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Assessing the Role of Asthma on the Relationship between Neurodevelopmental Disabilities and Adverse Birth Outcomes
Omobola Oluwafemi1, Sneha Manoharan2, Luyu Xie3
1Center for Pediatric Population Health, UTHealth Houston School of Public Health, Dallas, Texas; Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth Houston School of Public Health, Dallas, Texas; Department of Epidemiology, Human Genetics and Environmental Sciences, Southwest Center for Occupational and Environmental Health, UTHealth Houston School of Public Health, Houston, Texas.
Insights
Asthma does not modify the link between adverse birth outcomes and neurodevelopmental disabilities (NDDs). However, NDDs are more common in US children with adverse birth outcomes, especially among Black children.
Area of Science:
- Pediatric Health
- Neuroscience
- Public Health
Background:
- Understanding disparities in neurodevelopmental disabilities (NDDs) is critical for targeted interventions.
- Investigating asthma's role as an effect modifier in adverse birth outcomes and NDDs across racial groups is essential for addressing variable susceptibility.
Purpose of the Study:
- To examine if asthma modifies the association between adverse birth outcomes (preterm birth, low birth weight) and NDDs.
- To analyze racial differences in NDD prevalence among children with adverse birth outcomes.
Main Methods:
- Utilized data from the National Survey of Children's Health (131,774 children aged 0-17).
- Calculated prevalence and odds ratios for NDDs based on birth outcomes, stratified by asthma status.
- Assessed interactions between asthma, birth outcomes, and NDDs across different racial groups.
Main Results:
- Asthma did not significantly modify the relationship between adverse birth outcomes and NDDs.
- Children with adverse birth outcomes exhibited higher NDD prevalence.
- Non-Hispanic Black children with adverse birth outcomes showed higher NDD prevalence compared to Non-Hispanic White children.
Conclusions:
- Asthma is not an effect modifier for adverse birth outcomes and NDDs.
- Adverse birth outcomes are linked to increased NDD prevalence, particularly in Black children.
- Recommends NDD screening for children with adverse birth outcomes, especially ethnic minorities.
Background:
Investigating asthma as an effect modifier between adverse birth outcomes and neurodevelopmental disabilities (NDDs) across different races is crucial for tailored interventions and understanding variable susceptibility among diverse populations.
Methods:
Data were collected through the National Survey of Children's Health. This cross-sectional study included 131,774 children aged 0 to 17 years. Study exposures comprised adverse birth outcomes including preterm birth and low birth weight. Weighted prevalence estimates and odds ratios with 95% confidence intervals (CIs) among children with and without adverse birth outcomes were calculated for NDDs including attention-deficit/hyperactivity disorder, autism spectrum disorder, cerebral palsy, seizure, and several others including behavior problems. Adjusted odds ratios were stratified by asthma status and separate interactions were assessed for each outcome.
Results:
Of 131,774 participants, 10,227 were born low birth weight (9.12%; 95% CI: 8.77% to 9.49%), 14,058 were born preterm (11.35%; 95% CI: 10.94% to 11.76%), and 16,166 participants had asthma (11.97%; 95% CI: 11.58% to 12.37%). There were 68,100 males (51.11%), 63,674 females (48.89%), 102,061 non-Hispanic Whites (NHW) (66.92%), 8,672 non-Hispanic Blacks (NHB) (13.97%), and 21,041 participants (19.11%) categorized as other. NHB children with adverse birth outcomes had higher prevalence of several NDDs compared to NHW children.
Conclusions:
Asthma was not shown to be an effect modifier of the association between adverse birth outcomes and NDDs. Nevertheless, these results suggest that NDDs are more prevalent within US children with adverse birth outcomes, with higher rates among NHB compared to NHW children. These findings support screening for NDDs in pediatric health care settings among patients with adverse birth outcomes, particularly among those from ethnic minority backgrounds.
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