| 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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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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| 5. |
- Amera, Yohannes Tesfaye, et al.
(författare)
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Maternal age at delivery and risk of allergy and asthma in the offspring: a systematic review and meta-analysis protocol
- 2020
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 10:10
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Tidskriftsartikel (refereegranskat)abstract
- While several perinatal factors have been linked to the risk of developing asthma and allergy in childhood, the role of maternal age at delivery remains uncertain. Some studies suggest that young maternal age at delivery may increase the risk, while other studies suggested a reduced risk. To provide a clearer appreciation of the underlying evidence, we plan to undertake a systematic review to synthesise previous studies that have investigated the association between maternal age at delivery and the risk of asthma and allergy in the offspring.We will search PubMed, EMBASE, ISI Web of Science, Scopus and Google Scholar to identify relevant studies on the topic published in the databases from inception until October 2020. We will search databases of proceedings of international conferences, contact authors who have published on the topic and search the reference lists of the included studies in order to identify additional studies. Two investigators will independently screen the identified studies, perform data extraction and examine the risk of bias in the studies; a third investigator will arbitrate throughout these processes. We will use the Effective Public Health Practice Project tool for assessment of the risk of bias in included studies. We will perform random-effects meta-analysis to combine effect estimates from included studies judged to be homogeneous.Only data from the published literature will be included in this study, therefore no ethics approval is required. Our findings will be published in a peer-reviewed journal.The protocol has been submitted for registration on PROSPERO, University of York, and Centre for Review and Dissemination, now awaiting the assignment of a registration number.
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| 6. |
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| 7. |
- Eriksson, Emma, 1980, et al.
(författare)
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A microfluidic device for reversible environmental changes around single cells using optical tweezers for cell selection and positioning
- 2010
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Ingår i: Lab Chip. - : Royal Society of Chemistry (RSC). - 1473-0197 .- 1473-0189. ; 10:5, s. 617-625
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Tidskriftsartikel (refereegranskat)abstract
- Cells naturally exist in a dynamic chemical environment, and therefore it is necessary to study cell behaviour under dynamic stimulation conditions in order to understand the signalling transduction pathways regulating the cellular response. However, until recently, experiments looking at the cellular response to chemical stimuli have mainly been performed by adding a stress substance to a population of cells and thus only varying the magnitude of the stress. In this paper we demonstrate an experimental method enabling acquisition of data on the behaviour of single cells upon reversible environmental perturbations, where microfluidics is combined with optical tweezers and fluorescence microscopy. The cells are individually selected and positioned in the measurement region on the bottom surface of the microfluidic device using optical tweezers. The optical tweezers thus enable precise control of the cell density as well as the total number of cells within the measurement region. Consequently, the number of cells in each experiment can be optimized while clusters of cells, that render subsequent image analysis more difficult, can be avoided. The microfluidic device is modelled and demonstrated to enable reliable changes between two different media in less than 2 s. The experimental method is tested by following the cycling of GFP-tagged proteins (Mig1 and Msn2, respectively) between the cytosol and the nucleus in Saccharomyces cerevisiae upon changes in glucose availability.
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| 8. |
- Ermis, Özuygur, 1991, et al.
(författare)
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Sensitization patterns to cat molecular allergens in subjects with allergic sensitization to cat dander
- 2023
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Ingår i: Clinical and translational allergy. - : Wiley. - 2045-7022. ; 13:8
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Tidskriftsartikel (refereegranskat)abstract
- The use of molecular allergology has increasingly become common in the diagnosis and management of allergic diseases. However, there is still a lack of data on cat molecular allergens in adults. Therefore, we aimed to uncover the sensitization patterns to cat molecular allergens.Participants were recruited from the West Asthma Sweden Study, a population-based study enriched with asthma subjects aged 16-75years. Of 1872, 361 individuals were positive for cat dander immunoglobulin E and were further analysed for cat molecular allergens (Fel d 1/2/4/7). Sensitization patterns were classified as monosensitization, polysensitization, and concomitant sensitization, and were related to demographic and clinical measurements.Among cat-sensitized subjects, 84.2% were sensitized to secretoglobin, while 42.4% were sensitized to lipocalins. Nearly half of the subjects were monosensitized to Fel d 1. Polysensitization was observed in 20.2%, and concomitant sensitization to protein families was seen in 7.2%. Asthma prevalence, cat exposure, and rural living were associated with poly- and concomitant sensitization to protein families. Concomitant sensitization to single allergens was more common in those with asthma than in those without, while concomitant sensitization to both Fel d 1 and Fel d 4 was the most common pattern in individuals with asthma. Sensitization patterns also differed according to cat ownership and the degree of urbanization.Sensitization to molecular allergens was observed in 90.9% of cat-sensitized subjects and showed variations across participants' background characteristics and the presence of asthma. Identification of sensitization patterns to cat allergens might provide better characterization of cat-allergic subjects.
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| 9. |
- Ermis, Özuygur, 1991, et al.
