J Gerlich1,2, N Benecke3, A S Peters-Weist1, S Heinrich1, D Roller3, J Genuneit4, G Weinmayr4, D Windstetter1, H Dressel1,5, U Range6, D Nowak1,2, E von Mutius2,7, K Radon1,2, C Vogelberg3. 1. Institute and Clinic for Occupational, Social, and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany. 2. Comprehensive Pneumology Center Munich, German Center for Lung Research, Munich, Germany. 3. Paediatric Department, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany. 4. Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany. 5. Institute for Epidemiology, Biostatistics and Prevention, Zürich University, Zürich, Switzerland. 6. Institute for Medical Informatics and Biometry, Medical Faculty, "Carl Gustav Carus", TU, Dresden, Germany. 7. Dr v Haunersches Kinderspital, University Hospital, LMU Munich, Munich, Germany.
Abstract
BACKGROUND: Previous studies showed controversial results for the influence of pregnancy-related and perinatal factors on subsequent respiratory and atopic diseases in children. The aim of this study was to assess the association between perinatal variables and the prevalence of asthma, bronchial hyperreactivity (BHR), flexural eczema (FE), allergic rhinitis, and sensitization in childhood and early adulthood. METHODS: The studied population was first examined in Munich and Dresden in 1995/1996 at age 9-11 years. Participants were followed until age 19-24 years using questionnaires and clinical examinations. Associations between perinatal data and subsequent atopic diseases were examined using logistic regression analyses adjusting for potential confounders. RESULTS: Cesarean section was statistically significantly associated with BHR in early adulthood (odds ratio 4.8 [95% confidence interval 1.5-15.2]), while assisted birth was associated with presence of asthma symptoms in childhood (2.2 [1.2-3.9]), FE symptoms (2.2 [1.2-4.3]) and doctor's diagnosis of atopic dermatitis (1.9 [1.0-3.4]) in childhood, and sensitization in early adulthood (2.2 [1.1-4.3]). Lower birth length (1.9 [1.1-3.2]), lower birthweight (0.5 [0.3-0.9]), and higher birthweight (0.6 [0.4-1.0]) were predictive of sensitization in early adulthood compared to average birth length and birthweight, respectively. None of the other perinatal factors showed statistically significant associations with the outcomes. CONCLUSIONS: Our results indicate that children who are born by cesarean section and especially by assisted birth, might be at greater risk for developing asthma, FE, and sensitization and should hence be monitored. Prenatal maternal stress might partly explain these associations, which should be further investigated.
BACKGROUND: Previous studies showed controversial results for the influence of pregnancy-related and perinatal factors on subsequent respiratory and atopic diseases in children. The aim of this study was to assess the association between perinatal variables and the prevalence of asthma, bronchial hyperreactivity (BHR), flexural eczema (FE), allergic rhinitis, and sensitization in childhood and early adulthood. METHODS: The studied population was first examined in Munich and Dresden in 1995/1996 at age 9-11 years. Participants were followed until age 19-24 years using questionnaires and clinical examinations. Associations between perinatal data and subsequent atopic diseases were examined using logistic regression analyses adjusting for potential confounders. RESULTS: Cesarean section was statistically significantly associated with BHR in early adulthood (odds ratio 4.8 [95% confidence interval 1.5-15.2]), while assisted birth was associated with presence of asthma symptoms in childhood (2.2 [1.2-3.9]), FE symptoms (2.2 [1.2-4.3]) and doctor's diagnosis of atopic dermatitis (1.9 [1.0-3.4]) in childhood, and sensitization in early adulthood (2.2 [1.1-4.3]). Lower birth length (1.9 [1.1-3.2]), lower birthweight (0.5 [0.3-0.9]), and higher birthweight (0.6 [0.4-1.0]) were predictive of sensitization in early adulthood compared to average birth length and birthweight, respectively. None of the other perinatal factors showed statistically significant associations with the outcomes. CONCLUSIONS: Our results indicate that children who are born by cesarean section and especially by assisted birth, might be at greater risk for developing asthma, FE, and sensitization and should hence be monitored. Prenatal maternal stress might partly explain these associations, which should be further investigated.
Authors: Azahara María García-Serna; Elena Martín-Orozco; Trinidad Hernández-Caselles; Eva Morales Journal: Int J Environ Res Public Health Date: 2021-04-09 Impact factor: 3.390
Authors: Éadaoin M Butler; Valentina Chiavaroli; José G B Derraik; Celia P Grigg; Brooke C Wilson; Nicholas Walker; Justin M O'Sullivan; Wayne S Cutfield Journal: Medicine (Baltimore) Date: 2020-07-24 Impact factor: 1.817