| 1. |
- Alm, Bernt, 1951, et al.
(författare)
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A case-control study of smoking and sudden infant death syndrome in the Scandinavian countries, 1992 to 1995. The Nordic Epidemiological SIDS Study.
- 1998
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Ingår i: Archives of disease in childhood. - 1468-2044. ; 78:4, s. 329-34
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Tidskriftsartikel (refereegranskat)abstract
- To establish whether smoking is an independent risk factor for sudden infant death syndrome (SIDS), if the effect is mainly due to prenatal or postnatal smoking, and the effect of smoking cessation.The analyses were based on data from the Nordic epidemiological SIDS study, a case-control study with 244 cases and 869 controls. Odds ratios were computed by conditional logistic regression analysis.Smoking emerged as an independent risk factor for SIDS, and the effect was mainly mediated through maternal smoking in pregnancy (crude odds ratio 4.0 (95% confidence interval 2.9 to 5.6)). Maternal smoking showed a marked dose-response relation. There was no effect of paternal smoking if the mother did not smoke. Stopping or even reducing smoking was beneficial. SIDS cases exposed to tobacco smoke were breast fed for a shorter time than non-exposed cases, and feeding difficulties were also more common.Smoking is an independent risk factor for SIDS and is mainly mediated through maternal smoking during pregnancy. Stopping smoking or smoking less may be beneficial in reducing the risk of SIDS.
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| 2. |
- 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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| 3. |
- Alm, Bernt, 1951, et al.
(författare)
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Breast feeding and the sudden infant death syndrome in Scandinavia, 1992-95.
- 2002
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Ingår i: Archives of disease in childhood. - : BMJ. - 1468-2044 .- 0003-9888. ; 86:6, s. 400-2
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Tidskriftsartikel (refereegranskat)abstract
- To assess the effects of breast feeding habits on sudden infant death syndrome (SIDS).The analyses are based on data from the Nordic Epidemiological SIDS Study, a case-control study in which parents of SIDS victims in the Scandinavian countries between 1 September 1992 and 31 August 1995 were invited to participate, each with parents of four matched controls. The odds ratios presented were computed by conditional logistic regression analysis.After adjustment for smoking during pregnancy, paternal employment, sleeping position, and age of the infant, the adjusted odds ratio (95% CI) was 5.1 (2.3 to 11.2) if the infant was exclusively breast fed for less than four weeks, 3.7 (1.6 to 8.4) for 4-7 weeks, 1.6 (0.7 to 3.6) for 8-11 weeks, and 2.8 (1.2 to 6.8) for 12-15 weeks, with exclusive breast feeding over 16 weeks as the reference. Mixed feeding in the first week post partum did not increase the risk.The study is supportive of a weak relation between breast feeding and SIDS reduction.
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| 4. |
- Alm, Bernt, 1951, et al.
(författare)
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Breastfeeding and dummy use have a protective effect on sudden infant death syndrome.
- 2016
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 1651-2227 .- 0803-5253. ; 105:1, s. 31-38
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Tidskriftsartikel (refereegranskat)abstract
- We conducted a literature review on the effect of breastfeeding and dummy (pacifier) use on sudden infant death syndrome (SIDS). From the 4,343 abstracts, we identified 35 relevant studies on breastfeeding and SIDS, 27 on dummy use and SIDS and 59 on dummy use versus breastfeeding CONCLUSION: We found ample evidence that both breastfeeding and dummy use reduce the risk of SIDS. There has been a general reluctance to endorse dummy use in case it has a detrimental effect of breastfeeding. However, recent evidence suggests that dummy use might not be as harmful to breastfeeding as previously believed. This article is protected by copyright. All rights reserved.
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| 5. |
- Alm, Bernt, 1951, et al.
(författare)
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Caffeine and alcohol as risk factors for sudden infant death syndrome. Nordic Epidemiological SIDS Study.
- 1999
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Ingår i: Archives of disease in childhood. - : BMJ. - 1468-2044 .- 0003-9888. ; 81:2, s. 107-11
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Tidskriftsartikel (refereegranskat)abstract
- To assess whether alcohol and caffeine are independent risk factors for sudden infant death syndrome (SIDS).Analyses based on data from the Nordic epidemiological SIDS study, a case control study in which all parents of SIDS victims in the Nordic countries from 1 September 1992 to 31 August 1995 were invited to participate with parents of four controls, matched for sex and age at death. Odds ratios (ORs) were calculated by conditional logistic regression analysis.The crude ORs for caffeine consumption > 800 mg/24 hours both during and after pregnancy were significantly raised: 3.9 (95% confidence interval (CI), 1.9 to 8.1) and 3.1 (95% CI, 1.5 to 6.3), respectively. However, after adjustment for maternal smoking in 1st trimester, maternal age, education and parity, no significant effect of caffeine during or after pregnancy remained. For maternal or paternal alcohol use, no significant risk increase was found after adjusting for social variables, except for heavy postnatal intake of alcohol by the mother, where the risk was significantly increased.Caffeine during or after pregnancy was not found to be an independent risk factor for SIDS after adjustment for maternal age, education, parity, and smoking during pregnancy. Heavy postnatal but not prenatal intake of alcohol by the mother increased the risk.
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| 6. |
- Alm, Bernt, 1951, et al.
