Preterm infant growth and asthma at age 8years
Preterm infant growth and asthma at age 8years
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DOI：
10.1136/archdischild-2015-308340
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发表时间：
2016-05-01
影响因子：
4.4
通讯作者：
McCormick, Marie C.
中科院分区：
文献类型：
--
作者：
Belfort, Mandy B.;Cohen, Robyn T.;McCormick, Marie C.
目的研究一组早产儿8岁时体重指数（BMI）的增加和足月至18个月的线性生长与哮喘的关系。我们假设BMI快速增加会增加哮喘风险，而快速线性增长则具有保护作用。设计对婴儿健康与发展项目数据进行观察性二次分析。在美国设立了8个中心。863例早产（37周）、低出生体重（2500g）患儿。主要暴露变量体重指数（BMI）的增加以及z-score中从第1个月到第4个月、第4-12个月和第12-18个月的线性增长。主要结局指标：8岁时的哮喘，由父母报告评估儿童是否接受过医生的诊断。结果8岁时，149例（17%）曾被诊断为哮喘。在logistic回归中调整了母婴因素，从足月到4个月，BMI每增加一个z分数，8岁时哮喘的几率就会增加（OR 1.3, 95% CI 1.1至1.5）；4-12个月BMI增加的结果相似。从足月到4个月的快速线性生长与较低的哮喘发生率无关（OR 1.1, 95% CI 0.9至1.3），4-12个月和12-18个月的结果相似。结论：出生后第一年体重指数增长越快，患哮喘的几率越高，而线性增长似乎没有保护作用。我们的研究结果进一步证明，足月后体重增加过多可能对早产儿有害。
Objectives To examine associations of gain in body mass index (BMI) and linear growth from term to 18months with asthma at age 8years in a cohort of preterm infants. We hypothesised that rapid BMI gain would increase asthma risk, whereas rapid linear growth would be protective.Design Observational secondary analysis of data from the Infant Health and Development Program.Setting 8 centres in the USA.Patients 863 preterm (37weeks), low birthweight (2500g) children.Main exposure variables Gain in BMI and linear growth from term to 4 months, 4-12 months and 12-18months, in z-scores.Main outcome measure Asthma at age 8 years, assessed by parent report of the child ever receiving the diagnosis from a doctor.Results At age 8years, 149 (17%) had ever been diagnosed with asthma. Adjusting for maternal and child factors in logistic regression, for each additional z-score gain in BMI from term to 4months, odds of asthma at age 8 years were higher (OR 1.3, 95% CI 1.1 to 1.5); findings were similar for BMI gain from 4-12months. More rapid linear growth from term to 4months was not associated with lower odds of asthma (OR 1.1, 95% CI 0.9 to 1.3), with similar findings for 4-12 months and 12-18months.Conclusions More rapid BMI gain in the 1st year of life was associated with higher odds of asthma, whereas linear growth did not appear protective. Our results add to mounting evidence that excess weight gain after term may be harmful to preterm infants.