Infant Viral Exposure and Risk of Childhood Asthma

描述(申请人提供)：这项研究申请的目的是探索婴儿期病毒暴露强度对五岁前哮喘发展的影响，并确定婴儿期季节性呼吸道病毒感染增加儿童哮喘易感性的关键时间段。使用田纳西州医疗补助索赔数据与出生证明相关联的已建立的研究基础设施，我们将使用培训数据集确定与儿童哮喘高风险相关的关键年龄段。病毒暴露强度和婴儿年龄与儿童哮喘发病的关系将在单独的测试数据集中进行研究。此外，还将研究婴儿接触病毒与母亲哮喘(家庭危险因素)和母亲吸烟(环境危险因素)之间的潜在交互影响。限制性三次样条法将用于确定病毒暴露年龄、强度和儿童哮喘发展之间的平滑关系。这项研究的意义涉及识别关键时间段的可能性，在此期间预防感染可以防止或改变易患宿主的哮喘的表型表达。

DESCRIPTION (provided by applicant): The objective of this research application is to explore the influence of viral exposure intensity during infancy on the development of asthma by age five years, and to identify critical time periods in infancy during which seasonal respiratory viral infection increases susceptibility to develop childhood asthma. Using the established research infrastructure of the Tennessee Medicaid claims data linked to birth certificates, we will determine the critical age periods associated with high risk of developing childhood asthma using a training dataset. The relationship of viral exposure intensity and infant age on development of childhood asthma will be examined in a separate test dataset. Furthermore, the potential interaction effects between infant viral exposure and maternal asthma (familial risk factor) and maternal smoking (environmental risk factor) will be examined. Restricted cubic splines will be applied to determine the smooth relationship between viral exposure age, intensity and the development of childhood asthma. The implications of this research relate to the potential for identifying critical time periods during which preventing infection could prevent or alter the phenotypic expression of asthma in predisposed hosts.