio/análise , Dióxido de Nitrogênio/toxicidade , Otite Média/epidemiologia , Tamanho da Partícula , Fatores de Risco , Emissões de Veículos/análise
12.
Respir Res ; 6: 117, 2005 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-16223446

RESUMO

OBJECTIVE: To study the prevalence of respiratory and atopic symptoms in (young) adults born prematurely, differences between those who did and did not develop Bronchopulmonary Disease (BPD) at neonatal age and differences in respiratory health between males and females. DESIGN: Prospective cohort study. SETTING: Nation wide follow-up study, The Netherlands. PARTICIPANTS: 690 adults (19 year old) born with a gestational age below 32 completed weeks and/or with a birth weight less than 1500 g. Controls were Dutch participants of the European Community Respiratory Health Survey (ECRHS). MAIN OUTCOME MEASURES: Presence of wheeze, shortness of breath, asthma, hay fever and eczema using the ECRHS-questionnaire RESULTS: The prevalence of doctor-diagnosed asthma was significantly higher in the ex-preterms than in the general population, whereas eczema and hay fever were significant lower. Women reported more symptoms than men. Preterm women vs controls: asthma 13% vs 5% (p < 0.001); hay fever 8% vs 20% (p < 0.001); eczema 10% vs 42% (p < 0.001). Preterm men vs controls: asthma 9% vs 4% (p = 0.007); hay fever 8% vs 17% (p = 0.005); eczema 9% vs 31% (p < 0.001) Preterm women reported more wheeze and shortness of breath during exercise (sob) than controls: wheeze 30% vs 22% (p = 0.009); sob 27% vs 16% (p < 0.001); 19-year-old women with BPD reported a higher prevalence of doctor diagnosed asthma compared to controls (24% vs 5% p < 0.001) and shortness of breath during exercise (43% vs 16% p = 0.008). The prevalence of reported symptoms by men with BPD were comparable with the controls. CONCLUSION: Our large follow-up study shows a higher prevalence of asthma, wheeze and shortness of breath in the prematurely born young adults. 19-year-old women reported more respiratory symptoms than men. Compared to the general population atopic diseases as hay fever and eczema were reported less often.


Assuntos
Nível de Saúde , Pneumopatias/epidemiologia , Nascimento Prematuro/epidemiologia , Medição de Risco/métodos , Adulto , Estudos de Coortes , Feminino , Seguimentos , Humanos , Recém-Nascido , Masculino , Países Baixos/epidemiologia , Prevalência , Estudos Prospectivos , Fatores de Risco , Fatores Sexuais
13.
Environ Health Perspect ; 110(11): A693-8, 2002 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-12417497

RESUMO

The Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study is a birth cohort study that investigates the influence of allergen exposure on the development of allergy and asthma in the first several years of life. The objectives of this study were to investigate the relationship between a family history of allergy and/or asthma and exposure of newborn children to mite and pet allergen and to study the influence of different home and occupant characteristics on mite allergen exposure. Dust was sampled from the child's mattress and the parental mattress at 3 months after birth of the index child and analyzed for mite and pet allergens. Subjects were divided in groups according to history of asthma and allergy in their parents, and allergen exposure was studied in the different groups. Cat allergen exposure was significantly lower on parental mattresses in families with allergic mothers, but dog allergen exposure was not different. Mite allergen exposure was lower on parental mattresses in families with allergic mothers. Use of mite allergen-impermeable mattress covers reduced mite allergen exposure. Some other characteristics such as age of home and mattress were also found to influence mite allergen exposure. Parental mattresses in homes of allergic mothers had lower cat and mite (but not dog) allergen loadings than mattresses in homes of nonallergic parents. Paternal (as opposed to maternal) allergy seemed to have little influence.


Assuntos
Poluição do Ar em Ambientes Fechados/efeitos adversos , Alérgenos/efeitos adversos , Asma/etiologia , Roupas de Cama, Mesa e Banho , Cães , Exposição Ambiental , Predisposição Genética para Doença , Hipersensibilidade/etiologia , Ácaros , Adulto , Animais , Asma/genética , Criança , Proteção da Criança , Pré-Escolar , Estudos de Coortes , Poeira , Saúde da Família , Feminino , Humanos , Hipersensibilidade/genética , Hipersensibilidade/imunologia , Lactente , Bem-Estar do Lactente , Masculino , Medição de Risco , Estações do Ano
15.
Pediatrics ; 123(4): 1095-101, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19336367