(författare)
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Changes in the epidemiology of sudden infant death syndrome in Sweden 1973-1996.
- 2001
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Ingår i: Archives of disease in childhood. - 1468-2044. ; 84:1, s. 24-30
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Tidskriftsartikel (refereegranskat)abstract
- From the early 1970s to the early 1990s, there was a significant rise in the incidence of sudden infant death syndrome (SIDS) in Scandinavia. Following the risk reducing campaign, the incidence has fallen to about the same level as in 1973.To identify the changes that have occurred in the epidemiology of SIDS.We compared the Swedish part of the Nordic Epidemiological SIDS Study (NESS), covering the years 1992-1995, with two earlier, descriptive studies during this period. To assess the changing effects of risk factors, we analysed data from the Medical Birth Registry of Sweden, covering the years 1973-1996.There was a predominance of deaths during weekends in the 1970s and 1990s. The seasonal variation was most notable in the 1980s. The proportion of young mothers decreased from 14% to 5%. Cohabitation (living with the biological father) was as frequent in the 1990s as in the 1970s. The prevalence of high parity, admissions to neonatal wards, low birth weight, prematurity, and multiple pregnancies were all increased in the 1990s compared to the 1970s. No significant change in the prevalence of previous apparent life threatening events was found. Deaths occurring in cars diminished from 10% to below 2%. In the data from the Medical Birth Registry of Sweden, there were significantly increased odds ratios after the risk reducing campaign of the risk factors smoking during early pregnancy and preterm birth. We could find no increased effects of maternal age, parity, or being small for gestational age over time. The rate of deaths at weekends remained increased; the median age at death fell from 90 to 60 days. Seasonal variation was less notable in the periods of low incidence.
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| 7. |
- 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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| 8. |
- 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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| 9. |
- 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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| 10. |
- Alm, Bernt, 1951, et al.
(författare)
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Living conditions in early infancy in Denmark, Norway and Sweden 1992-95: results from the Nordic Epidemiological SIDS study.
- 2000
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - 0803-5253. ; 89:2, s. 208-14
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Tidskriftsartikel (refereegranskat)abstract
- The objective was to study living conditions of infants and their families in Scandinavia in the 1990s and to assess similarities and differences among the three Scandinavian countries. The emphasis is on health and normality rather than on diseases and other deviations from well-being. The subjects are the 869 controls in the Nordic Epidemiological SIDS study carried out between 1 September 1992 and 31 August 1995 in Norway, Denmark and Sweden. The controls were matched with the 244 SIDS cases for sex, age and maternity hospital. Parents of the SIDS cases and the controls filled in the same questionnaire on family, pregnancy, delivery, the neonatal and the post-perinatal period. The most striking findings were that 99% of the mothers went to regular maternity controls, 97% to well-baby clinics and 84% breastfed exclusively. On the other hand, 11% drank alcohol more than once a month during pregnancy and 29% smoked during pregnancy. Compared to official statistics, to the extent they exist, the differences were small. The material contains valuable information on normal infant care in Scandinavia in the 1990s. Living conditions of infants in Scandinavia are similar in the three countries. Differences exist, but only to a small extent.
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| 11. |
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| 12. |
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| 13. |
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| 14. |
- 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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| 15. |
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| 16. |
- 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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| 17. |
- Alm, Bernt, 1951
(författare)
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Piperidine: effects on locomotor activity and brain monoamine turnover
- 1976
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Ingår i: Psychopharmacology (Berl). - 0033-3158. ; 50:3, s. 301-4
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Tidskriftsartikel (refereegranskat)abstract
- The effects of piperidine HCl (PHCl) on locomotor activity, flexor reflex activity and monoamine levels, turnover, and synthesis were studied. Results indicate a sedative action and an increased turnover of noradrenaline (NA), but no effects on 5-hydroxytryptamine (5-HT) or dopamine (DA). Data obtained from flexor reflex experiments suggest that this is not secondary to alpha-adrenergic receptor blockade. One explanation might be an increased impulse activity of NA neurons, but the exact mechanism remains to be elucidated.
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| 18. |
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| 19. |
- Alm, Bernt, 1951, et al.
(författare)
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Plötslig oväntad död hos spädbarn. Kunskapsstöd med nationella rekommendationer till hälso- och sjukvården
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I detta kunskapsstöd presenteras rekommendationer till hälso- och sjukvår-den för rutiner vid plötslig oväntad död hos spädbarn. Vid plötslig oväntad död hos spädbarn bör hälso- och sjukvården använda Socialstyrelsens checklista för anamnesuppgifter använda Socialstyrelsens checklista för statusuppgifter använda Socialstyrelsens checklista för provtagningar och röntgenundersökning. Utredning av plötslig oväntad död hos spädbarn innefattar samverkan mellan tre aktörer med olika uppgifter, nämligen hälso- och sjukvården, Polismyndigheten och Rättsmedicinalverket. Rekommendationerna är avsedda som ett stöd till hälso- och sjukvårdspersonal vid omhändertagandet av det döda barnet och familjen. Rekommendationerna utgör även en grund för utveckling av lokala vårdprogram och de förväntas dessutom bidra till jämlikhet över landet när det gäller utredning samt till att förebygga plötslig oväntad död hos spädbarn. Eftersom det delvis saknas vetenskapliga studier med tillräcklig relevans och kvalitet om utredning av plötslig oväntad död hos spädbarn har Social-styrelsen genomfört en konsensusprocess för att formulera rekommendationerna. Att som förälder påträffa sitt spädbarn livlöst, eller att informeras om att barnet dött, innebär en extrem känslomässig påfrestning. I ett kapitel ger Socialstyrelsen stöd till hälso- och sjukvården med syfte att underlätta informationen till familjen om dödsorsaksutredningen och dödsorsaksdia-gnosen. I ett sista kapitel om stöd till föräldrar under utredningsprocessen ges vägledning om vad som är viktigt att tänka på i mötet med föräldrarna och andra närstående samt vad som bör göras för att utredningen ska bli så komplett som möjligt. I bilagan till kunskapsstödet finns också en beskrivning av de rättsliga förutsättningarna för utredning av plötslig oväntad död hos spädbarn.