(författare)
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Sensitization to molecular dog allergens in an adult population: Results from the West Sweden Asthma Study
- 2023
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Ingår i: Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology. - : Wiley. - 0954-7894 .- 1365-2222. ; 53:1, s. 88-104
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Tidskriftsartikel (refereegranskat)abstract
- As the prevalence of dog allergy rises, component resolved diagnosis might improve the diagnosis, understanding of the clinical outcomes, and the effectiveness of immunotherapy. Considering the paucity of data in adults, the current study characterized the patterns of sensitization to dog molecular allergens in an adult population.Data were derived from the West Sweden Asthma Study, a population-based and representative sample of adults from western Sweden. Of the 2006 subjects clinically examined, 313 participants sensitized to whole dog allergen extract were measured for specific immunoglobulin E (sIgE) levels to Can f 1, Can f 2, Can f 3, Can f 4, Can f 5, Can f 6 using ImmunoCAPTM . Poly-sensitization was defined as sensitization to ≥3 components. Overlapping sensitization was defined as having concomitant sensitization to at least two dog molecular allergen families (lipocalin, albumin, or prostatic kallikrein).Of 313, 218 (70%) subjects tested positive to at least one dog allergen component. Sensitization to Can f 1 (43%) was the most common, followed by Can f 5 (33%) among molecular allergens, while sensitization to lipocalins (56%) was the most common among component families. Polysensitization was found in 22% of all participants and was more common in participants with than in those without asthma. Subjects with asthma were less likely to be monosensitized to Can f 5 than those without asthma. Subjects with asthma had higher IgE levels of Can f 3, Can f 4 and Can f 6 than those without asthma. Overlapping sensitizations also differed between those with asthma and allergic rhinitis and those without.Increased knowledge about the sensitization patterns of dog allergen components can aid in defining their role in asthma and rhinitis. In complex clinical cases of dog allergy, a detailed analysis of dog allergen components can provide additional information on the nature of sensitization.
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| 10. |
- 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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| 11. |
- Goksör, Emma, 1974, et al.
(författare)
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Bradycardic response during submersion in infant swimming.
- 2002
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - 0803-5253. ; 91:3, s. 307-12
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Tidskriftsartikel (refereegranskat)abstract
- The diving response involves reflex bradycardia, apnoea and peripheral vasoconstriction and is known to exist in human infants. The response diminishes with increasing age and has been reported to disappear by the age of 6 mo. This study was performed to analyse the physiological events during natural diving of full-term healthy infants and describe how these events alter with maturation. Thirty-six infants were studied during diving exercises in infant swimming. All of the infants who participated showed an immediate decrease in heart rate when submerged. On average, the heart rate decreased by 25% (range -5.0% to -50.7%, p <0.0001). The bradycardia was sustained during the dive and for some seconds afterwards. The response was often followed by a tachycardia as the bradycardia ceased. A decline of reflex bradycardia was observed with increasing age (p = 0.03), but the response was still clearly evident in infants over the age of 6 mo.This study demonstrates the existence of a diving response in infants, which includes an immediate bradycardic response, suggesting vagal mediation. Although the bradycardic response gradually decreases, the study shows that a clear-cut response exists in children older than has previously been reported.
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| 12. |
- 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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| 13. |
- Goksör, Emma, 1974
(författare)
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Epidemiological Studies of Childhood Wheeze - Risk factors and Long-term Outcome
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Wheezing with viral infections is common in childhood and both genetic and environmental factors have been reported to influence the risk of subsequent asthma development. The overall aim of this thesis was to study the factors influencing the risk of wheezing at preschool age and the long-term outcome following severe wheezing in early life. In a prospective study of 5,600 children born in the region of western Sweden in 2003 questionnaires were answered at six and 12 months and at 4.5 years of age. Data were also obtained from the Swedish Medical Birth Register. Special reference was made to the effects of prenatal paracetamol exposure, antibiotic treatment during the first week of life and feeding strategies in infancy. Possible differences between multiple-trigger and episodic viral wheeze were analysed. In a prospective study of 101 children hospitalised due to wheezing bronchitis before the age of two years, the long-term prognosis and factors influencing the risk of subsequent asthma were explored. A re-investigation at 17-20 years of age included a questionnaire and tests for allergy, bronchial hyper-responsiveness (BHR) and airway function. The study group was compared with agematched controls. We were able to confirm known risk factors for recurrent wheeze at age 4.5 years, such as atopic heredity, male gender, eczema and doctor-diagnosed food allergy in infancy. In addition, neonatal antibiotic treatment increased the risk, while the introduction of fish before nine months of age reduced the risk. Paracetamol exposure in utero increased the risk of preschool wheeze treated with inhaled corticosteroids. The risk was more pronounced among those with multiple-trigger wheeze. An increased risk of asthma at age 17-20 years was seen in subjects with early viral wheeze. Current allergy, BHR and active smoking increased the risk of current asthma. In addition, female gender was an independent risk factor. Wheeze was more prevalent among boys in early childhood, but more boys than girls became symptom free as they grew up. Girls had more persistent asthma and relapsing symptoms during adolescence. Signs of reduced airway function were seen in the study group and were most pronounced among females with current asthma. However, a difference was also seen among symptom-free subjects. Prenatal smoke exposure was associated with reduced airway function and independently increased the risk of BHR at 17-20 years of age. On the other hand, postnatal smoke exposure was associated with becoming an active smoker, which in turn increased the risk of current asthma. In conclusion, paracetamol exposure during pregnancy and treatment with antibiotics neonatally independently increased the risk of wheeze at age 4.5 years. The early introduction of fish had a protective effect. Individuals with severe viral wheeze in early life run an increased risk of asthma and have signs of reduced airway function at age 17-20 years. The highest risk of asthma is seen among those with current allergy or BHR and among females. Prenatal smoke exposure increases the risk of subsequent BHR and asthma, while smoke exposure in infancy and childhood increases the risk of becoming an active smoker.