RESUMO

OBJECTIVE: Studies among patients have shown accelerated weight gain after (adeno)tonsillectomy. Whether (adeno)tonsillectomy is also a risk factor for the development of overweight is unknown. We investigated the association between (adeno)tonsillectomy and the subsequent development of overweight in the general population. METHODS: The study population consisted of 3963 children participating in the Dutch Prevention and Incidence of Asthma and Mite Allergy birth cohort. Data on weight and height, adenoidectomy and tonsillectomy, and covariates (gender, birth weight, maternal education, maternal overweight, maternal smoking during pregnancy, breastfeeding, and smoking in the home) were obtained from annual questionnaires completed by the parents. In addition to the questionnaire data, weight and height were measured by the investigators when the children were 8 years old. RESULTS: (Adeno)tonsillectomy between 0 and 7 years of age was significantly associated with overweight and obesity at age 8. Overweight at the age of 2 years was not associated with increased risk of (adeno)tonsillectomy in later years, indicating that the association between (adeno)tonsillectomy and overweight was not explained by preexisting overweight. Longitudinal data on weight and height in the years before and after surgery suggest that (adeno)tonsillectomy forms a turning point between a period of growth faltering and a period of catch-up growth, which might explain the increased risk to develop overweight after the operation. CONCLUSION: Children who undergo (adeno)tonsillectomy are at increased risk to develop overweight in the years after surgery.


Assuntos
Adenoidectomia , Sobrepeso/epidemiologia , Tonsilectomia , Aumento de Peso , Adenoidectomia/estatística & dados numéricos , Estatura , Índice de Massa Corporal , Peso Corporal , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Modelos Logísticos , Masculino , Período Pós-Operatório , Estudos Prospectivos , Fatores de Risco , Tonsilectomia/estatística & dados numéricos
16.
Obesity (Silver Spring) ; 16(11): 2498-503, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18756263

RESUMO

Breastfeeding has been associated with a reduced risk of overweight later in life. This study investigates whether differences in diet and lifestyle at 7 years of age between breastfed and formula-fed children can explain the difference in overweight prevalence at 8 years of age. We studied 2,043 Dutch children born in 1996-1997 who participated in the Prevention and Incidence of Asthma and Mite Allergy birth cohort study. Data on breastfeeding duration and diet and lifestyle factors at 7 years were collected using questionnaires. Weight and height were measured at 8 years. Overweight was defined according to international gender- and age-specific standards. Compared to nonbreastfed children (15.5%, n = 316), children breastfed for >16 weeks (38.0%, n = 776) consumed fruit and vegetables significantly more often and meat, white bread, carbonated soft drinks, chocolate bars, and fried snacks less often. Overall, breastfed children were less likely to have an unhealthy diet (adjusted prevalence ratio: 0.77, 95% confidence interval: 0.61-0.98). The associations could only partly be explained by maternal education, maternal overweight, and smoking during pregnancy. At 8 years, 14.5% (n = 297) of the children were overweight. Breastfeeding for >16 weeks was significantly associated with a lower overweight risk at 8 years (adjusted odds ratio: 0.67, 95% confidence interval: 0.47-0.97), and the association hardly changed after adjustment for diet (adjusted odds ratio: 0.71, 95% confidence interval: 0.49-1.03). Breastfed children had a healthier diet at 7 years compared to nonbreastfed children, but this difference could not explain the lower overweight risk at 8 years in breastfed children.


Assuntos
Aleitamento Materno , Dieta , Estilo de Vida , Sobrepeso/epidemiologia , Sobrepeso/prevenção & controle , Criança , Desenvolvimento Infantil/fisiologia , Estudos de Coortes , Escolaridade , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Bem-Estar Materno , Sobrepeso/fisiopatologia , Estudos Prospectivos , Fatores de Risco
17.
Respir Med ; 102(10): 1446-51, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18590955

RESUMO

OBJECTIVE: In young children with asthmatic symptoms diagnostic difficulties lead to use of trials of asthma medication as a diagnostic tool. Our aim is to quantify the persistent use of asthma medication, initiated in the first year of life and identify determinants of this persistent use. PATIENTS AND METHODS: We identified 165 children within the PIAMA (Prevention and Incidence of Asthma and Mite Allergy) birth cohort who used asthma medication before the age of one. Persistent use was investigated during three years after the first prescription. A Cox regression analysis was performed to identify factors associated with persistent use. RESULTS: A total of 58.8% of children continued using asthma medication after the first prescription and 10.3% continued during three years. Children with doctor-diagnosed asthma (Hazard ratio of discontinuation (HR)=0.64, 95% CI: 0.45-0.91) or prescribed inhaled corticosteroids in the first year of life (HR of discontinuation=0.59, 95% CI: 0.40-0.86) were 1.6-1.7 times more likely to continue using asthma medication. CONCLUSIONS: Persistence of asthma medication, prescribed in the first year of life is very low and is positively associated with doctor-diagnosed asthma and use of inhaled corticosteroids. Characterizing persistent users of asthma medication is important to understand prescribing of asthma medication in this age group.


