Antenatal steroid therapy for fetal lung maturation and the subsequent risk of childhood asthma
Bibliographic record
Abstract
The prevalence of childhood asthma saw a dramatic rise from the 1980's up until the early 2000's. Among the explanations for this increase in asthma prevalence are exposures occurring in the gestational period. Overlapping the time period of the increasing prevalence of childhood asthma is an increased use of antenatal corticosteroid therapy for fetal lung maturation. The objective of this thesis is to examine the hypothesis that fetal exposure to corticosteroids in the antenatal period is an independent risk factor for the development of asthma in childhood with the greatest increased risk being in early childhood with little or no risk in late childhood. A population-based cohort study of all pregnant women who resided in Nova Scotia, Canada, and gave birth to a singleton fetus between January 1989 and December 1998, who lived to discharge was undertaken. Using linked health care utilization records, incident asthma cases after 36 months of age were identified. Generalized Estimating Equations were used to estimate the odds ratio of the association between exposure to corticosteroids and the diagnosis of childhood asthma between 36 and 72 months of age. Extended Cox proportional hazards models were used to estimate hazard ratios of the association between exposure to antenatal corticosteroids and the onset of asthma at different ages. Over the 10 year time period of the study corticosteroid therapy increased threefold. Exposure to antenatal corticosteroids was associated with a significant increased risk of developing childhood asthma between 36 and 72 months of age: adjusted odds ratio of 1.23 (95 percent confidence interval: 1.06, 1.44). When examining the time dependent nature of this increased risk, asthma in childhood between 3--5 years of age was seen to have an increased risk: adjusted hazard ratio of 1.19 (95 percent confidence interval: 1.03, 1.39), with no significant association noted after 5 years of age: adjusted hazard ratio for 5--7 years was 1.06 (95 percent confidence interval: 0.86, 1.30) and for 8 or greater years was 0.74 (95 percent confidence interval: 0.54, 1.03). Antenatal steroid therapy appears to be an independent risk factor for the development of asthma childhood, specifically between the ages of 3 to 5 years. Further research into the smallest possible steroid dose required to achieve the desired postnatal effect could be undertaken to reduce the risk of developing childhood asthma.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".