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| 14. |
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| 15. |
- 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.
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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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| 16. |
- 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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| 17. |
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| 18. |
- 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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| 19. |
- 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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| 20. |
- 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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| 21. |
- 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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| 22. |
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| 23. |
- 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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| 24. |
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| 25. |
- Ilmarinen, Pinja, et al.
(författare)
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Level of education and asthma control in adult-onset asthma
- 2022
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Ingår i: The Journal of asthma : official journal of the Association for the Care of Asthma. - : Informa UK Limited. - 1532-4303 .- 0277-0903. ; 59:4, s. 840-849
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Education in itself and as a proxy for socioeconomic status, may influence asthma control, but remains poorly studied in adult-onset asthma. Our aim was to study the association between the level of education and asthma control in adult-onset asthma. Methods: Subjects with current asthma with onset >15years were examined within the Obstructive Lung Disease in Northern Sweden study (OLIN, n=593), Seinäjoki Adult Asthma Study (SAAS, n=200), and West Sweden Asthma Study (WSAS, n=301) in 2009-2014 in a cross-sectional setting. Educational level was classified as primary, secondary and tertiary. Uncontrolled asthma was defined as Asthma Control Test (ACT) score ≤19. Altogether, 896 subjects with complete data on ACT and education were included (OLIN n=511, SAAS n=200 and WSAS n=185). Results: In each cohort and in pooled data of all cohorts, median ACT score was lower among those with primary education than in those with secondary and tertiary education. Uncontrolled asthma was most common among those with primary education, especially among daily ICS users (42.6% primary, 28.6% secondary and 24.2% tertiary; p=0.001). In adjusted analysis, primary education was associated with uncontrolled asthma in daily ICS users (OR 1.92, 95%CI 1.15-3.20). When stratified by atopy, the association between primary education and uncontrolled asthma was seen in non-atopic (OR 3.42, 95%CI 1.30-8.96) but not in atopic subjects. Conclusions: In high-income Nordic countries, lower educational level was a risk factor for uncontrolled asthma in subjects with adult-onset asthma. Educational level should be considered in the management of adult-onset asthma.
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| 26. |
- Lisik, Daniil, et al.
(författare)
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Birth order, sibship size, and risk of atopic dermatitis, food allergy, and atopy: A systematic review and meta-analysis
- 2023
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Ingår i: Clinical and translational allergy. - 2045-7022. ; 13:6
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Tidskriftsartikel (refereegranskat)abstract
- Atopic dermatitis and food allergy are two frequently concomitant manifestations of the presence of atopy. A substantial number of studies have been published on the association of birth order and sibship size (number of siblings) with atopic dermatitis, food allergy, and atopy. The present work is the first systematic synthesis of the existing literature on this topic.Fifteen databases were searched. Screening, data extraction, and quality assessment were performed by independent pairs. Comparable numerical data were statistically synthesized using random-effects robust variance estimation.In total, 114 studies were included out of 8819 papers obtained from database searches. Birth order ≥2 versus 1 was associated with lower risk of ever atopic dermatitis (pooled risk ratio [RR] 0.91, 95% CI 0.84-0.98), current food allergy (RR 0.77, 95% CI 0.66-0.90), and positive skin prick test (SPT) to common aeroallergens (RR 0.86, 95% CI 0.77-0.97). Sibship size ≥2 versus 1 was associated with decreased risk of current atopic dermatitis (RR 0.90, 95% CI 0.83-0.98), ever atopic dermatitis (RR 0.92, 95% CI 0.86-0.97), and positive SPT to common aeroallergens (RR 0.88, 95% CI 0.83-0.92). No putative associations were seen regarding atopy assessed through allergen-specific immunoglobulin E with common allergens.The presence of siblings and being second-born or later may decrease the lifetime risk of atopic dermatitis and food allergy, albeit marginally. Similar association was seen with SPT sensitization. However, significant protection was not found for IgE sensitization.
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| 27. |
- Lisik, Daniil, et al.
