Yabin Hu1, Yiting Chen2, Shijian Liu1, Fan Jiang3, Meiqin Wu4, Chonghuai Yan4, Jianguo Tan5, Guangjun Yu6, Yi Hu6, Yong Yin7, Jiajie Qu8, Shenghui Li9, Shilu Tong10,11,12,13. 1. Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Pudong, Shanghai, 200127, China. 2. School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu, Shanghai, 200025, China. 3. Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 4. Shanghai Key Laboratory of Environmental and Child Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 5. Shanghai Key Laboratory of Meteorology and Health (Shanghai Meteorological Service), Shanghai, China. 6. Center for Biomedical Informatics, Shanghai Children's Hospital, Shanghai, China. 7. Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 8. Shanghai Municipal Education Commission, Shanghai, China. 9. School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu, Shanghai, 200025, China. lsh9907@163.com. 10. Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Pudong, Shanghai, 200127, China. tongshilu@scmc.com.cn. 11. School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China. tongshilu@scmc.com.cn. 12. Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China. tongshilu@scmc.com.cn. 13. School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia. tongshilu@scmc.com.cn.
Abstract
BACKGROUND: Childhood asthma and allergic diseases are a significant global problem. There are inconsistent findings on the associations of delivery mode, the number of children in the household and breastfeeding with childhood asthma and allergic diseases. We assessed these associations and examined whether breastfeeding modified the effects of neonatal and familial risk factors on childhood asthma and allergic diseases. METHODS: A population-based cross-sectional study was conducted in Shanghai, China. A total of 17 primary schools were randomly selected from 13 districts of Shanghai in this study. The International Study of Asthma and Allergies in Childhood questionnaire was adopted to assess the childhood asthma and allergic diseases. Multivariable logistic regression models were used to evaluate the associations between neonatal and familial factors and childhood asthma and allergic diseases, and to examine the modification effects of breastfeeding on the associations assessed. RESULTS: Of 10,464 primary school children aged 6-11 years, the overall prevalence of childhood asthma, allergic rhinitis, urticaria, food allergy and drug allergy was 13.9, 22.7, 15.3, 8.1 and 4.6%, respectively. Male sex, high socioeconomic status, cesarean section delivery, only one child in the household and having family history of allergy were associated with increased odds ratio (OR) of childhood asthma and allergic diseases while longer breastfeeding duration (> 6 months) was inversely associated with these diseases. Longer breastfeeding duration also attenuated the OR of neonatal and familial risk factors on childhood asthma and allergic diseases. For instance, the adjusted OR of childhood asthma in the group of vaginal delivery and breastfeeding duration > 6 months was lowest (0.78, 95% confidence interval: 0.66, 0.92). CONCLUSIONS: Longer breastfeeding duration was inversely associated with childhood asthma and allergic diseases, and also reduced the OR of neonatal and familial risk factors on these diseases. Giving the prevalence of childhood asthma and allergic diseases is rapidly rising across the globe, these findings may have important clinical and public health implications.
BACKGROUND:Childhood asthma and allergic diseases are a significant global problem. There are inconsistent findings on the associations of delivery mode, the number of children in the household and breastfeeding with childhood asthma and allergic diseases. We assessed these associations and examined whether breastfeeding modified the effects of neonatal and familial risk factors on childhood asthma and allergic diseases. METHODS: A population-based cross-sectional study was conducted in Shanghai, China. A total of 17 primary schools were randomly selected from 13 districts of Shanghai in this study. The International Study of Asthma and Allergies in Childhood questionnaire was adopted to assess the childhood asthma and allergic diseases. Multivariable logistic regression models were used to evaluate the associations between neonatal and familial factors and childhood asthma and allergic diseases, and to examine the modification effects of breastfeeding on the associations assessed. RESULTS: Of 10,464 primary school children aged 6-11 years, the overall prevalence of childhood asthma, allergic rhinitis, urticaria, food allergy and drug allergy was 13.9, 22.7, 15.3, 8.1 and 4.6%, respectively. Male sex, high socioeconomic status, cesarean section delivery, only one child in the household and having family history of allergy were associated with increased odds ratio (OR) of childhood asthma and allergic diseases while longer breastfeeding duration (> 6 months) was inversely associated with these diseases. Longer breastfeeding duration also attenuated the OR of neonatal and familial risk factors on childhood asthma and allergic diseases. For instance, the adjusted OR of childhood asthma in the group of vaginal delivery and breastfeeding duration > 6 months was lowest (0.78, 95% confidence interval: 0.66, 0.92). CONCLUSIONS: Longer breastfeeding duration was inversely associated with childhood asthma and allergic diseases, and also reduced the OR of neonatal and familial risk factors on these diseases. Giving the prevalence of childhood asthma and allergic diseases is rapidly rising across the globe, these findings may have important clinical and public health implications.
Entities:
Keywords:
Allergic disease; Association; Asthma; Breastfeeding; Children
Authors: Norbert Krautenbacher; Michael Kabesch; Elisabeth Horak; Charlotte Braun-Fahrländer; Jon Genuneit; Andrzej Boznanski; Erika von Mutius; Fabian Theis; Christiane Fuchs; Markus J Ege Journal: Pediatr Allergy Immunol Date: 2020-10-15 Impact factor: 6.377