Assuntos
Glucocorticoides/administração & dosagem , Glucocorticoides/efeitos adversos , Sons Respiratórios , Administração Oral , Asma/tratamento farmacológico , Contagem de Células Sanguíneas , Densidade Óssea/efeitos dos fármacos , Pré-Escolar , Eosinófilos/metabolismo , Humanos , Terapia de Imunossupressão , Uso Excessivo de Medicamentos Prescritos , Ensaios Clínicos Controlados Aleatórios como Assunto , Infecções Respiratórias/complicaçõesRESUMO
OBJECTIVE: To determine whether different modes of infant feeding are associated with childhood asthma, including differentiating between direct breastfeeding and expressed breast milk. STUDY DESIGN: We studied 3296 children in the Canadian Healthy Infant Longitudinal Development birth cohort. The primary exposure was infant feeding mode at 3 months, reported by mothers and categorized as direct breastfeeding only, breastfeeding with some expressed breast milk, breast milk and formula, or formula only. The primary outcome was asthma at 3 years of age, diagnosed by trained healthcare professionals. RESULTS: At 3 months of age, the distribution of feeding modes was 27% direct breastfeeding, 32% breastfeeding with some expressed breast milk, 26% breast milk and formula, and 15% formula only. At 3 years of age, 12% of children were diagnosed with possible or probable asthma. Compared with direct breastfeeding, any other mode of infant feeding was associated with an increased risk of asthma. These associations persisted after adjusting for maternal asthma, ethnicity, method of birth, infant sex, gestational age, and daycare attendance (some expressed breast milk: aOR, 1.64, 95% CI, 1.12-2.39; breast milk and formula, aOR, 1.73, 95% CI, 1.17-2.57; formula only: aOR, 2.14, 95% CI, 1.37-3.35). Results were similar after further adjustment for total breastfeeding duration and respiratory infections. CONCLUSIONS: Modes of infant feeding are associated with asthma development. Direct breastfeeding is most protective compared with formula feeding; indirect breast milk confers intermediate protection. Policies that facilitate and promote direct breastfeeding could have impact on the primary prevention of asthma.
Assuntos
Asma/etiologia , Aleitamento Materno , Fórmulas Infantis/efeitos adversos , Asma/prevenção & controle , Extração de Leite , Canadá , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Estudos Longitudinais , Masculino , Estudos Prospectivos , Fatores de Proteção , Fatores de RiscoRESUMO
OBJECTIVE: To determine risk factors associated with transient tachypnea of the newborn (TTN) and whether TTN is associated with development of wheezing syndromes in early life. STUDY DESIGN: The Population Health Research Data Repository at the Manitoba Centre for Health Policy is a healthcare administrative and prescription database. Data for children diagnosed with a wheezing syndrome (defined as bronchiolitis, acute bronchitis, chronic bronchitis, asthma, or prescription for asthma medication) were obtained. Term children diagnosed with TTN at birth were selected. Cox proportional hazards regression analysis for time to first event of hospitalizations, physician visits, or prescription for an asthma medication up to 7 years of age were calculated. The hazard ratios for wheezing in a child with TTN were compared with healthy newborns. RESULTS: Twelve thousand seven hundred sixty-three children were born at term in 1995 and currently live in the province of Manitoba. Of these children, 308 (2.4%) developed TTN. Maternal asthma, birth weight > or = 4500 g, male sex, and urban location were risk factors for development of TTN. Infants with TTN at birth were at significantly increased risk of a wheezing disorder in childhood (adjusted hazard ratio [HR] = 1.17, 95% CI 1.02-1.34). CONCLUSION: TTN is associated with development of wheezing syndromes in childhood.