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Gestational Age, Birthweight for Gestational Age, and Childhood Hospitalisations for Asthma and Other Wheezing Disorders
Author(s) -
Leung June Y. Y.,
Lam Hugh S.,
Leung Gabriel M.,
Schooling C. Mary
Publication year - 2016
Publication title -
paediatric and perinatal epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 88
eISSN - 1365-3016
pISSN - 0269-5022
DOI - 10.1111/ppe.12273
Subject(s) - medicine , gestational age , hazard ratio , pediatrics , bronchiolitis , asthma , bronchitis , confidence interval , proportional hazards model , confounding , birth weight , cohort study , population , cohort , small for gestational age , full term , obstetrics , pregnancy , respiratory system , environmental health , genetics , biology
Background Preterm birth, early term birth, and low birthweight are associated with childhood wheezing disorders in developed Western settings, but observed associations could be confounded by socio‐economic position. This study aims to clarify such associations in a developed non‐ W estern setting with a different confounding structure. Methods Using Cox regression, we examined the adjusted associations of gestational age and birthweight for gestational age with time to first public hospital admission for asthma, bronchitis, and bronchiolitis ( I nternational C lassification of D iseases, N inth V ersion C linical M odification 466, 490, and 493) from 9 days to 12 years in a population‐representative birth cohort of 8327 C hinese children in H ong K ong, a developed setting with less clear social patterning of prematurity or birthweight. Analyses were adjusted for infant and parental characteristics and socio‐economic position. Results Children born late preterm (34 to <37 weeks) had higher risk of hospitalisation for asthma and other wheezing disorders [hazard ratio ( HR ) 1.99, 95% confidence interval ( CI ) 1.48, 2.67] than children born full term (39 to <41 weeks). Early term births (37 to <39 weeks) had HR 1.01 (95% CI 0.84, 1.22), late term births (41 to <42 weeks) had HR 0.77 (95% 0.59, 1.01), and post‐term births (≥42 weeks) had HR 0.56 (95% CI 0.32, 0.98). Large for gestational age was associated with lower risk of hospitalisation ( HR 0.76, 95% CI 0.57, 0.99). Conclusion The association of preterm birth with childhood wheezing could be biologically mediated. We cannot rule out an association for early term births.