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Early fish introduction and neonatal antibiotics affect the risk of asthma into school age.

Journal article
Authors Emma Goksör
Bernt Alm
Rolf Pettersson
Per Möllborg
Laslo Erdes
Nils Åberg
Göran Wennergren
Published in Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology
Volume 24
Issue 4
Pages 339–344
ISSN 1399-3038
Publication year 2013
Published at Institute of Clinical Sciences, Department of Pediatrics
Pages 339–344
Language en
Links dx.doi.org/10.1111/pai.12078
Keywords antibiotics, asthma, atopic asthma, cohort study, fish
Subject categories Pediatrics

Abstract

BACKGROUND: The early introduction of fish has been reported to reduce the risk of wheezing disorder in early childhood, while broad-spectrum antibiotics in the first week have been associated with an increased risk. However, it is uncertain whether the effects remain into school age. The aim was to explore these risk factors for doctor-diagnosed asthma at 8 years. METHODS: Data were obtained from a prospective, longitudinal study of a cohort of children born in western Sweden. The parents answered questionnaires at 6 months and 1, 4.5 and 8 years of age. The response rate at 8 years was 80% of the questionnaires distributed (4051/5044), that is, 71% of the families entering the study (4051/5654). RESULTS: At 8 years, 5.7% reported current doctor-diagnosed asthma. Of these, 65% had atopic asthma and 35% non-atopic asthma. In the multivariate analysis, atopic heredity, male gender and own allergic disease during infancy were risk factors for doctor-diagnosed asthma at 8 years. In addition, the introduction of fish before the age of 9 months independently reduced the risk (adjusted OR 0.6; 95% CI 0.4-0.96), while broad-spectrum antibiotics in the first week independently increased the risk of current asthma at school age (aOR 2.3; 1.2-4.2). Regarding types of asthma, the effects were significant in atopic asthma but not in non-atopic asthma. CONCLUSION: The early introduction of fish and neonatal antibiotic treatment influence the risk of asthma into school age. The significant effect on atopic asthma is of particular importance, as this phenotype is of major clinical significance.

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