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| 20. |
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| 21. |
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| 22. |
- Alm, Bernt, 1951, et al.
(författare)
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SIDS diagnosis should not be put to bed.
- 2008
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 0803-5253 .- 1651-2227. ; 97:6, s. 695-6
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The finding that prone sleeping position and smoking are important risk factors for SIDS has considerably reduced the incidence. Although these risk factors can be found in many cases of SIDS, they cannot be regarded as causes of death. CONCLUSION: The diagnosis of SIDS must be adhered to, and risk factors must not be confused with diagnoses. A structured follow-up of all cases of SIDS can be a cost-effective mean to ensure that parents and researchers are given adequate information.
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| 23. |
- 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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| 24. |
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| 25. |
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| 26. |
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| 27. |
- Alm, Bernt, 1951
(författare)
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To co-sleep or not to sleep?
- 2007
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 0803-5253 .- 1651-2227. ; 96:10, s. 1385-6
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Tidskriftsartikel (refereegranskat)
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| 28. |
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| 29. |
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| 30. |
- Alm, Bernt, 1951, et al.
(författare)
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Vitamin A and sudden infant death syndrome in Scandinavia 1992-1995.
- 2003
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 0803-5253. ; 92:2, s. 162-4
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Tidskriftsartikel (refereegranskat)abstract
- To assess the effect of vitamin supplementation on the risk of sudden infant death syndrome (SIDS).The analyses are based on data from the Nordic Epidemiological SIDS Study, a case-control study in which parents of SIDS victims in the Scandinavian countries were invited to participate together with parents of four matched controls between 1 September 1992 and 31 August 1995. The odds ratios presented are computed by conditional logistic regression analysis.The crude odds ratio in Scandinavia for not giving vitamin substitution was 2.8 (95% CI (1.9, 4.3)). This effect was statistically significant in Norway and Sweden, which use A and D vitamin supplementation, but not in Denmark, where only vitamin D supplementation is given. The odds ratios remained significant in Sweden when an adjustment was made for confounding factors (OR 28.4, 95% CI (4.7, 171.3)).We found an association between increased risk of sudden infant death syndrome and infants not being given vitamin supplementation during their first year of life. This was highly significant in Sweden, and the effect is possibly connected with vitamin A deficiency. This effect persisted when an adjustment was made for potential confounders, includingsocioeconomic factors.
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| 31. |
- Almquist-Tangen, Gerd, et al.
(författare)
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Consuming milk cereal drinks at one year of age was associated with a twofold risk of being overweight at the age of five
- 2019
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Ingår i: Acta Paediatrica. - Chichester : Wiley-Blackwell Publishing Inc.. - 0803-5253 .- 1651-2227. ; 108:6, s. 1115-1121
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Tidskriftsartikel (refereegranskat)abstract
- Aim: We previously reported that consuming milk cereal drinks at six months of age was associated with a high body mass index (BMI) at 12 and 18 months. This study examined the association between daily consumption at 12 months of age and BMI at the age of five.Methods: We followed up 1870/2666 (70%) children recruited at birth in 2007–2008 for the Swedish longitudinal population‐based Halland Health and Growth Study a mean of 5.09 ± 0.28 years. Feeding practices were obtained from parental questionnaires, and anthropometric data were collected by child health nurses.Results: At five years, 11.6% were overweight and 2.3% were obese. Milk cereal drinks were consumed by about 85% and 10% at one and five years of age, respectively. Consumption at 12 months was associated with almost double the risk of being overweight at five years of age (adjusted odds ratio 1.94, 95% confidence interval 1.08–3.50). Other risk factors were a family history of obesity, low paternal educational level and paternal smoking.Conclusion: Consuming milk cereal drinks daily at 12 months was associated with a twofold risk of being overweight at five years. These findings may affect the counselling guidelines used at child healthcare centres. Copyright © 2019 John Wiley & Sons, Inc. All rights reserved
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| 32. |
- Almquist-Tangen, Gerd, et al.