(författare)
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Is sibship composition a risk factor for childhood asthma? Systematic review and meta-analysis
- 2023
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Ingår i: World journal of pediatrics : WJP. - 1867-0687. ; 19:12, s. 1127-38
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Tidskriftsartikel (refereegranskat)abstract
- Following the "hygiene hypothesis", the role of sibship composition in asthma and wheezing has been extensively studied, but the findings are inconsistent. For the first time, this systematic review and meta-analysis synthesized evidences from studies investigating the association of sibship size and birth order with risk of asthma and wheezing.Fifteen databases were searched to identify eligible studies. Study selection and data extraction were performed independently by pairs of reviewers. Meta-analysis with robust variance estimation (RVE) was used to produce pooled risk ratio (RR) effect estimates from comparable numerical data.From 17,466 identified records, 158 reports of 134 studies (>3 million subjects) were included. Any wheezing in the last≤1.5years occurred more frequently in infants with≥1 sibling [pooled RR 1.10, 95% confidence interval (CI) 1.02-1.19] and≥1 older sibling (pooled RR 1.16, 95% CI 1.04-1.29). The pooled effect sizes for asthma were overall statistically nonsignificant, although having≥1 older sibling was marginally protective for subjects aged≥6years (pooled RR 0.93, 95% CI 0.88-0.99). The effect estimates weakened in studies published after 2000 compared with earlier studies.Being second-born or later and having at least one sibling is associated with a slightly increased risk of temporary wheezing in infancy. In contrast, being second-born or later is associated with marginal protection against asthma. These associations appear to have weakened since the turn of the millennium, possibly due to lifestyle changes and socioeconomic development. Video Abstract.
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| 28. |
- Lisik, Daniil, et al.
(författare)
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Machine learning-derived phenotypic trajectories of asthma and allergy in children and adolescents: protocol for a systematic review
- 2024
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Ingår i: BMJ open. - 2044-6055. ; 14:8
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Tidskriftsartikel (refereegranskat)abstract
- Development of asthma and allergies in childhood/adolescence commonly follows a sequential progression termed the 'atopic march'. Recent reports indicate, however, that these diseases are composed of multiple distinct phenotypes, with possibly differential trajectories. We aim to synthesise the current literature in the field of machine learning-based trajectory studies of asthma/allergies in children and adolescents, summarising the frequency, characteristics and associated risk factors and outcomes of identified trajectories and indicating potential directions for subsequent research in replicability, pathophysiology, risk stratification and personalised management. Furthermore, methodological approaches and quality will be critically appraised, highlighting trends, limitations and future perspectives.10 databases (CAB Direct, CINAHL, Embase, Google Scholar, PsycInfo, PubMed, Scopus, Web of Science, WHO Global Index Medicus and WorldCat Dissertations and Theses) will be searched for observational studies (including conference abstracts and grey literature) from the last 10 years (2013-2023) without restriction by language. Screening, data extraction and assessment of quality and risk of bias (using a custom-developed tool) will be performed independently in pairs. The characteristics of the derived trajectories will be narratively synthesised, tabulated and visualised in figures. Risk factors and outcomes associated with the trajectories will be summarised and pooled estimates from comparable numerical data produced through random-effects meta-analysis. Methodological approaches will be narratively synthesised and presented in tabulated form and figure to visualise trends.Ethical approval is not warranted as no patient-level data will be used. The findings will be published in an international peer-reviewed journal.CRD42023441691.
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| 29. |
- Lisik, Daniil, et al.
(författare)
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Siblings and risk of allergic rhinitis: A systematic review and meta-analysis
- 2023
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Ingår i: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. - 1399-3038. ; 34:7
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Tidskriftsartikel (refereegranskat)abstract
- Following the "hygiene hypothesis" and the increase in the prevalence of atopic diseases such as allergic rhinitis, a plethora of studies have investigated the role of sibship composition as a protective factor, but findings are conflicting. The aim of this study was to synthesize the global literature linking birth order and sibship size (number of siblings) to the risk of allergic rhinitis. Fifteen databases were systematically searched, with no restrictions on publication date or language. Observational studies with defined sibship composition (birth order or sibship size) as exposure and allergic rhinitis or allergic rhinoconjunctivitis (self-reported or clinically diagnosed) as outcome were eligible. Study selection, data extraction, and quality assessment were performed independently in pairs. Relevant data were summarized in tables. Comparable numerical data were analyzed using meta-analysis with robust variance estimation (RVE). Seventy-six reports with >2million subjects were identified. Being second- or later-born child was associated with protection against both current (pooled risk ratio [RR] 0.79, 95% CI 0.73-0.86) and ever (RR 0.77, 95% CI 0.68-0.88) allergic rhinitis. Having siblings, regardless of birth order, was associated with a decreased risk of current allergic rhinitis (RR 0.89, 95% CI 0.83-0.95) and allergic rhinoconjunctivitis (RR 0.92, 95% CI 0.86-0.98). These effects were unchanged across age, time period, and geographical regions. Our findings thus indicate that primarily, a higher birth order, and to a lesser extent the number of siblings, is associated with a lower risk of developing allergic rhinitis.
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| 30. |
- Lisik, Daniil, et al.
