Birth Weight for Gestational Age and the Risk of Asthma in Childhood and Adolescence: A Retrospective Cohort Study
Notice bibliographique
Résumé
To evaluate the possible correlation between birth weight for gestational age and asthma in childhood and adolescents.This was a cohort of all children of a term (≥37 weeks), singleton gestation born in the Canadian province Nova Scotia between January 1, 1989, and December 31, 2014.The retrospective cohort was created through the Nova Scotia Atlee Perinatal Database and with provincial administrative health data. Linkage was conducted by Health Data Nova Scotia on the basis of the health card number. Infants were categorized as small for gestational age (SGA; < 10th percentile), large for gestational age (LGA; >90th percentile), or appropriate for gestational age (10th–90th percentile). Birth weight z scores were calculated by using sex- and gestational age–specific means and SDs from the same reference population. Confounders included the following: maternal age, area of residence (urban versus rural), area-level income quintile at birth, parity, prepregnancy weight status (normal, overweight, or obese), asthma during pregnancy, mode of delivery (vaginal delivery versus cesarean delivery), and smoking in pregnancy (yes or no). Unadjusted and adjusted Cox proportional hazards regression with robust SEs was used to estimate the association between birth weight for gestational age and asthma. Associations between birth weight for gestational age and smoking in pregnancy were also examined.The final sample included 40 727 children. Of those, 10 155 children (23.6%) had asthma by 6 years of life, and 12 997 children (30.2%) had asthma during the first 18 years of life. LGA was not associated with the risk of developing asthma. There was an additive interaction between SGA and smoking. In mothers who smoked, there was an increased risk for asthma in children with low birth weight. However, in mothers who do not smoke, there was no increased risk of asthma across the birth weight spectrum among children.Term infants who are SGA are not at increased risk for asthma in the absence of smoking during pregnancy. There is also no association between LGA and the development of asthma.Infants who are low birth weight are believed to be at increased risk for asthma in childhood, but multiple factors may influence this risk. This cohort has an impressive number of infants managed in a universal health care system, in which asthma diagnosis sensitivity is 89% and specificity is 72% for this population, based on physician diagnosis, not parent recall. This study is unique in that with its regression models it was able to clearly demonstrate the role smoking has on the development of asthma. Prenatal smoking has a significantly stronger negative influence on developing asthma than early postnatal exposures. SGA infants born to smoking mothers are at a significantly increased risk for asthma. It was also interesting that although LGA infants are at risk later for obesity (a risk factor for asthma), they have no increase in asthma. Prevention of childhood asthma is essential to decrease future morbidity and possible mortality. The more risk factors we understand, the better counseling we can provide mothers early in pregnancy. Do not smoke!
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».