(författare)
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Factors associated with discontinuation of breastfeeding before 1 month of age
- 2012
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Ingår i: Acta Paediatrica. - Chichester : Wiley-Blackwell Publishing Inc.. - 0803-5253 .- 1651-2227. ; 101:1, s. 55-60
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Breastfeeding is associated with many benefits for both mother and child. Initiation rates are high in Sweden. Recently a slight decline is seen.AIM: The aim of this study was to assess factors associated with discontinuation of breastfeeding during the first 4 weeks.METHOD: A population-based longitudinal birth cohort study recruiting from 2007 to 2008 in south-western Sweden. At the first visit to the child health centre, parents were asked to complete a questionnaire. Also, the infants' height, weight, head and waist circumference were collected. Response rate was 69.2%.RESULTS: Twenty-seven per cent of mothers had breastfeeding problems. In a multivariate analysis, there was a negative correlation between breastfeeding and use of pacifier (OR 3.72; CI 2.09-6.63), maternal smoking (OR 2.09; CI 1.08-4.05) and breastfeeding problems (OR 2.54; CI 1.73-3.71). Breastfeeding problems were correlated with poor sucking technique (OR 2.96; CI 2.14-4.07), support from maternity ward (OR 2.56; CI 2.05-3.19) and perceived poor weight gain (OR 1.37; CI 1.00-1.86).CONCLUSION: Many mothers reported breastfeeding problems that are associated with an early cessation. This is preventable with support, but the timing is crucial. To promote breastfeeding, the support from the child health centres must be tailored with the maternal perspective in mind.© 2011 Foundation Acta Pædiatrica
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| 33. |
- Almquist-Tangen, Gerd, et al.
(författare)
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Influence of neighbourhood purchasing power on breastfeeding at four months of age : a Swedish population-based cohort study
- 2013
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Ingår i: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Parental socioeconomic status (SES) is an important determinant in child health, influencing beneficial factors such as breastfeeding. A better understanding of the influence of neighbourhood-level SES measures, relating to spatial determinants, might lead to targeted actions to promote breastfeeding during infancy.METHODS: A cross-sectional study analysis the association between breastfeeding at four months of age and neighbourhood purchasing power, taking account of individual-level variables including maternal age, smoking and parental level of education. Data were obtained from a prospective population- based cohort study recruited from birth in 2007-2008 in the Halland region, southwestern Sweden. Questionnaire data on the individual-level variables and the outcome variable of breastfeeding at four months (yes/no) were used (n=2,407). Each mother was geo-coded with respect to her residential parish (there are 61 parishes in the region) and then stratified by parish-level household purchasing power. It emerged that four neighbourhood characteristics were reasonable to use, viz. <10%, 10-19%, 20-29% and ≥ 30% of the resident families with low purchasing power.RESULTS: The proportion of mothers not breastfeeding at four months of age showed a highly significant trend across the neighbourhood strata (p=0.00004): from 16.3% (< 10% with low purchasing power) to 29.4% (≥ 30% with low purchasing power), yielding an OR of 2.24 (95% confidence interval: 1.45-3.16). After adjusting for the individual-level variables, the corresponding OR=1.63 (1.07-2.56) was significant and the trend across the strata was still evident (p=0.05). A multi-level analysis estimated that, in the neighbourhoods with ≥ 30% of the families with low purchasing power, 20% more mothers than expected, taking account of the individual-level factors, reported no breastfeeding at four months of age (≥ 95% posterior probability of an elevated observed-to-expected ratio).CONCLUSION: The neighbourhood purchasing power provided a spatial determinant of low numbers of mothers breastfeeding at four months of age, which could be relevant to consider for targeted actions. The elevated observed-to-expected ratio in the neighbourhoods with the lowest purchasing power points toward a possible contextual influence. © 2013 Almquist-Tangen et al.; licensee BioMed Central Ltd.
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| 34. |
- Almquist-Tangen, Gerd, et al.
(författare)
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Milk cereal drink increases BMI risk at 12 and 18 months, but formula does not
- 2013
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Ingår i: Acta Paediatrica. - Chichester : Wiley-Blackwell. - 0803-5253 .- 1651-2227. ; 102:12, s. 1174-1179
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Infant feeding affects growth, obesity and life-long health. This study examined the impact of dietary patterns on body mass index (BMI) at 12 and 18 months.METHODS: We followed a cohort of 2,666 children recruited in 2007-2008. Feeding practices were obtained from parental questionnaires and anthropometric data collected by child health nurses.RESULTS: At six months, 58.3% of the infant were breastfed, but only 1.6% exclusively. Many had begun eating solids (91.8%), porridge (87.7%) or milk cereal drink (46.6%). Bottle-feeding at four months was not a risk factor for a high BMI (>1 SD) at 12 or 18 months. Milk cereal drink at six months increased the risk of a high BMI at 12 and 18 months respectively (OR 1.58, 95% CI 1.12-2.22, and 1.52, 1.07-2.17). Milk cereal drink use was increased by low parental education and maternal obesity and reduced by troubled sleep and parental group participation.CONCLUSION: Formula at four months did not predict a high BMI at 12 or 18 months. Milk cereal drink use at six months was a risk factor for a high BMI at 12 and 18 months. The choice of milk cereal drink was influenced by parental factors, especially educational levels. ©2013 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd.
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| 35. |
- Almquist-Tangen, Gerd, et al.