(författare)
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Sibship size, birth order and risk of asthma and allergy: protocol for a systematic review and meta-analysis
- 2021
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 11:8
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction The hygiene hypothesis suggests that reduced exposure to microbes might have contributed to the increase in prevalence and incidence of asthma and allergy observed during the second half of the last century. Following this proposal, several studies have investigated the role of sibship size and birth order in the development of asthma and allergic diseases, but the underlying evidence is conflicting. The objective of the present systematic review will be to identify, critically appraise and synthesise previous primary studies investigating the association of sibship size and birth order with the risk of asthma and allergic diseases. Methods and analysis The following databases will be searched: AMED, CABI, CINAHL, Embase, Google Scholar, OAIster, Open Access Theses and Dissertations, Open Grey, ProQuest Dissertations & Theses Global, PsycINFO, PubMed, SciELO, Scopus, Web of Science and WHO Global Index Medicus. Studies published up until 31 December 2020 will be eligible. There will be no restrictions by language and geographical location. Risk of bias in the included studies will be assessed using the Effective Public Health Practice Project quality assessment tool. The produced evidence will be synthesised narratively, and studies that present comparable numerical data will be included in meta-analyses using random effects model. Ethics and dissemination Only data from the published literature will be included in this systematic review. Therefore, no ethical approval is required. The final review paper will be published in a peer-reviewed journal. PROSPERO registration number CRD42020207905.
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| 31. |
- Loid, Petra, et al.
(författare)
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A persistently high body mass index increases the risk of atopic asthma at school age.
- 2015
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 1651-2227 .- 0803-5253. ; 104:7, s. 707-712
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Tidskriftsartikel (refereegranskat)abstract
- Being overweight has been associated with the risk of developing childhood asthma, but studies have produced conflicting results, for example with regard to possible links to allergic diseases. This study aimed to explore the relationship between body mass index (BMI) and school age asthma.
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| 32. |
- Pasanen, Anu, et al.
(författare)
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Genome-Wide Association Study of Polymorphisms Predisposing to Bronchiolitis.
- 2017
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Ingår i: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Bronchiolitis is a major cause of hospitalization among infants. Severe bronchiolitis is associated with later asthma, suggesting a common genetic predisposition. Genetic background of bronchiolitis is not well characterized. To identify polymorphisms associated with bronchiolitis, we conducted a genome-wide association study (GWAS) in which 5,300,000 single nucleotide polymorphisms (SNPs) were tested for association in a Finnish-Swedish population of 217 children hospitalized for bronchiolitis and 778 controls. The most promising SNPs (n=77) were genotyped in a Dutch replication population of 416 cases and 432 controls. Finally, we used a set of 202 Finnish bronchiolitis cases to further investigate candidate SNPs. We did not detect genome-wide significant associations, but several suggestive association signals (p<10(-5)) were observed in the GWAS. In the replication population, three SNPs were nominally associated (p<0.05). Of them, rs269094 was an expression quantitative trait locus (eQTL) for KCND3, previously shown to be associated with occupational asthma. In the additional set of Finnish cases, the association for another SNP (rs9591920) within a noncoding RNA locus was further strengthened. Our results provide a first genome-wide examination of the genetics underlying bronchiolitis. These preliminary findings require further validation in a larger sample size.
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| 33. |
- Pasanen, Anu, et al.
(författare)
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NKG2D gene variation and susceptibility to viral bronchiolitis in childhood.
- 2018
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Ingår i: Pediatric research. - : Springer Science and Business Media LLC. - 1530-0447 .- 0031-3998. ; 84, s. 451-457
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Tidskriftsartikel (refereegranskat)abstract
- Genetic factors associated with bronchiolitis are inadequately characterized. We therefore inspected a selected subpopulation of our previous genome-wide association study (GWAS) of bronchiolitis for overlap with known quantitative trait loci (QTLs) to identify susceptibility loci that potentially affect mRNA and protein levels.GWAS included a Finnish-Swedish case-control population (n=187), matched for age and site. We integrated GWAS variants (p<10-4) with QTL data. We subsequently verified allele-specific expression of identified QTLs by flow cytometry. Association of the resulting candidate loci with bronchiolitis was tested in three additional cohorts from Finland and Denmark (n=1201).Bronchiolitis-susceptibility variant rs10772271 resided within QTLs previously associated with NKG2D (NK group 2, member D) mRNA and protein levels. Flow cytometric analysis confirmed the association with protein level in NK cells. The GWAS susceptibility allele (A) of rs10772271 (odds ratio [OR]=2.34) corresponded with decreased NKG2D expression. The allele was nominally associated with bronchiolitis in one Finnish replicate (OR=1.50), and the other showed directional consistency (OR=1.43). No association was detected in Danish population CONCLUSIONS: The bronchiolitis GWAS susceptibility allele was linked to decreased NKG2D expression in the QTL data and in our expression analysis. We propose that reduced NKG2D expression predisposes infants to severe bronchiolitis.
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| 34. |
- Rentzos, Georgios K., et al.
