Association between prenatal and neonatal factors and occurrence of asthma symptoms in six-year-old children

Esmeraldino, Leonardo; Traebert, Eliane; Nunes, Rodrigo Dias; Traebert, Jefferson

doi:10.1590/1413-81232022272.44892020

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ARTICLE • Ciênc. saúde coletiva 27 (02) • Feb 2022 • https://doi.org/10.1590/1413-81232022272.44892020 copy

Association between prenatal and neonatal factors and occurrence of asthma symptoms in six-year-old children

Associação entre fatores pré-natais e neonatais e ocorrência de sintomas de asma em crianças aos seis anos de idade

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The objective was to estimate association between prenatal and neonatal factors and asthma symptoms in children at six years of age. A cross-sectional study using secondary data from a cohort study with a sample of 578 children was carried out. Data were analyzed using three levels hierarchical Poisson Regression. Of the 578 children included in the study, 43.4% (95% CI 39.4; 47.4) had asthma symptoms. The variables with significantly higher prevalence of symptoms and asthma at six years of age were: male gender, with 5% higher prevalence (PR = 1.05 95% CI 1.01; 1.11) (p = 0.043); children of pregnant women presenting infectious diseases with 7% higher prevalence (PR = 1.07; 95% CI 1.02; 1.13) (p = 0.011); children who were not breastfed, with a 12% higher prevalence (PR = 1.12; 95% CI 1.02; 1.24) (p = 0.022) and children with respiratory problems in the first month of life, with a 14% higher prevalence (PR = 1.14; 95% CI 1.01; 1.29) (p = 0.033). It could be concluded that male gender, time-independent breastfeeding deprivation and respiratory problems in the first month of life were independently associated with asthma symptoms at six years of age. The occurrence of infectious diseases during pregnancy was the only factor with intrauterine physiology that was associated with the occurrence of asthma symptoms at six years of age.

Key words:
Asthma; Child; Child health

Variables	Asthma Symtomps
Variables	n	%	PR_c	95% CI	p
1st Level - Socio-Demographic
Child sex					0.017
Male	148	48.1	1.06	1.01; 1.12
Female	103	38.1	1,00
Ethnicity of child					0.342
Caucasian	45	47.9	1,03	0.96; 1.11
Non-Caucasian	206	42.6
Mother’s age at birth
19 or less	31	44.3	1.01	0.92; 1.08	0.972
Between 20 and 34	193	44.1	1.04	0.93; 1.15	0.491
35 or more	23	38.3	1.00
Mother’s schooling at birth					0.300
Up to 8	116	46.8	1.03	0.97; 1.09
More than 8	121	42.3	1.00
2nd Level - Pregnancy conditions
Number of prenatal consultations					0.851
Up to 6	17	41.5	0.99	0.90; 1.09
7 or more	202	43.0	1.00
Way of delivery					0.314
Vaginal	103	41.2	1.00
Cesarean	148	45.4	1.03	0.97; 1.08
Smoking during pregnancy					0.057
Yes	58	51.3	1.07	0.99; 1.14
No	190	41.3	1.00
Alcohol in pregnancy					0.056
Yes	21	58.3	1.11	0.99; 1.25
No	218	42.0	1.00
Illegal drug use in pregnancy					0.023
Yes	7	63.6	1.15	1.01; 1.42
No	240	43.0	1.00
Diabetes in pregnancy					0.573
Yes	34	46.6	1.02	0.95; 1.11
No	205	43.1	1.00
Hypertension in pregnancy					0.054
Yes	17	60.7	1.13	1.01; 1.29
No	229	42.3	1.00
Infectious diseases in pregnancy					0.008
Yes	116	49.2	1.12	1.03; 1.21
No	122	37.9	1.00
3rd Level - Birth and neonatal conditions
Prematurity					0.301
Up to 37 weeks	30	50.0	1.05	0.96; 1.14
38 weeks or more	195	43.0	1.00
Weight at birth					0.210
Up to 2,500g	13	34.2	0.94	0.85; 1.03
More than 2,500g	234	44.7	1.00
Weight per gestational age
Large for gestational age	32	38.1	0.95	0.89; 1.02	0.192
Small for gestational age	21	40.4	0.99	0.89; 1.09	0.791
Appropriate for gestational age	169	45.7	1.00
APGAR 1th minute					0.267
Up to 7	23	54.8	1.06	0.95; 1.18
8 or more	191	45.8	1.00
APGAR 5th minute					1.000
Up to 7	4	50.0	1.02	0.81; 1.29
8 or more	209	46.4	1.00
Head circumference					0.586
Less than 32 cm or bigger than 36 cm	45	44.6	0.98	0.91; 1.05
between 33 and 34 cm	161	47.6	1.00
Breastfed					0.004
Yes	214	41.3	1.00
No	35	61.4	1.14	1.04; 1.26
Respiratory problem in the first month of life					0.006
Yes	23	65.7	1.18	1.04; 1.33
No	226	41.9	1.00
Need for intubation in the first month of life					0.183
Yes	14	56.0	1.09	0.95; 1.25
No	233	42.7	1.00
Jaundice					0.909
Yes	49	43.0	0.99	0.93; 1.06
No	200	43.6	1.00

Variables	Asthma Symtopms
Variables	PR_a	95% CI	p
Child sex			0.021
Male	1.06	1.01; 1.20
Female	1.00
Smoking during pregnancy			0.121
Yes	1.06	0.98; 1.14
No	1.00
Alcohol in pregnancy			0.277
Yes	1.06	0.95; 1.20
No	1.00
Illegal drug use in pregnancy			0.523
Yes	1.09	0.84; 1.40
No	1.00
Infectious diseases in pregnancy			0.011
Yes	1.07	1.02; 1.13
No	1.00

Variables	Asthma Symptoms
Variables	PR_a	95% CI	p
Child sex			0.043
Male	1.05	1.01; 1.11
Female	1.00
Smoking during pregnancy			0.134
Yes	1.05	0.98; 1.13
No	1.00
Infectious diseases in pregnancy			0.011
Yes	1.07	1.02; 1.13
No	1,00
Breastfed			0.022
Yes	1.00
No	1.12	1.02; 1.24
Respiratory problem in the first month of life
Yes	1.14	1.01; 1.29	0.033
No	1.00

Variables	Asthma Symptoms
Variables	PR_a	95% CI	p
1st Level - Socio-Demographic
Child sex			0.043
Male	1.05	1.01; 1.11
Female	1.00
2nd Level - Pregnancy Conditions
Infectious diseases in pregnancy			0.011
Yes	1.07	1.02; 1.13
No	1.00
3rd Level - Birth and Neonatal Conditions
Breastfed			0.022
Yes	1.00
No	1.12	1.02; 1.24
Respiratory problem in the first month of life
Yes	1.14	1.01; 1.29	0.033
No	1.00

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[1] Collaborations

Leonardo Esmeraldino: conception and design, analysis and interpretation of data, review and approval of the final version of the article. Eliane Traebert: conception and design, analysis and interpretation of data, review and approval of the final of the article. Rodrigo Dias Nunes: analysis and interpretation of data, review and approval of the final version of the article. Jefferson Traebert: conception and design, analysis and interpretation of data, review and approval of the final version of the article.