(författare)
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What makes parents act and react? Parental views and considerations relating to "child health' during infancy
- 2017
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Ingår i: Journal of Child Health Care. - London : SAGE Publications. - 1367-4935 .- 1741-2889. ; 21:4, s. 415-423
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Tidskriftsartikel (refereegranskat)abstract
- Lifestyle factors and behaviours are adopted very early in life and tend to persist throughout life. Considering that the parents are the primary gatekeepers for their child's health, there is a need to gain more knowledge and deeper understanding about what causes parents to act and react in order for early preventive efforts to have any effect. The aim was to explore the parental views and considerations concerning child health' among parents with infants 8-10 months old. The sample was strategic and 16 parents (aged 23-41) were recruited from three child health centres in Sweden. Open-ended interviews were conducted and a qualitative, manifest content analysis approach was utilized. The parents described the subject child health' as a large, multifaceted concept. Three categories emerged during data analysis: developing a sixth sense, being affected by perceptions and believing health and ill health as a continuum. The parents perceived food and feeding issues as one of the most worrying aspects and a significant indicator of child health'. In order to meet the parents on their turf, the healthy health message' conveyed needs to take the parental perspective into consideration rather than attempting to educate the parents from predetermined assumption, belief and values.
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| 36. |
- Berggren, Sara, et al.
(författare)
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Parents with overweight children age two and five years of age did not perceive them as weighing too much.
- 2018
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Ingår i: Acta paediatrica. - : Wiley. - 1651-2227 .- 0803-5253. ; 107:6, s. 1060-1064
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Tidskriftsartikel (refereegranskat)abstract
- This study examined whether the parents of children who were overweight at two and five years of age perceived their children as being too heavy and related the findings to sociodemographic factors.The data collection included parental questionnaires and anthropometric data from a longitudinal birth cohort of 2,666 children born in the southwest region of Sweden in 2007-2008.We found that 14.9% and 11.8% of the children were considered overweight or obese at the age of two and five, but 96.4% and 87.1% of their parents perceived their weight to be just about right at these ages. The difference was statistically significant (p<0.001). Parents who were overweight themselves and had a low educational level were associated with a higher probability of misperception: at two years of age the odds ratio was 2.75 (95% confidence interval 1.80-4.21) and at the age of five it was 1.92 (1.24-2.97).Most parents did not perceive that their overweight children weighed too much, but their judgement improved as the child got older. Parents who were overweight or had a low educational level were more likely to misperceive their child's weight. Health professionals need to be aware of this gap in perception. This article is protected by copyright. All rights reserved.
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| 37. |
- Daltveit, A K, et al.
(författare)
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Sociodemographic risk factors for sudden infant death syndrome: associations with other risk factors. The Nordic Epidemiological SIDS Study.
- 1998
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - 0803-5253. ; 87:3, s. 284-90
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate associations between sudden infant death syndrome (SIDS) and social factors in the Nordic countries. A case-control study was conducted in Denmark, Norway and Sweden: The Nordic Epidemiological SIDS Study. Parents of 244 SIDS infants and 869 control infants matched on gender, age at death and place of birth filled in questionnaires. The dataset was analysed by conditional logistic regression. In univariate analysis, the following sociodemographic factors were associated with an increased risk of SIDS: low maternal age [odds ratio (OR) 7.8; 2.8-21.5], high birth order (OR 4.4; 2.5-7.5), single motherhood (OR 2.9; 1.7-5.0), low maternal education (OR 4.5; 2.8-7.1), low paternal education (OR 3.0; 1.9-4.7), maternal unemployment (OR 2.4; 1.8-3.4) and paternal unemployment (OR 4.0; 2.7-5.9). In a multivariate analysis where maternal smoking was also included, only paternal unemployment, young maternal age and high birth order remained significantly associated with SIDS. Housing conditions were not associated with SIDS. However, the risk of SIDS was high if the family had lived in their present home for only a few years (OR 2.3; 1.3-4.1). Sociodemographic differences remain a major concern in SIDS in a low-incidence situation and even in an affluent population with adequate health services.
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| 38. |
- Edner, A., et al.
(författare)
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Why do ALTE infants not die in SIDS?
- 2007
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Ingår i: Acta Paediatr. - : Wiley. - 0803-5253 .- 1651-2227. ; 96:2, s. 191-4
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To compare known risk factors for sudden infant death syndrome (SIDS) amongst infants with apparent life threatening events (ALTE) with their matched controls, and ALTE infants who subsequently died of SIDS with infants surviving an ALTE. METHODS: Questionnaires with replies were obtained from 58 ALTE infants and 56 sex and age matched ALTE control infants. 244 SIDS cases and 868 SIDS controls were used as comparison. RESULTS: The incidence of ALTE was found to be 1.9% among SIDS controls, but 7.4% among infants who later on died of SIDS. The parents sought medical advice in 0.9% vs 3.7%. ALTE infants did not differ from their matched controls. In the ALTE group 13.3% of the survivors had the combination of prone sleeping and maternal smoking compared with 33.3% of those who became SIDS victims. CONCLUSIONS: Our results show some major differences between the ALTE infants and SIDS victims not supporting that these conditions belong to the same entity. However, we cannot exclude the possibility that there is a subpopulation of ALTE infants who did not die in SIDS due to that they were sleeping on the back and not exposed to nicotine.
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| 39. |
- Goksör, Emma, 1974, et al.
(författare)
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Asthma symptoms in early childhood--what happens then?
