TY - JOUR
T1 - Prematurity and prescription asthma medication from childhood to young adulthood
T2 - a danish national cohort study
AU - Damgaard, Anne Louise
AU - Hansen, Bo Moelholm
AU - Mathiasen, Rene
AU - Buchvald, Frederik
AU - Lange, Theis
AU - Greisen, Gorm
PY - 2015/2/4
Y1 - 2015/2/4
N2 - Introduction Preterm birth is associated with increased risk of asthma-like symptoms and purchase of prescription asthma medication in childhood. We investigated whether this association persists into adulthood and whether it is affected by accounting for neonatal respiratory morbidity (acute respiratory disease and bronchopulmonary dysplasia). Methods A national cohort of all infants born in Denmark in the period 1980-2009 was included in this register study. Data on purchase of asthma medication (combination of inhaled -2 agonists and other drugs for obstructive airway disease) in 2010-2011 were obtained from the Danish National Prescription Registry. Associations between gestational age (GA), neonatal respiratory morbidity and a cross-sectional evaluation of asthma medication purchase were explored by multivariate logistic regressions. Results A full dataset was obtained on 1,790,241 individuals, 84.6% of all infants born in the period. Odds-ratios (95% CI) for the association between GA and purchase of asthma medication during infancy were: 3.86 (2.46-6.04) in GA 23-27 weeks, 2.37 (1.84-3.04) in GA 28-31 weeks and 1.59 (1.43-1.77) in GA 32-36 weeks compared to term infants with GA 37-42 weeks. Associations weakened in older age groups and became insignificant in young adults born extremely and very preterm with odds-ratios: 1.41 (0.63-3.19) and 1.15 (0.83- 1.60) in GA 23-27 and 28-31 respectively. When adjusting for neonatal respiratory morbidity, the associations weakened but persisted both in childhood and adolescence. Conclusion There was a strong dose-response association between gestational age and the purchase of prescription asthma medication in infancy and childhood. This association weakened during adolescence and was mostly non-significant in young adulthood. The increased risk of prescription asthma medication purchase in ex-preterm children could only partly be explained by neonatal respiratory morbidity.
AB - Introduction Preterm birth is associated with increased risk of asthma-like symptoms and purchase of prescription asthma medication in childhood. We investigated whether this association persists into adulthood and whether it is affected by accounting for neonatal respiratory morbidity (acute respiratory disease and bronchopulmonary dysplasia). Methods A national cohort of all infants born in Denmark in the period 1980-2009 was included in this register study. Data on purchase of asthma medication (combination of inhaled -2 agonists and other drugs for obstructive airway disease) in 2010-2011 were obtained from the Danish National Prescription Registry. Associations between gestational age (GA), neonatal respiratory morbidity and a cross-sectional evaluation of asthma medication purchase were explored by multivariate logistic regressions. Results A full dataset was obtained on 1,790,241 individuals, 84.6% of all infants born in the period. Odds-ratios (95% CI) for the association between GA and purchase of asthma medication during infancy were: 3.86 (2.46-6.04) in GA 23-27 weeks, 2.37 (1.84-3.04) in GA 28-31 weeks and 1.59 (1.43-1.77) in GA 32-36 weeks compared to term infants with GA 37-42 weeks. Associations weakened in older age groups and became insignificant in young adults born extremely and very preterm with odds-ratios: 1.41 (0.63-3.19) and 1.15 (0.83- 1.60) in GA 23-27 and 28-31 respectively. When adjusting for neonatal respiratory morbidity, the associations weakened but persisted both in childhood and adolescence. Conclusion There was a strong dose-response association between gestational age and the purchase of prescription asthma medication in infancy and childhood. This association weakened during adolescence and was mostly non-significant in young adulthood. The increased risk of prescription asthma medication purchase in ex-preterm children could only partly be explained by neonatal respiratory morbidity.
U2 - 10.1371/journal.pone.0117253
DO - 10.1371/journal.pone.0117253
M3 - Journal article
C2 - 25651521
SN - 1932-6203
VL - 10
SP - 1
EP - 17
JO - PLoS Computational Biology
JF - PLoS Computational Biology
IS - 2
M1 - e0117253
ER -