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What accounts for the association between late preterm births and risk of asthma?
Insights
Late preterm (LPT) infants do not have an increased risk of asthma. Maternal smoking during pregnancy is a significant risk factor for childhood asthma development.
Area of Science:
- Pediatric Pulmonology
- Neonatal Health
- Epidemiology
Background:
- Previous studies suggested an increased asthma risk in late preterm (LPT) infants.
- Many studies did not adequately address covariate imbalance, potentially biasing results.
Purpose of the Study:
- To compare asthma incidence in LPT infants versus matched term infants.
- To account for covariate imbalance in assessing LPT birth and asthma risk.
Main Methods:
- Population-based cohort study of LPT and term infants (born 2002-2006).
- Follow-up through 2010 with asthma status determined by predefined criteria.
- Kaplan-Meier and Cox models used to analyze cumulative incidence and adjust for confounders.
Main Results:
- LPT infants showed a higher unadjusted asthma frequency (29.9%) than term infants (19.5%).
- After adjusting for covariates, LPT birth was not associated with increased asthma risk.
- Maternal smoking during pregnancy was identified as a significant risk factor for asthma.
Conclusions:
- Late preterm birth is not an independent risk factor for asthma.
- Reducing maternal smoking during pregnancy is crucial for mitigating asthma risk in children.
Background:
Although results of many studies have indicated an increased risk of asthma in former late preterm (LPT) infants, most of these studies did not fully address covariate imbalance.
Objective:
To compare the cumulative frequency of asthma in a population-based cohort of former LPT infants to that of matched term infants in their early childhood, when accounting for covariate imbalance.
Methods:
From a population-based birth cohort of children born 2002-2006 in Olmsted County, Minnesota, we assessed a random sample of LPT (34 to 36 6/7 weeks) and frequency-matched term (37 to 40 6/7 weeks) infants. The subjects were followed-up through 2010 or censored based on the last date of contact, with the asthma status based on predetermined criteria. The Kaplan-Meier method was used to estimate the cumulative incidence of asthma during the study period. Cox models were used to estimate the hazard ratio and 95% confidence interval for the risk of asthma, when adjusting for potential confounders.
Results:
LPT infants (n = 282) had a higher cumulative frequency of asthma than did term infants (n = 297), 29.9 versus 19.5%, respectively; p = 0.01. After adjusting for covariates associated with the risk of asthma, an LPT birth was not associated with a risk of asthma, whereas maternal smoking during pregnancy was associated with a risk of asthma.
Conclusion:
LPT birth was not independently associated with a risk of asthma and other atopic conditions. Clinicians should make an effort to reduce exposure to smoking during pregnancy as a modifiable risk factor for asthma.
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