| 1. |
- 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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| 2. |
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| 3. |
- 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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| 4. |
- 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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| 5. |
- Fellman, Vineta, et al.
(författare)
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One-year survival of extremely preterm infants after active perinatal care in Sweden.
- 2009
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Ingår i: JAMA : the journal of the American Medical Association. - : American Medical Association (AMA). - 1538-3598 .- 0098-7484. ; 301:21, s. 2225-33
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Tidskriftsartikel (refereegranskat)abstract
- Up-to-date information on infant survival after extremely preterm birth is needed for assessing perinatal care services, clinical guidelines, and parental counseling.
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| 6. |
- 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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| 7. |
- 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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| 8. |
- 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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