Assuntos
Glucocorticoides/uso terapêutico , Administração por Inalação , Antiasmáticos/uso terapêutico , Asma/tratamento farmacológico , Pré-Escolar , Esquema de Medicação , Escolaridade , Saúde da Família , Feminino , Seguimentos , Humanos , Lactente , Masculino , Pais , Modelos de Riscos Proporcionais , Fatores de Tempo
18.
Am J Respir Crit Care Med ; 175(10): 1078-85, 2007 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-17290040

RESUMO

RATIONALE: The relation between birth weight and respiratory symptoms and asthma in children remains unclear. Previous studies focused on a relation at separate ages. A longitudinal analysis may lead to a better understanding. OBJECTIVES: To estimate the effect of birth weight on the development and course of respiratory symptoms and asthma in the first 7 years of life. METHODS: In a prospective birth cohort study, 3,628 children with a gestational age 37 weeks or more were monitored for 7 years. Parental questionnaires were used to assess respiratory health yearly. Associations of birth weight with respiratory symptoms (wheezing, coughing, respiratory infections) and doctor's diagnosis of asthma were assessed in a repeated-event analysis. MEASUREMENTS AND MAIN RESULTS: Lower birth weight was associated with more respiratory symptoms (odds ratio [OR] per kg decrease in birth weight, 1.21; 95% confidence interval [CI], 1.09-1.34). The effect of birth weight increased from age 1 to 5, but decreased thereafter and was no longer significant at the age of 7. The effect of birth weight on respiratory symptoms was significantly greater among children exposed to tobacco smoke in their home than among nonexposed children (OR at 5 yr: 1.21 [95% CI, 1.02-1.44] and 1.52 [95% CI, 1.23-1.87], respectively). Birth weight and a doctor's diagnosis of asthma were not related (OR, 1.06; 95% CI, 0.82-1.37). CONCLUSIONS: A lower birth weight in children born at term is associated with a transiently increased risk of respiratory symptoms. This effect is enhanced by environmental tobacco smoke exposure.


Assuntos
Asma/epidemiologia , Peso ao Nascer , Recém-Nascido de Baixo Peso , Transtornos Respiratórios/epidemiologia , Poluição por Fumaça de Tabaco , Asma/diagnóstico , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Hipersensibilidade/diagnóstico , Técnicas In Vitro , Incidência , Lactente , Recém-Nascido , Gravidez , Transtornos Respiratórios/diagnóstico , Fatores Sexuais
19.
Am J Epidemiol ; 165(8): 919-26, 2007 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-17277294

RESUMO

Compared with nonbreastfed children, breastfed children tend to have a lower body mass index (BMI) at about 1 year of age. How the BMI of breastfed children develops after the first year when this difference in BMI at 1 year of age is considered is not clear. The authors studied the association between breastfeeding and BMI development from 1 to 7 years of age independently of BMI at 1 year of age. Longitudinal BMI data reported by parents of 2,347 Dutch children born in 1996-1997 who participated in the Prevention and Incidence of Asthma and Mite Allergy birth cohort study were collected. Linear regression and mixed-effects models were used for data analyses. Mean BMI at 1 year of age was 17.2 kg/m(2) (standard deviation, 1.4). Compared with nonbreastfed children, children breastfed for >16 weeks had a lower BMI at 1 year of age, after adjustment for confounders (beta = -0.22, 95% confidence interval: -0.39, -0.06). The association between breastfeeding and BMI between 1 and 7 years of age was negligible, while a high BMI at 1 year of age was strongly associated with a high BMI between 1 and 7 years of age in the same model. These findings suggest that the lower BMI and lower risk of overweight among breastfed children later in life are already achieved at 1 year of age.


Assuntos
Índice de Massa Corporal , Aleitamento Materno , Desenvolvimento Infantil/fisiologia , Aumento de Peso/fisiologia , Estatura/fisiologia , Peso Corporal/fisiologia , Criança , Pré-Escolar , Humanos , Lactente , Estudos Longitudinais
20.
Eur J Public Health ; 17(4): 369-74, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17124194

RESUMO

BACKGROUND: In adults, body weight tends to be underestimated when based on self-reported data. Whether this discrepancy between measured and reported data exists in healthy young children is unclear. We studied whether parental reported body weight and height of 4-year-old children corresponded with measured body weight and height. In addition, we studied the determinants and the consequences of differences between reported and measured data. METHODS: Data on body weight and height of 864 4-year-old Dutch children born in 1996/1997 enrolled in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study were collected via a questionnaire and a medical examination. Overweight was defined according to standard international age and gender specific definitions. RESULTS: Mean differences between measured and reported body weight, height, and body mass index (BMI) were small. Parents of children with a low BMI tended to over report body weight while parents of children with a high BMI tended to underreport body weight. Whereas 9.5% of the children were overweight according to reported BMI, the prevalence of overweight was 13.4% based on measured BMI. Over 45% of the overweight children according to measured BMI were missed when reported BMI was used. CONCLUSION: These findings suggest that overweight prevalence rates in children are underestimated when based on reported weight and height.


Assuntos
Antropometria , Peso Corporal , Obesidade/epidemiologia , Pré-Escolar , Feminino , Humanos , Masculino , Países Baixos/epidemiologia , Pais , Inquéritos e Questionários
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