(författare)
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Prevalence of food hypersensitivity in relation to IgE sensitisation to common food allergens among the general adult population in West Sweden
- 2019
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Ingår i: Clinical and Translational Allergy. - : Wiley. - 2045-7022. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe prevalence of self-experienced adverse reactions to foods seems to have an increasing trend in both adults and children. However, it is unclear if the prevalence of food hypersensitivity in the Swedish adult population is still rising, what symptoms are caused by different foods and which are the most common foods to which adults are more frequently IgE-sensitised.MethodsIn a cross-sectional study based on questionnaire responses, interviews and clinical examinations as part of the West Sweden Asthma Study, 1042 subjects from the general population, 17-78years of age, living in Vastra Gotaland, Sweden, were included. The subjects reported symptoms for 56 specified foods and blood samples were taken to examine the IgE-sensitisation pattern for 9 common foods.ResultsApproximately 32% of adults reported food hypersensitivity, affecting mostly women and subjects less than 61years old. The foods most often reported to cause adverse reactions were hazelnut (8.9%), apple (8.4%), milk (7.4%) and kiwi (7.3%). Less than one percent (0.9%) reported symptoms from ingestion of meat. Symptoms mostly affected the gastrointestinal tract (15%) and the skin (2.7%). Sixteen per cent were IgE-sensitised to common foods, most often to hazelnut (13.3%), peanut (4.9%) and almond (3.0%), while 5.9% reported symptoms and were IgE-sensitised to the same food, mainly to hazelnut (5.3%).ConclusionsThe prevalence of self-reported food hypersensitivity in West Sweden indicates a rising trend. The correspondence between self-reported symptoms and IgE-sensitisation to foods is generally poor, except for hazelnut and almond which exhibit moderate or fair correlation.
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| 35. |
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| 36. |
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| 37. |
- Strömberg Celind, Frida, 1980, et al.
(författare)
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Antibiotics in the first week of life were associated with atopic asthma at 12 years of age.
- 2018
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Ingår i: Acta paediatrica. - : Wiley. - 1651-2227 .- 0803-5253. ; 107:10, s. 1798-1804
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Tidskriftsartikel (refereegranskat)abstract
- This study explored the prevalence of atopic and nonatopic asthma in 12-year-old children and whether they were associated with different risk factors. In particular, we wanted to analyse whether receiving antibiotics during the first week of life was associated with asthma at that age.Data were obtained from a longitudinal cohort study of 5654 Swedish children born in 2003. The parents answered questionnaires from the age of six months until 12 years. The response rate at 12 years was 3637/4777 (76%).At 12 years, 6.4% reported current doctor-diagnosed asthma. Treatment with antibiotics during the first week of life was associated with an increased risk of atopic asthma, with an adjusted odds ratio of 2.2 and 95% confidence interval of 1.2-4.2. Being born small for gestational age was associated with an increased risk of nonatopic asthma, with an adjusted odds ratio of 3.8 and 95% confidence interval of 1.1-13.7. Asthma that only occurred with colds was reported by 28%.Antibiotic treatment during the first week of life was associated with an increased risk of atopic asthma at 12 years, suggesting an immune-mediated effect. Being born small for gestational age increased the risk of nonatopic asthma.
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| 38. |
- Strömberg Celind, Frida, 1980, et al.
(författare)
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Area-based study shows most parents follow advice to reduce risk of sudden infant death syndrome.
- 2017
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253. ; 104:4, s. 579-585
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Tidskriftsartikel (refereegranskat)abstract
- Guidance on reducing the risk of sudden infant death syndrome (SIDS) was successfully introduced to a number of countries in the early 1990s. The most important recommendations were supine sleeping for infants and non-smoking for mothers. This 2012-2014 study examined adherence to the national Swedish SIDS advice.We asked 1,000 parents with infants registered at child healthcare centresin western Sweden to complete a questionnaire on infant care from birth to 12 months of age.We analysed 710 responses and found that, in the first three months, 1.3% of the infants were placed in the prone sleeping position and 14.3% were placed on their side. By three to five months this had risen to 5.6% and 23.6%. In the firstthree months, 83.1% were breastfed, 84.1% used a pacifier and 44.2% shared their parents' bed, while 5.8% slept in another room. Bed sharing was more likely if infants were breastfed and less likely if they used pacifiers. During pregnancy, 2.8% of the mothers smoked and the mothers who had smoked during pregnancy were less likely to bed share.Overall adherence to the SIDS advice was good, but both prone and side sleeping practices should be targeted. This article is protected by copyright. All rights reserved.
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| 39. |
- Strömberg Celind, Frida, 1980, et al.
(författare)
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Higher parental education was associated with better asthma control
- 2019
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 108:5, s. 920-926
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Tidskriftsartikel (refereegranskat)abstract
- Inhaled corticosteroids have resulted in the improved control of asthma and a reduced need for hospitalisation. This study aimed to examine the prevalence of uncontrolled asthma and factors that affect asthma control.The data came from a longitudinal cohort study of children. The parents answered questionnaires from age 6months to 12years. The response rate at age 12years was 76% (3637/4777) and doctor-diagnosed asthma was reported in 6.4% (n=233). Asthma control was examined with the Asthma Control Test (ACT), where scores below 20 denote uncontrolled asthma.Of the children with asthma at age 12 years, 15% had an ACT value below 20, that is uncontrolled asthma. Independent risk factors for uncontrolled asthma were wheeze triggered by exercise (adjusted OR, aOR 5.6; 1.9-16.6), cat at home (aOR 3.5; 1.2-10.0) and current doctor-diagnosed rhinitis (aOR 2.8; 95% CI 1.1-7.0). A higher education in the parents reduced the risk of uncontrolled asthma (aOR 0.3; 95% CI 0.1-0.8). Only six children (i.e. 2.6%) reported hospitalisation due to asthma during the last year.Of the children with asthma, 15% had uncontrolled asthma. Higher education in the parents was associated with better asthma control in the children.
