High incidence of respiratory disease in Australian infants despite low rate of maternal cigarette smoking

Gray, Lawrence; Ponsonby, Anne–Louise; Lin, Tiffany; O’Hely, Martin; Collier, Fiona; Ranganathan, Sarath; Sly, Peter D.; Pezic, Angela; Tang, Mimi L.K.; Burgner, David; Vuillermin, Peter

doi:10.1111/jpc.14436

Cited by 6 publications

(12 citation statements)

References 24 publications

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“…Prior studies have found that boys are at higher risk for developing wheezes than girls 41 . Our results also showed that the male sex is an associated factor of wheeze.…”

Section: Discussionsupporting

confidence: 81%

Prevalence and associated factors of wheeze in early infancy

Sugiura

Hiramitsu²,

Futamura

et al. 2021

Pediatrics International

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Background The aim of this study was to assess the prevalence of wheeze in early childhood and to characterize associated factors for wheeze that could identify potentially feasible interventions for the future prevention of wheeze. Methods We performed a cross‐sectional analysis of the data from the International Study of Asthma and Allergies in Childhood (ISAAC)‐modified self‐administered questionnaire of parents of 4‐month‐old infants at well‐child visits (mandatory health check‐ups) in Nagoya City, Japan, between April 2016 and March 2017 (development dataset) and between April 2017 and March 2018 (validation dataset). We used a multivariable, multilevel analysis to identify significant (P < 0.05), associated factors (Bonferroni correction was applied as necessary) after adjustment for local outbreaks of virus‐transmitted diseases, access to medical facilities, and socioeconomic status. Results Among the 20 362 questionnaires given to families of infants living in Nagoya City (development dataset), 19 104 questionnaires (93.8%) were analyzed after data cleaning. In all, 1,446 (7.6%) infants experienced wheeze at least once within 4 months of age, 991 (5.2%) visited the clinic/hospital with wheeze, and 244 (1.3%) underwent hospitalization at that time. In the multilevel, multivariable model for hospitalization with wheeze, significant associated factors were male sex (adjusted odds ratio 1.8; 95% confidence interval 1.4–2.3), maternal current smoking (3.3; 2.0–5.5), and having at least one sibling (3.0; 2.2–4.1). These factors were also associated with wheeze and clinic/hospital visit with wheeze, and the results were confirmed in the validation dataset. Conclusions Our study highlights that smoking cessation among mothers and improved hand hygiene at home are two interventions that could potentially decrease wheeze in early infancy.

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“…Prior studies have found that boys are at higher risk for developing wheezes than girls 41 . Our results also showed that the male sex is an associated factor of wheeze.…”

Section: Discussionsupporting

confidence: 81%

Prevalence and associated factors of wheeze in early infancy

Sugiura

Hiramitsu²,

Futamura

et al. 2021

Pediatrics International

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“…This may suggest that birth by caesarean section does not increase the incidence of infection but does increase the severity of infection, measured by hospitalisation. Very few infants in our cohort were exposed to tobacco smoke in the home, 13 and this homogeneity likely explains why we did not observe an association between passive smoke exposure and infection. We also did not find any evidence suggesting that the ALSPAC hygiene score, 14 measured at 12 months of life, was associated with incidence of infection.…”

Section: Discussionmentioning

confidence: 83%

“…We did not adjust for season as each child was followed for a complete year. We used inverse probability weighting to account for selection bias, as in previous studies of this cohort 8,13 . Regression models were reweighted to account for potential differential distribution of exposures between the inception cohort and non‐enrolled mothers.…”