- 2006
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Ingår i: Acta Paediatr. - : Wiley. - 0803-5253. ; 95:4, s. 471-8
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To study the outcome in early adulthood for children with early asthma symptoms and to analyse the factors associated with current asthma. METHODS: In a prospective study, we have re-investigated 89/101 children who were hospitalized before the age of two years due to wheezing. The children were investigated using a questionnaire and allergy and bronchial hyper-responsiveness tests at the age of 17-20 years and compared with age-matched controls. RESULTS: In the cohort, 43% had had asthma symptoms in the preceding 12 months compared with 15% in the control group. The strongest risk factors for asthma were current allergy, bronchial hyper-responsiveness and female gender. Female gender and passive smoking in infancy were independent infantile risk factors. In addition to female gender, two pathways led to current asthma: an allergic pathway from family atopy via the development of allergy and another pathway from early passive smoking via hyper-responsiveness and active smoking. CONCLUSION: In children with early wheezing disorder, current allergy, bronchial hyper-responsiveness and female gender were the strongest risk factors for asthma in early adulthood, while female gender and passive smoking in infancy were independent infantile risk factors. The effects of early passive smoking persist longer than previously reported.
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| 40. |
- 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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| 41. |
- Goksör, Emma, 1974, et al.
(författare)
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High risk of adult asthma following severe wheeze in early life
- 2012
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Ingår i: EAACI International Severe Asthma Forum (ISAF 2012), 11-13 October 2012, Gothenburg, Sweden. Clinical and Translational Allergy. - : Springer. - 2045-7022 .- 2045-7022.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background We have previously reported on the outcome in childhood and adolescence in children with severe wheeze in early life. The aim of the present follow-up was to report on the asthma prevalence and risk factors for asthma in adult age. Methods We have prospectively studied asthma development in 101 children hospitalized due to wheezing before the age of two. The cohort was re-investigated at age 25-29 years and tested for bronchial hyper-responsiveness and allergic sensitization. The response rate at adult age was 81%. The results were compared to a population based aged matched control group (n=1210) recruited from the West Sweden Asthma Study. Results Current asthma was seen in 37% (30/82) and 50% of these had a moderate to severe asthma. In the control group 10% reported current asthma (OR 5.3, 95% CI 3.2-8.9; p<0.001) and 17% had wheezing during the last 12 months (p<0.001). Current use of asthma medication was reported in 31% of the cohort (of which 66% used inhaled corticosteroids and/or montelukast), compared to 8% in the control group (p<0.001). Current atopy was found in 54%, with 42% reporting doctor-diagnosed rhinitis, 11% current eczema and 16% food allergy. Among the controls rhinitis was reported in 29% (p=0.013) and eczema in 13% (ns). Smoking was reported in 30 % of the cohort, compared to 16% in the control group (p=0.002). In the cohort, current allergy (OR 9.7, 95% CI 3.0-31.1) and female gender (OR 3.2, 1.1-9.5) increased the risk of adult asthma independently of each other. Females with current allergy had the highest risk of adult asthma, compared to males without allergy (OR 29.4, 5.0-173.3).This is illustrated in a stratified Cox regression analysis where the females with current allergy have the lowest chance of recovery (Hazard Ratio 0.2, 95% CI 0.06-0.5) compared to males without allergy. Conclusion Subjects with severe early wheezing have an increased risk of adult asthma. Females with current allergy had the highest risk of persistent asthma and the lowest chance of recovery.
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| 42. |
- Goksör, Emma, 1974, et al.
(författare)
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High risk of adult asthma following severe wheezing in early life.
- 2015
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Ingår i: Pediatric pulmonology. - : Wiley. - 1099-0496 .- 8755-6863. ; 50:8, s. 789-797
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Tidskriftsartikel (refereegranskat)abstract
- Background: Severe wheezing in early life is associated with an increased risk of asthma during childhood and adolescence. The aim of the present follow-up was to investigate the asthma prevalence and risk factors for asthma in adulthood. Methods: We have prospectively studied asthma development in 101 children hospitalized due to severe wheezing before the age of 24 months. The cohort was re-investigated at a mean age of 27 years and tested for bronchial hyper-responsiveness and allergic sensitization. The response rate in adulthood was 81% (82/101). The results were compared with a population-based, age-matched control group (n=1,210) recruited from the West Sweden Asthma Study. Results: Current doctor-diagnosed asthma was found in 37% (30/82) compared with 7% (82/1,210) in the control group. The risk of adult asthma in the cohort compared with the control group was increased 10-fold (adjusted OR 10.0, 95% CI 5.3-18.7), independently of allergic rhinitis, gender, smoking and heredity. Within the cohort, current allergy (aOR 9.6, 95% CI 3.0-31.2) and female gender (aOR 3.2, 95% CI 1.1-9.3) independently increased the risk of adult asthma. Females with current allergy had the highest risk of adult asthma (OR 29.4, 95% CI 5.0-173.3), compared with males without allergy. When separately adjusting for factors present at admission in early life within the cohort, a family history of asthma was a significant risk factor for asthma in adulthood (aOR 4.0, 95% CI 1.3-12.5). Conclusion: Subjects with severe early wheezing have a 10-fold increase in the risk of adult asthma compared to an age-matched control group, adjusted for allergic rhinitis, gender, smoking and heredity. Pediatr Pulmonol. © 2014 Wiley Periodicals, Inc.
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| 43. |
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| 44. |
- Goksör, Emma, 1974, et al.
