| 1. |
- Alm, Bernt, 1951, et al.
(författare)
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Antibiotics in the first week of life is a risk factor for allergic rhinitis at school age.
- 2014
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Ingår i: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. - : Wiley. - 1399-3038. ; 25:5, s. 468-472
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Tidskriftsartikel (refereegranskat)abstract
- Heredity as well as external factors influences the development of allergic rhinitis. The aim of this study was to analyse early risk factors and protective factors for allergic rhinitis at school age.
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| 2. |
- Alm, Bernt, 1951, et al.
(författare)
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Early introduction of fish decreases the risk of eczema in infants.
- 2009
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Ingår i: Archives of disease in childhood. - : BMJ. - 1468-2044 .- 0003-9888. ; 94:1, s. 11-5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Atopic eczema in infants has increased in western societies. Environmental factors and the introduction of food may affect the risk of eczema. AIMS: To investigate the prevalence of eczema among infants in western Sweden, describe patterns of food introduction and assess risk factors for eczema at 1 year of age. METHODS: Data were obtained from a prospective, longitudinal cohort study of infants born in western Sweden in 2003; 8176 families were randomly selected and, 6 months after the infant's birth, were invited to participate and received questionnaires. A second questionnaire was sent out when the infants were 12 months old. Both questionnaires were completed and medical birth register data were obtained for 4921 infants (60.2% of the selected population). RESULTS: At 1 year of age, 20.9% of the infants had previous or current eczema. Median age at onset was 4 months. In multivariable analysis, familial occurrence of eczema, especially in siblings (OR 1.87; 95% confidence interval (CI) 1.50 to 2.33) or the mother (OR 1.54; 95% CI 1.30 to 1.84), remained an independent risk factor. Introducing fish before 9 months of age (OR 0.76; 95% CI 0.62 to 0.94) and having a bird in the home (OR 0.35; 95% CI 0.17 to 0.75) were beneficial. CONCLUSIONS: One in five infants suffer from eczema during the first year of life. Familial eczema increased the risk, while early fish introduction and bird keeping decreased it. Breast feeding and time of milk and egg introduction did not affect the risk.
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| 3. |
- Alm, Bernt, 1951, et al.
(författare)
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Early protective and risk factors for allergic rhinitis at age 4½ yr.
- 2011
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Ingår i: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. - : Wiley. - 1399-3038 .- 0905-6157. ; 22:4, s. 398-404
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Tidskriftsartikel (refereegranskat)abstract
- Allergic heredity plays a major role in the development of allergic rhinitis. In addition the introduction of food may influence the risk of subsequent allergic disease. The aim of this study was to analyse early risk factors and protective factors for allergic rhinitis at preschool age. Data were obtained from a prospective, longitudinal study of a cohort of children born in the region of western Sweden in 2003 and 8,176 families (50% of the birth cohort) were randomly selected. The parents answered questionnaires at 6 and 12 months and at 4½ yr of age. The response rate at 4½ yr was 4,496, i.e. 83% of the 5,398 questionnaires distributed at 4½ yr. At 4½ yr of age, 5.5% reported symptoms of allergic rhinitis during the last year. In the multivariate analysis, independent risk factors for allergic rhinitis were: allergic sensitisation to food allergens at 4½ yr (OR 10.21; 95% confidence interval 4.22-24.73), recurrent wheeze at 4½ yr (3.33; 1.56-7.10), doctor-diagnosed eczema at 4½ yr (2.72; 1.62-4.55), parental rhinitis (2.21; 1.39-3.53), eczema first year (1.97; 1.19-3.26) and male gender (1.82; 1.13-2.94). The risk was reduced with fish introduction before 9 months (0.49; 0.29-0.82). In conclusion, we found that previous and present allergic disease, heredity and male gender increased the risk of allergic rhinitis at 4½ yr of age. The introduction of fish before the age of 9 months reduced the risk.
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| 4. |
- Alm, Bernt, 1951, et al.