Section: Methodsmentioning

confidence: 99%

Burden of infection in Australian infants

Rowland

Sass

Ponsonby

et al. 2020

J Paediatrics Child Health

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Aim To determine the incidence, risk factors and health service utilisation for infection in the first 12 months of life in a population‐derived Australian pre‐birth cohort. Methods The Barwon Infant Study is a population‐derived pre‐birth cohort with antenatal recruitment (n = 1074) based in Geelong, Victoria, Australia. Infection data were collected by parent report, and general practitioner and hospital records at 1, 3, 6, 9 and 12 months of age. We calculated the incidence of infection, attendance at a health service with infection and used multiple negative binomial regression to investigate the effects of a range of exposures on incidence of infection. Results In the first 12 months of life, infections of the upper and lower respiratory tract (henceforth ‘respiratory infections’), conjunctivitis and gastroenteritis occurred at a rate of 0.35, 0.04 and 0.04 episodes per child‐month, respectively. A total of 482 (72.4%) infants attended a general practitioner with an infection and 69 (10.4%) infants attended the emergency department. Maternal antibiotic exposure in pregnancy and having older siblings were associated with respiratory infection. Childcare attendance by 12 months of age was associated with respiratory infections and gastroenteritis. Breastfeeding, even if less than 4 weeks in total, was associated with reduced respiratory infection. Conclusion Infection, especially of the respiratory tract, is a common cause of morbidity in Australian infants. Several potentially modifiable risk factors were identified, particularly for respiratory infections. Most infections were managed by general practitioners and 1 in 10 infants attended an emergency department with infection in the first year of life.

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“…Children may suffer from asthma morbidities due to exposure to environmental tobacco smoke or parental prenatal/postnatal smoking [ 42 ]. Although the rate of maternal cigarette smoking during pregnancy has decreased in the last decade in Australia [ 4 ], the evidence of the influence of smoking during pregnancy on childhood asthma persists [ 45 ]. However, few studies have investigated the number of cigarettes smoked during pregnancy and its effects on respiratory and allergic morbidities in their children [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Are wheezing, asthma and eczema in children associated with mother’s health during pregnancy? Evidence from an Australian birth cohort

et al. 2021

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Background This study investigated the prevalence of wheezing, asthma, and eczema among Australian children using longitudinal data from birth to 15 years of age. This study also examined the association between maternal health status during pregnancy and their offspring’s respiratory and allergic morbidities using sex-segregated data. Methods This study used data from the Longitudinal Study of Australian Children (LSAC) where approximately 5000 children of a birth cohort across Australia were surveyed in 2004. These children were followed biennially in eight waves up to their age of 15 years until 2018. The status of the children’s wheezing, asthma, and eczema were reported by the mothers upon doctors’ diagnosis (for asthma) or self-assessment (for wheezing or eczema). Binomial logistic regression models were used to analyse associations between maternal health during pregnancy and their children’s health outcomes. Results Asthma prevalence among 0–1-year aged children was 11.7%, increased to 15.4% when the children were 10–11 years old, and then decreased to 13.6% when they were 14–15 years old. Wheezing and eczema were most prevalent when the children were 2–3 years old (26.0 and 17.8% respectively) and were least prevalent when the children were 14–15 years old (7.3 and 9.5% respectively). Maternal asthma, smoking during pregnancy, and pre-pregnancy obesity were significantly associated with an increased risk of wheezing and asthma in Australian children. Childhood eczema was associated only with maternal asthma. These associations were stronger among male children up to age 10–11 and during adolescence (12–15 years of age), female children were more prone to wheezing, asthma, and eczema. Conclusion This is a comprehensive longitudinal study of Australian children (0–15 years of age) to assess the prevalence (with sex-specific differences) of wheezing, asthma and eczema as well as the association between these respiratory and allergic morbidities and maternal health during pregnancy. The study findings suggest that careful medical and obstetric monitoring, improved specific age-sex wise risk factor prevention for children and health promotion for pregnant women would help protect child health.

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High incidence of respiratory disease in Australian infants despite low rate of maternal cigarette smoking

Cited by 6 publications

References 24 publications

Prevalence and associated factors of wheeze in early infancy

Prevalence and associated factors of wheeze in early infancy

Burden of infection in Australian infants

Are wheezing, asthma and eczema in children associated with mother’s health during pregnancy? Evidence from an Australian birth cohort

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