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Effect of fetal and infant growth on respiratory symptoms in preterm-born children

Lowe, John, Kotecha, Sarah, Watkins, William and Kotecha, Sailesh 2018. Effect of fetal and infant growth on respiratory symptoms in preterm-born children. Pediatric Pulmonology 53 (2) , pp. 189-196. 10.1002/ppul.23920

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Abstract

Objectives: Fetal growth and rapid postnatal weight gain are associated with adverse respiratory outcomes in childhood. However, the preterm-born population is less well studied. We assessed if the increased respiratory symptoms associated with altered fetal growth and infant weight gain were mediated by early factors. Study Design: Weused data from our cohort of preterm- and term-born (n = 4284 and 2865) children, aged 1-10 years. Respiratory outcomes obtained from a respiratory questionnaire were regressed on measures of fetal growth and infant weight gain, defined as >0.67 SD change in fetal measurement or weight between birth and nine months of age, then adjusted for covariates.Weused mediation analysis to investigate which variables were effect modifiers. Results: Accelerated fetal growth between the 1st trimester and birth (OR 2.01; 95%CI 1.25, 2.32), and between the 2nd trimester and birth (1.60; 1.15, 2.22) was associated with increased wheeze-ever in preterm-born children. Rapid infant weight gain was associated with increased wheeze-ever (1.22; 1.02, 1.45); children born ≤32 weeks’ gestation exhibiting rapid weight gain had fivefold higher risk of wheeze-ever compared to term-born without weight gain. Current maternal smoking and gestational age were identified as candidate mediating effects. Conclusions: Our study suggested that antenatal and postnatal growth rates are important for future respiratory health in preterm-born children, and that their effects may be mediated by modifiable factors. Minimizing exposure to environmental pollutants, especially maternal tobacco smoking, may improve outcomes.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: Wiley
ISSN: 8755-6863
Funders: CARBS Research Committee Internal Schemes, Fujitsu, NERC, Horizon 2020, Arthritis Research UK: Grant number 20305, Medical Research Council, Wellcome Trust, Cancer Research UK, Victorian Government's Operational Infrastructure Support Program, National Health and Medical Research Council of Australia (NHMRC), NHMRC Senior Research Fellowships, Australian Government Australian Postgraduate Award, Life Sciences Research Network Wales, International Postgraduate Scholarship (Monash University), Medical Research Council, Grant number: MR/M022552/1
Date of First Compliant Deposit: 27 November 2017
Date of Acceptance: 9 November 2017
Last Modified: 28 Jun 2019 14:55
URI: http://orca-mwe.cf.ac.uk/id/eprint/107088

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