(författare)
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Föräldrar har tagit till sig råden för att förebygga plötslig spädbarnsdöd : [Parents have accepted the advice on how to prevent sudden infant death]
- 2004
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Ingår i: Läkartidningen. - 0023-7205. ; 101:14, s. 1268-1270
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Tidskriftsartikel (refereegranskat)abstract
- We have compared 430 healthy Swedish infants born between 1991 and 1995 with 599 healthy, six months old infants born in 2002, regarding the prevalence of risk factors for SIDS. Following the introduction of the campaign to reduce the risk of SIDS in Sweden in 1992, we could see a decrease in prone sleeping from 32% to 7% together with an increase in supine sleeping from 35% to 44%. Maternal smoking during pregnancy has gone down from 24% to 10%. The prevalence of breast feeding, already high in Sweden in the 90s, was largely unchanged, 69% at six months of age in 2002. This comparison shows that parents of small infants have accepted the advice on ways to reduce the risk of SIDS, and that information given at infant welfare clinics is still effective ten years later. Further improvements are possible by changing the side sleeping position to supine, and by decreasing tobacco smoking among pregnant mothers.
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| 5. |
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| 6. |
- Alm, Bernt, 1951, et al.
(författare)
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Neonatal antibiotic treatment is a risk factor for early wheezing.
- 2008
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Ingår i: Pediatrics. - : American Academy of Pediatrics (AAP). - 1098-4275 .- 0031-4005. ; 121:4, s. 697-702
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The use of antibiotics in infancy and subsequent changes in the intestinal bacterial flora have been discussed as risk factors for the development of asthma. However, it has been difficult to exclude the possibility that antibiotics have been given in early episodes of wheezing. As a result, there has been a risk of reverse causation. To minimize the risk of reverse causation, we have focused on the effect of antibiotics that are already administered on the neonatal ward. METHODS: In a cohort study of infants born in western Sweden in 2003, we studied the development of wheezing. The families of the infants were randomly selected and sent a questionnaire at child ages 6 and 12 months. The response rate was 68.5% to the 6-month questionnaire and 68.9% to the 12-month questionnaire. RESULTS: At 12 months, 20.2% of infants had had 1 or more episodes of wheezing, and 5.3% had had 3 or more episodes. Inhaled corticosteroids had been taken by 4.1% of the infants. Independent risk factors for wheezing disorder treated with inhaled corticosteroids were neonatal antibiotic treatment, male gender, gestational age of <37 weeks, having a mother with asthma, having a sibling with asthma or eczema, and breastfeeding for <5 months. CONCLUSIONS: Treatment with antibiotics in the neonatal period was an independent risk factor for wheezing that was treated with inhaled corticosteroids at 12 months of age. These results indirectly support the hypothesis that an alteration in the intestinal flora can increase the risk of subsequent wheezing.
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| 7. |
- Alm, Bernt, 1951, et al.
(författare)
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PD12 - Living on a farm protects from allergic rhinitis at school age.
- 2014
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Ingår i: Clinical and translational allergy. - 2045-7022. ; 4:Suppl 1 3rd Pediatric Allergy and Asthma Meeting
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Tidskriftsartikel (refereegranskat)abstract
- Background Family history plays a major role in the development of allergic rhinitis. External influences, such as a farm childhood and fish introduction have been suggested to play a protective role. The aim was to analyse early risk factors and protective factors for allergic rhinitis at school age. Methods The material is a prospective, longitudinal study of a cohort of children born in the region of western Sweden in 2003 where 8,176 families (50% of the birth cohort) were randomly selected. The parents answered questionnaires at 6 months, 12 months, 4½ years and 8 years of age. The response rate at eight years was 80% (4,051 of 5,044 questionnaires distributed). Results At eight years of age, 441 children (11.3%) had used medicines for allergic rhinitis the past twelve months. The mean onset age was 5.1 year and 61.9% were boys. In a multivariate analysis of factors associated with allergic rhinitis with p<0.1, we found that living on a farm at 4½ years was inversely associated with allergic rhinitis treated with medicines at 8 years (adjusted odds ratio 0.31, 95% confidence interval (0.13, 0.78)). Positive associations were seen with parental allergic rhinitis (2.73 (2.12, 3.52)), food allergy first year (2.45 (1.61, 3.73)), eczema first year (1.97 (1.50, 2.59)), neonatal antibiotics (1.75 (1.03, 2.97)) and male gender (1.35 (1.05, 1.74)). Conclusion In conclusion, we found that a family history of rhinitis, early food allergy, early eczema and male gender increased the risk of rhinitis at school age. Furthermore, we found a protective effect of living on a farm at preschool age, and that antibiotics neonatally increased the risk. Both findings are compatible with the hygiene hypothesis.
