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Risk of Asthma in Late Preterm Infants: A Propensity Score Approach
Gretchen A Voge1, Slavica K Katusic2, Rui Qin2
1Department of Pediatrics, Hennepin County Medical Center, Minneapolis, Minn.
Insights
Late preterm birth is not linked to childhood asthma. Propensity score matching revealed similar asthma risks between late preterm and full-term infants, indicating prior disparities were due to covariate imbalance.
Area of Science:
- Pediatric respiratory health
- Neonatal outcomes research
- Epidemiological studies
Background:
- The association between late preterm birth and childhood asthma risk is not well-established.
- Previous studies show inconsistent results due to covariate imbalance.
Purpose of the Study:
- To investigate the risk of asthma in former late preterm infants.
- Utilize a propensity score approach to control for confounding factors.
Main Methods:
- Population-based birth cohort study of children born in Rochester, Minn, 1976-1982.
- Asthma status assessed during the first 7 years of life.
- Propensity score matching used to compare late preterm (34-36 weeks) and term infants (37-40 weeks).
Main Results:
- Before matching, late preterm infants had a higher asthma risk (7.6% vs 4.8%).
- Propensity score matching showed similar asthma risks (6.6% vs 7.7%).
- Results were consistent with Cox regression models controlling for covariates.
Conclusions:
- Late preterm birth history is not an independent risk factor for childhood asthma.
- Observed asthma risk differences in prior studies are likely due to covariate imbalance.
Background:
The risk of asthma, specifically in former late preterm infants, has not been well defined. Covariate imbalance and lack of controlling for this has led to inconsistent results in prior studies.
Objective:
The objective of this study was to determine the risk of asthma in former late preterm infants using a propensity score approach.
Methods:
The study was a population-based birth cohort study. Study subjects were all children born in Rochester, Minn, between 1976 and 1982. Asthma status during the first 7 years of life was assessed by applying predetermined criteria. The propensity score was formulated using 15 covariates by fitting a logistic regression model for late preterm birth versus term birth. We applied the propensity score method to match late preterm infants (34 0/7 to 36 6/7 weeks of gestation) to term infants (37 0/7 to 40 6/7 weeks of gestation) within a caliper of 0.2 standard deviation of logit of propensity score.
Results:
Of the eligible 7040 infants, 5915 children had complete data. Before propensity score matching, late preterm infants had a higher risk of asthma (20 of 262, 7.6%) compared with full-term infants (272 of 5653, 4.8%) (P = .039). There was significant covariate imbalance between comparison groups. After matching with propensity scores, we found that former late preterm infants had a similar risk of asthma to the matched full-term infants (6.6% vs 7.7%, respectively, P = .61), and the result was consistent with covariate-adjustment Cox regression models controlling for significant covariates (P = .57).
Conclusion:
A late preterm birth history is not independently associated with childhood asthma, as the reported risk of asthma among former late preterm infants appears to be due to covariate imbalance.
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