Ahmad Kabir, Keramat Syed Afroz, Sathi Nusrat Jahan, Kabir Enamul, Khanam Rasheda
School of Business, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Australia.
Present Address: School of Business, Faculty of Business, Education, Law and Arts, and, Centre for Health Research, University of Southern Queensland, Toowoomba, Australia.
Arch Public Health. 2022 Jun 23;80(1):158. doi: 10.1186/s13690-022-00913-3.
The incidence of any medical condition (e.g., sight, hearing, and speech problems, blackouts, chronic pain etc.) or disability (e.g., limited use of arms or fingers, legs, and feet, or other physical long-term health condition limiting everyday activities etc.) have been increasing among Australian children in recent decades.
This study assessed whether infant or child health characteristics might be predictors of subsequent medical conditions or disabilities in children in the first 15 years of life.
Using time to event data of 5107 children, obtained from the Birth cohort of the Longitudinal Study of Australian Children, the study estimated the incidence of any medical condition or disability using the survival analysis technique. This study followed up the children from birth to 14 or 15 years of age (2004-2018) and assessed the association of infant and child health characteristics (birthweight, gestational age, use of intensive care unit or ventilator during their neonatal age and obesity) with hazard of any medical condition or disability using the random effect parametric survival regression model. The infant characteristics were measured in the Wave 1 while the children were aged 0/1 year and obesity characteristics were measured longitudinally over all the waves up to 14/15 years of age.
The hazard rate of any medical condition or disability for all participants was 26.13 per 1000 person-years among children in Australia. This hazard incidence rate was higher among low birthweight (39.07) children compared to the children of normal birthweight (24.89) children. The hazard rate also higher among obese (34.37) children compared to the normal weight children (24.82) and among those who had received after-birth ventilation or intensive care unit emergency services (36.87) compared to those who have not received these services (24.20). The parametric panel regression model also suggests that children with low birthweight were 1.43 times (Hazard Ratio: 1.43, 95% Confidence Interval: 1.05-1.94) more likely to have any medical condition or disability than children with normal birthweight. The time to event analyses also revealed that being recipient of after-birth emergencies (HR: 1.47, 95% CI: 1.23-1.75), being male children (HR: 1.30, 95% CI: 1.14-1.48) or being obese (HR: 1.38, 95% CI: 1.07-1.79) significantly increased the likelihood of the incidence of a medical condition or disability among children. The regression model was adjusted for socio-demographic characteristics of children and mothers..
The study findings suggest that infants with low birth weight, hospital emergency service use and children with obesity would benefit from additional health care monitoring to minimize the risk of any medical condition or disability.
近几十年来，澳大利亚儿童中任何医疗状况（如视力、听力和言语问题、昏厥、慢性疼痛等）或残疾（如手臂或手指、腿部和脚部使用受限，或其他限制日常活动的身体长期健康状况等）的发生率一直在上升。
本研究评估婴儿或儿童的健康特征是否可能是儿童生命最初15年中后续医疗状况或残疾的预测因素。
利用从澳大利亚儿童纵向研究出生队列中获得的5107名儿童的事件发生时间数据，该研究采用生存分析技术估计任何医疗状况或残疾的发生率。本研究对这些儿童从出生到14或15岁（2004 - 2018年）进行随访，并使用随机效应参数生存回归模型评估婴儿和儿童健康特征（出生体重、胎龄、新生儿期使用重症监护病房或呼吸机情况以及肥胖）与任何医疗状况或残疾风险之间的关联。婴儿特征在第1波中测量，当时儿童为0/1岁，肥胖特征在所有波次中纵向测量，直至14/15岁。
在澳大利亚儿童中，所有参与者任何医疗状况或残疾的风险率为每1000人年26.13例。与正常出生体重儿童（24.89）相比，低出生体重儿童（39.07）的这种风险发生率更高。与正常体重儿童（24.82）相比，肥胖儿童（34.37）的风险率也更高；与未接受这些服务的儿童（24.20）相比，接受出生后通气或重症监护病房紧急服务的儿童（36.87）的风险率也更高。参数面板回归模型还表明，低出生体重儿童出现任何医疗状况或残疾的可能性比正常出生体重儿童高1.43倍（风险比：1.43，95%置信区间：1.05 - 1.94）。事件发生时间分析还显示，接受出生后紧急情况治疗（风险比：1.47，95%置信区间：1.23 - 1.75）、男性儿童（风险比：1.30，95%置信区间：1.14 - 1.48）或肥胖儿童（风险比：1.38，95%置信区间：1.07 - 1.79）显著增加了儿童发生医疗状况或残疾的可能性。该回归模型对儿童和母亲的社会人口学特征进行了调整。
研究结果表明，低出生体重婴儿、使用医院紧急服务的儿童和肥胖儿童将受益于额外的医疗保健监测，以将任何医疗状况或残疾的风险降至最低。