(författare)
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Prenatal paracetamol exposure and risk of wheeze at preschool age*
- 2011
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 1651-2227 .- 0803-5253.
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To analyse the association between prenatal paracetamol exposure and preschool wheeze. Methods: Data were obtained from a prospective, longitudinal study of a cohort of children born in the region of western Sweden in 2003; 8176 families were randomly selected. The parents answered questionnaires at 6 and 12months and at 4.5years of age. The response rate was 55%, i.e. 4496 of the 5398 questionnaires distributed at 4.5years (83%). Inhaled corticosteroid (ICS) treated wheeze during the last year was regarded as a proxy for doctor-diagnosed asthma. Episodic viral wheeze was defined as wheezing only with viral infections and multiple-trigger wheeze as wheezing also in between infections. Results: In the multivariate analysis, the risk of ICS-treated wheeze was increased by paracetamol (OR 1.6; 95% CI 1.01-2.6). Within the ICS-treated group, the effect was significant for multiple-trigger wheeze (OR 2.4; 1.2-4.8) but not for episodic viral wheeze (OR 1.1; 0.5-2.3). Conclusion: Prenatal paracetamol exposure was an independent risk factor for ICS-treated wheeze at preschool age, especially among children with ICS-treated multiple-trigger wheeze. Although the analysis adjusted for e.g. maternal asthma and antibiotic use, the possibility of residual confounding by maternal indication (respiratory illness) should be acknowledged.
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| 45. |
- Goksör, Emma, 1974, et al.
(författare)
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Preschool wheeze - impact of early fish introduction and neonatal antibiotics.
- 2011
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 1651-2227 .- 0803-5253.
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to analyse the risk factors for preschool wheeze with special reference to the early introduction of fish and early antibiotic treatment. To avoid reverse causation regarding antibiotics, we focused on the influence of broad-spectrum antibiotics given during the first week of life. Methods: Data were obtained from a prospective, longitudinal study of a cohort of children born in western Sweden where 50% of the birth cohort was randomly selected. The parents answered questionnaires at 6 and 12months and at 4.5years of age. The response rate at 4.5years was 83% (4496 of 5398 questionnaires distributed). Results: In the multivariate analysis, broad-spectrum antibiotics in the first week increased the risk of recurrent wheeze (≥3 episodes) during the last 12months at age 4.5years (adjusted OR 2.2; 95% CI 1.3-3.8) and multiple-trigger wheeze (aOR, 2.8; 1.3-6.1). The introduction of fish before the age of 9months reduced the risk of recurrent wheeze (aOR, 0.6; 0.4-0.8). Conclusion: Treatment with broad-spectrum antibiotics during the first week of life increased the risk of recurrent wheeze and multiple-trigger wheeze at preschool age. The early introduction of fish reduced the risk of recurrent wheeze.
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| 46. |
- Goksör, Emma, 1974, et al.
(författare)
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Reduced airway function in early adulthood among subjects with wheezing disorder before two years of age.
- 2008
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Ingår i: Pediatric pulmonology. - : Wiley. - 1099-0496 .- 8755-6863. ; 43:4, s. 396-403
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To compare airway function in early adulthood in subjects with wheezing in infancy with age-matched controls and to analyze what accounts for a possible difference. METHODS: Asthma development has been prospectively studied in 101 children hospitalized due to wheezing before the age of two. The cohort was re-investigated at age 17-20 years and tested with spirometry and for bronchial hyper-responsiveness and allergic sensitization. An age-matched population (n = 294) was used for comparison. RESULTS: The cohort had a significantly lower FEV(1)/FVC ratio and MEF(50), both pre- and post-bronchodilation, compared with the controls, P < 0.01. The reduction in airway function was most evident in current asthmatic female subjects, but a reduced pre-bronchodilation FEV(1)/FVC ratio was also seen in symptom-free cohort subjects, P = 0.03. In the multivariate analysis, female gender was the most prominent independent risk factor for reduced airway function in early adulthood, pre-bronchodilation OR 4.0 (1.4-11.3) and post-bronchodilation OR 8.8 (1.8-42.0). In addition, a history of early wheezing, that is, belonging to the cohort, was an independent risk factor for reduced airway function pre-bronchodilation, OR 3.3 (1.3-8.7). Furthermore, there was an association between current bronchial hyper-responsiveness and an increased risk of reduced airway function post-bronchodilation, OR 7.3 (2.0-26.6). CONCLUSION: Reduced airway function in early adulthood was found in subjects with wheezing early in life, compared with age-matched controls. The reduction was most prominent in females with current asthma.
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| 47. |
- Goksör, Emma, 1974, et al.
