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Lower respiratory tract infections in an ethnic and social context
A Hjern1, B Haglund, S Bremberg
1Department of Clinical Sciences, Huddinge University Hospital, Karolinska Institutet, Sweden. anders.hjern@sos.se
Insights
Maternal smoking during pregnancy and larger family size increase lower respiratory tract infection (LRI) risk in young children. Ethnicity and social factors mediate these risks, impacting hospital admissions for LRI in Sweden.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Social and ethnic variations influence childhood lower respiratory tract infection (LRI) rates.
- Family size and maternal smoking during pregnancy are potential mediating factors for these variations.
Purpose of the Study:
- To investigate the role of family size and maternal smoking during pregnancy as mediators of social and ethnic disparities in LRI hospitalizations.
- To analyze the risk of LRI in children aged 0-4 years in relation to these factors.
Main Methods:
- Retrospective analysis of hospital discharge data for children aged 0-4 years in Sweden (1990-1994).
- Statistical analysis using adjusted odds ratios (OR) to assess the risk associated with maternal smoking and number of siblings.
Main Results:
- Maternal smoking during pregnancy increased LRI hospitalization risk (OR 1.3 for 0-1 year olds).
- Having at least one sibling also increased LRI risk (OR 2.2 for 0-1 year olds).
- The risk associated with siblings was lower in children of mothers born in specific non-European regions, suggesting an ethnic context.
Conclusions:
- Family size and maternal smoking during pregnancy are significant mediators of LRI risk linked to social adversity and ethnicity in young Swedish children.
- These factors are crucial for understanding and potentially mitigating ethnic and social disparities in childhood respiratory infections.
Abstract:
Family size and smoking during pregnancy were studied as mediating factors for social and ethnic variation of lower respiratory tract infection (LRI) in hospital discharge data. The study population consisted of all children aged 0-4 years in the three largest metropolitan areas of Sweden during 1990-94. Maternal smoking during pregnancy increased the risk of children being admitted to hospital for LRI during their first 3 years of life, with an adjusted odds ratio (OR) of 1.3 for the age-group 0-1 years. The risk attributed to smoking during pregnancy was the same in children of mothers in ethnic groups in which smoking during pregnancy was related to social adversity as in those in which it was not. Having at least one sibling increased the risk of being admitted to hospital for LRI in the age group 0-1 years (adjusted OR 2.2). This risk was lower in children in families in which the mother was born in southern Europe, Africa, Asia or Latin America, suggesting a contextual relation to ethnicity for this risk factor. It is concluded that family size and smoking during pregnancy are important mediators of the risk for LRI related to social adversity and ethnicity in Swedish children below 2 years of age.