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| 40. |
- Strömberg Celind, Frida, 1980, et al.
(författare)
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Infants were introduced to complementary feeding earlier in 2018 compared with 2003
- 2023
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 112:7, s. 1485-1492
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Tidskriftsartikel (refereegranskat)abstract
- Until 2001, the Swedish advice was to postpone the introduction of eggs, fish and peanuts until the age of one year. One reason was to reduce the risk of food allergy. The earlier introduction of complementary feeding is now advised. Our aim was to study adherence to current recommendations and whether the time of introduction changed between 2003 and 2018.Data were obtained from two prospective, longitudinal, population-based cohort studies of children born in 2003 (n=4,987) and in 2018 (n=3,936). Parents answered comparable questionnaires when the children were six and twelve months old.At six months, in the 2018 cohort, eggs were introduced to 67.2% of the infants, fish to 78.9%, gluten to 89.1%, cow's milk to 76.6% and peanuts to 46.2%. In adjusted Cox regression analyses, introduction of complementary feeding with gluten, fish and eggs was made significantly earlier in the 2018 cohort compared with the 2003 cohort, adjusted for heredity, own allergic disease and parental educational level (p <0.01).Complementary feeding with eggs, fish and gluten was introduced earlier in infants born in 2018 compared with 2003, possibly reducing the risk of developing allergic disease. Current recommendations from child welfare centres are being followed.
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| 41. |
- Strömberg Celind, Frida, 1980, et al.
(författare)
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Parental questionnaires provided reliable data on childhood asthma compared with national registers
- 2021
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Ingår i: Pediatric Allergy and Immunology. - : Wiley. - 0905-6157 .- 1399-3038. ; 32:5, s. 917-924
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Tidskriftsartikel (refereegranskat)abstract
- Background Much of our knowledge of childhood asthma comes from questionnaire-based studies. Our main aim was to assess the agreement between parental-reported data at 12 years of age and data from two national Swedish registers. Methods Data were obtained from the prospective, longitudinal, population-based Children of Western Sweden cohort, which focused on children born in 2003. The parents answered questionnaires at six months and one, four, eight and 12 years of age. Personal identity numbers linked 3634 children to the Swedish Prescribed Drug Register (SPDR) and the National Patient Register (NPR). Results At 12 years of age, there was substantial overall agreement between the asthma medication reported by the parents in the questionnaire and the SPDR for any asthma medication (94.8%, kappa 0.71) and maintenance treatment (95.3%, kappa 0.68). In contrast, the agreement between the outpatient asthma diagnoses in the NPR and the questionnaire-based asthma was 30.5% and it was 32.8% between the NPR and the dispensed asthma medication in the SPDR. Hospitalization was rare for obstructive diseases after early childhood, and 38.2% of the 12-year-old children only received a short-acting beta agonist, with no maintenance treatment. Conclusion There was good agreement between the questionnaire-based data on asthma medication and the national drug register, but the National Patient Register provided incomplete information on asthma diagnoses, probably because it did not include primary care diagnoses. The results show that well-constructed parental questionnaires can provide reliable data on childhood asthma.
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| 42. |
- Vasileiadou, Styliana, et al.
(författare)
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Asthma increased in young adults from 2008-2016 despite stable allergic rhinitis and reduced smoking
- 2021
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 16:6
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Tidskriftsartikel (refereegranskat)abstract
- Background Studies have produced inconsistent results on prevalence trends in asthma and allergic rhinitis (AR). We surveyed young adults about asthma in 2008 and 2016 and examined the impact of gender, AR and smoking. Methods Thirty-thousand randomly selected subjects aged 16-75 years in Western Sweden received postal questionnaires in 2008 and 50,000 in 2016. This study is based on responders aged 16-25 years, 2,143 in 2008 and 2,484 in 2016. Results From 2008-2016 current asthma increased from 9.3% to 11.5% (p = 0.014) and was significant in males without AR (aOR 1.83, 95% CI 1.09-3.07) and male smokers (aOR 3.02, 95% CI 1.12-8.13). In both years the risk of current asthma was reduced by growing up on a farm (aOR 0.26, 95% CI 0.81-0.84 and aOR 0.47, 95% CI 0.23-0.996), independent of a family history of asthma or allergy. AR did not differ significantly from 2008-2016 (22.5% vs 24.4%, p = 0.144). Current smoking decreased from 20.3% to 15.2% (p<0.001), especially in females (23.5% to 16.2%, p<0.001). Female smokers started smoking later and smoked fewer cigarettes in 2016 than 2008. In 2016, 4.8% of the cohort reported using electronic cigarettes. Of those, 60.7% also smoked tobacco and more than two-thirds who used both (67.2%) were heavy smokers. Conclusion Current asthma increased in respondents aged 16-25 from 2008-2016, mainly among males without AR and male smokers. Current AR levelled off in this young population, while current smoking decreased among females.
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| 43. |
- Vasileiadou, Styliana, et al.