(författare)
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The allergic march comprises the coexistence of related patterns of allergic disease not just the progressive development of one disease
- 2016
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Ingår i: Acta Paediatrica, International Journal of Paediatrics. - : Wiley. - 0803-5253 .- 1651-2227. ; 105, s. 1472-1479
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Tidskriftsartikel (refereegranskat)abstract
- ©2016 The Authors. Acta Pædiatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta PædiatricaAim: This study explored the development and comorbidity of allergic diseases by analysing the relationship between allergic manifestations in infancy and at the age of 8. Methods: We included 5654 children born in Sweden in 2003 in a longitudinal study. Parents answered postal questionnaires when the children were six months and one, four-and-a-half and eightyears of age. Results: The response rate at eight years was 4051 (71.6%), and we analysed 3382 children with complete data. The number of manifestations in infancy increased the risk of allergic disease at eight years of age: 72% of children with one early manifestation were symptom free at 8, compared to 45% with two or more manifestations. Similar manifestations occurred in infancy and at the age of 8, for example recurrent wheeze increased the risk of doctor-diagnosed asthma by an adjusted odds ratio of 6.5. Eczema and food allergy independently increased the risk of all four allergic manifestations at eight years. Conclusion: Allergic disease at the age of 8 was related to the number of allergic manifestations in infancy. Manifestations were similar at both ages, suggesting an allergic march with the coexistence of disease patterns rather than the progressive development of one disease.
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| 48. |
- Goksör, Emma, 1974, et al.
(författare)
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The impact of pre- and post-natal smoke exposure on future asthma and bronchial hyper-responsiveness
- 2007
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Ingår i: Acta Paediatr. - : Wiley. - 0803-5253. ; 96:7, s. 1030-5
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To analyse the impact of pre- and post-natal smoke exposure on asthma presence, bronchial hyper-responsiveness, airway function and active smoking in early adulthood. METHODS: We have prospectively studied 101 children hospitalized due to wheezing before the age of 2 years. The cohort was re-investigated at age 17-20 years and tested for airway function and bronchial hyper-responsiveness. Data on maternal smoking during pregnancy were obtained from the Swedish Medical Birth Register. RESULTS: There was a significant, independent correlation between both pre- and post-natal smoke exposure and asthma at age 17-20 years, OR 3.5 (1.1-11.3) and 3.4 (1.2-10.1), respectively. Maternal smoking during pregnancy was an independent risk factor for current bronchial hyper-responsiveness, OR 6.6 (1.2-35.5). Pre-natal smoke exposure seemed to negatively affect small airway function in early adulthood due to structural changes. Post-natal smoke exposure was independently associated with an increased risk of current smoking, OR 7.4 (1.6-35.2). CONCLUSION: In subjects hospitalized due to early wheezing, pre- and post-natal smoke exposure increase the risk of asthma in early adulthood. The connection between pre-natal smoke exposure and asthma appears to be mediated via the development of bronchial hyper-responsiveness. Smoke exposure in infancy is associated with an increased risk of active smoking in early adult age, which is in turn linked to current asthma.
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| 49. |
- Helweg-Larsen, K, et al.
(författare)
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Interactions of infectious symptoms and modifiable risk factors in sudden infant death syndrome. The Nordic Epidemiological SIDS study.
- 1999
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - 0803-5253. ; 88:5, s. 521-7
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to investigate the effect of infection on sudden infant death syndrome (SIDS) and to analyse whether modifiable risk factors of SIDS, prone sleeping, covered head and smoking act as effect modifiers. In a consecutive multicentre case-control study of SIDS in Denmark, Norway and Sweden, questionnaires on potential risk factors for SIDS were completed by parents of SIDS victims, and for at least two controls matched for gender, age and place of birth. All SIDS cases were verified by an autopsy. The study comprised 244 SIDS cases and 869 controls, analysed by conditional logistic regression. Significantly more cases than controls presenting symptoms of infectious diseases during the last week and/or last day were treated with antibiotics and had been seen by a physician. The finding is consistent with the hypothesis of an infectious mechanism in SIDS induced by local microorganism growth and toxin or cytokine production, and also adds further support to a possible association between infection and SIDS by loss of protective mechanisms, such as arousal. The risk of SIDS among infants with the combined presence of infectious symptoms and either of the other modifiable risk factors, prone sleeping, head covered or parental smoking, was far greater than the sum of each individual factor. These risk factors thus modify the dangerousness of infection in infancy.
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| 50. |
- Kjellberg, Emma, et al.
(författare)
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Longitudinal birth cohort study found that a significant proportion of children had abnormal metabolic profiles and insulin resistance at 6years of age. : Metabolic syndrome in 6-year-olds
- 2019
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 1651-2227 .- 0803-5253. ; 108:3, s. 486-492
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Tidskriftsartikel (refereegranskat)abstract
- Metabolic syndrome represents a cluster of risk factors for cardiovascular disease, and we investigated whether otherwise healthy 6-year-olds showed metabolic alterations.This study followed up a representative Swedish population-based cohort of full-term infants recruited on the maternity ward at Hallands Hospital Halmstad, Sweden, from 2008 to 2011. They were examined at a mean of 6.6years of age (range 6.5-6.9) using various measures for signs of metabolic syndrome.One key measure showed that 55 (26%) of the 212 children had one or more risk factors for metabolic syndrome requiring action. The 37 who were obese (3%) or overweight (14%) were significantly more likely to be insulin resistant than the normal weight group (28% versus 5%, p<0.001) and have high triglycerides (8% versus 0%, p<0.001). Children with high waist circumferences had higher systolic (p=0.01) and diastolic (p=0.02) blood pressure than those with normal waist circumferences. Waist circumference identified children at high risk of metabolic syndrome better than body mass index.A significant percentage of 6-year-old children showed abnormal metabolic profiles, including insulin resistance, which increased their risk of cardiovascular disease. Waist circumference was a stronger marker for metabolic alterations than body mass index.
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