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| 8. |
- Alm, Bernt, 1951, et al.
(författare)
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SIDS risk factors and factors associated with prone sleeping in Sweden
- 2006
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Ingår i: Archives of Disease in Childhood. - : BMJ. - 0003-9888 .- 1468-2044. ; 91:11, s. 915-9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the current prevalence of risk factors for sudden infant death syndrome (SIDS) in Sweden with a decade earlier, and assess factors associated with prone sleeping. METHODS: The results of a cohort study (Infants of Western Sweden) and a population based case-control study (Nordic Epidemiological SIDS Study) were examined. Subjects were 5600 healthy 6 month old infants born in 2003 in the Western Sweden region and 430 healthy Swedish infants born between 1991 and 1995. RESULTS: Prone sleeping decreased from 31.8% to 5.6% and supine sleeping increased from 35.3% to 47.3%. Side or side/supine sleeping increased from 25.2% to 43.8%. Maternal smoking during pregnancy decreased from 23.5% to 9.5%. The risk for prone sleeping increased if the mother was unemployed (OR 2.4, 95% CI 1.5 to 4.0), if she was a heavy smoker in the third trimester (OR 44.1, 95% CI 1.6 to 1199.6), and if the child was irritable (OR 2.5, 95% CI 1.3 to 5.1), shared a bedroom with siblings (OR 2.6, 95% CI 1.0 to 6.6), or never used a dummy (OR 3.2, 95% CI 1.9 to 5.4). CONCLUSIONS: Parents have complied with advice to prevent SIDS given at infant welfare centres for the last 10 years. A change in the preferred sleeping position from side variants to exclusively supine, and reducing the number of pregnant women smoking may be beneficial. Use of a prone sleeping position was associated with maternal employment status, maternal smoking, temperament of the child, dummy use, and sharing a bedroom with siblings.
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| 9. |
- Goksör, Emma, 1974, et al.
(författare)
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Early fish introduction and neonatal antibiotics affect the risk of asthma into school age.
- 2013
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Ingår i: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. - : Wiley. - 1399-3038. ; 24:4, s. 339-344
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The early introduction of fish has been reported to reduce the risk of wheezing disorder in early childhood, while broad-spectrum antibiotics in the first week have been associated with an increased risk. However, it is uncertain whether the effects remain into school age. The aim was to explore these risk factors for doctor-diagnosed asthma at 8years. METHODS: Data were obtained from a prospective, longitudinal study of a cohort of children born in western Sweden. The parents answered questionnaires at 6months and 1, 4.5 and 8years of age. The response rate at 8years was 80% of the questionnaires distributed (4051/5044), that is, 71% of the families entering the study (4051/5654). RESULTS: At 8years, 5.7% reported current doctor-diagnosed asthma. Of these, 65% had atopic asthma and 35% non-atopic asthma. In the multivariate analysis, atopic heredity, male gender and own allergic disease during infancy were risk factors for doctor-diagnosed asthma at 8years. In addition, the introduction of fish before the age of 9months independently reduced the risk (adjusted OR 0.6; 95% CI 0.4-0.96), while broad-spectrum antibiotics in the first week independently increased the risk of current asthma at school age (aOR 2.3; 1.2-4.2). Regarding types of asthma, the effects were significant in atopic asthma but not in non-atopic asthma. CONCLUSION: The early introduction of fish and neonatal antibiotic treatment influence the risk of asthma into school age. The significant effect on atopic asthma is of particular importance, as this phenotype is of major clinical significance.
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| 10. |
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