(författare)
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Eating fish and farm life reduce allergic rhinitis at the age of twelve
- 2018
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Ingår i: Pediatric allergy and immunology. - : Wiley. - 1399-3038 .- 0905-6157. ; 29:3, s. 283-289
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Tidskriftsartikel (refereegranskat)abstract
- The prevalence of allergic rhinitis has increased, but the cause of this rise is partly unknown. Our aim was to analyse the prevalence, risk factors, and protective factors for allergic rhinitis in 12-year-old Swedish children.Data were collected from a prospective, longitudinal cohort study of children born in western Sweden in 2003. The parents answered questionnaires when the children were 6months to 12years. The response rate at 12years was 76% (3637/4777) of the questionnaires distributed.At the age of 12, 22% of children had allergic rhinitis and 57% were boys. Mean age at onset was 7.8years, and 55% reported their first symptoms after 8years. The most common trigger factors were pollen (85%), furry animals (34%), and house dust mites (17%). A multivariate analysis showed that the adjusted odds ratios and 95% confidence intervals for the independent risk factors for allergic rhinitis at 12 were as follows: parental allergic rhinitis (2.32, 1.94-2.77), doctor-diagnosed food allergy in the first year (1.75, 1.21-2.52), eczema in the first year (1.61, 1.31-1.97), and male gender (1.25, 1.06-1.47). Eating fish once a month or more at age of 12months reduced the risk of allergic rhinitis at 12years of age (0.70, 0.50-0.98) as did living on a farm with farm animals at 4years (0.51, 0.32-0.84). Continuous farm living from age 4 to 12 seemed to drive the association.Allergic rhinitis affected > 20% of 12-year-olds, but was lower in children who ate fish at 12months or grew up on a farm with farm animals.
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| 44. |
- Vasileiadou, Styliana, et al.
(författare)
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Low agreement between Swedish national registers and parental questionnaires on allergic rhinitis
- 2023
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Ingår i: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. - 1399-3038. ; 34:11
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Tidskriftsartikel (refereegranskat)abstract
- Allergic rhinitis (AR) has been well documented using questionnaire-based studies. Here, we examine the agreement between parental-reported data during childhood with the emphasis on 12-year-olds and data from two national Swedish registers to determine whether register data on AR can supplement or replace questionnaire data.Data were collected from a prospective, longitudinal cohort study of children born in western Sweden in 2003. Parental questionnaires were filled out at 6months and one, four, eight, and 12years of age. A total of 3634 children were linked to the Swedish Prescribed Drug Register (SPDR) and the National Patient Register (NPR) using personal identity numbers. The agreement between the register and questionnaire data was estimated using Cohen's kappa with 95% confidence intervals.According to the SPDR, 9.9% (n=360/3634) of the children were dispensed specific AR medication at 11-13years of age compared with the 12years questionnaire where 23% reported AR medication use during the last 12months. The overall agreement between questionnaire and SPDR data on AR medication was slight (kappa 0.05). At 11-12years, 1.8% (n=65/3634) of the children received an outpatient AR diagnosis in the NPR, while 10% reported doctor-diagnosed AR in the questionnaire. The overall agreement between questionnaire and NPR data on AR diagnosis was slight (kappa 0.16).There was poor agreement between questionnaire and register data regarding AR and dispensed medication. Explanations could include over-the-counter drugs and diagnosis in primary care, which are not included in the registers.
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| 45. |
- Vasileiadou, Styliana, et al.
(författare)
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Reply to Mariam Zaidi.
- 2018
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Ingår i: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. - : Wiley. - 1399-3038. ; 29:5, s. 574-575
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Tidskriftsartikel (refereegranskat)
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| 46. |
- Wennergren, Göran, 1947, et al.
(författare)
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Allergisjukdomar
- 2020
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Ingår i: Barnmedicin. - Lund : Studentlitteratur AB. - 9789144129563 ; , s. 437-450
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Bokkapitel (refereegranskat)
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| 47. |
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| 48. |
- Wennergren, Göran, 1947, et al.
(författare)
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Swedish survey of infant sleep practices showed increased bed sharing and positive associations with breastfeeding
- 2021
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 110:6, s. 1835-1841
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Many countries lack monitoring of infant sleep practices, despite associations with sudden infant death. We studied sleep positions, bed sharing and breastfeeding in a new birth cohort. Methods: Data were obtained from a prospective, population-based cohort study of children born in western Sweden in 2018. The parents of 9,465 six-month-old infants, via postal questionnaires, were asked about their infants' sleeping positions at three and six months, including where they slept and any bed sharing arrangements. The data were compared with our earlier 2003-2004 birth cohort. Results: Questionnaires were completed by the parents of 3,590 (38%) infants. At three months, 54% of the infants slept in a separate cot in their parents' room. A further 43% slept in their parents' bed: 42% in baby nests and 42% in close contact with their parents. At six months, 33% bed shared, compared to 20% in 2003-2004 (p<0.001). Bed sharing was positively associated with breastfeeding (odds ratio at three months 1.5-2.8, 95% confidence interval 1.1-4.5). Conclusion: Most infants slept in separate cots during the first three months. However, bed sharing showed an increasing trend and baby nests were popular. Bed sharing was positively associated with breastfeeding, but the association may not be causal.
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