Center for Pediatric Population Health, UTHealth Houston School of Public Health, Dallas, Texas; Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth Houston School of Public Health, Dallas, Texas; Department of Epidemiology, Human Genetics and Environmental Sciences, Southwest Center for Occupational and Environmental Health, UTHealth Houston School of Public Health, Houston, Texas.
Center for Pediatric Population Health, UTHealth Houston School of Public Health, Dallas, Texas; The University of North Texas Health Science Center, Fort Worth, Texas.
Pediatr Neurol. 2024 Jul;156:131-138. doi: 10.1016/j.pediatrneurol.2024.04.023. Epub 2024 May 3.
Investigating asthma as an effect modifier between adverse birth outcomes and neurodevelopmental disabilities (NDDs) across different races is crucial for tailored interventions and understanding variable susceptibility among diverse populations.
Data were collected through the National Survey of Children's Health. This cross-sectional study included 131,774 children aged 0 to 17 years. Study exposures comprised adverse birth outcomes including preterm birth and low birth weight. Weighted prevalence estimates and odds ratios with 95% confidence intervals (CIs) among children with and without adverse birth outcomes were calculated for NDDs including attention-deficit/hyperactivity disorder, autism spectrum disorder, cerebral palsy, seizure, and several others including behavior problems. Adjusted odds ratios were stratified by asthma status and separate interactions were assessed for each outcome.
Of 131,774 participants, 10,227 were born low birth weight (9.12%; 95% CI: 8.77% to 9.49%), 14,058 were born preterm (11.35%; 95% CI: 10.94% to 11.76%), and 16,166 participants had asthma (11.97%; 95% CI: 11.58% to 12.37%). There were 68,100 males (51.11%), 63,674 females (48.89%), 102,061 non-Hispanic Whites (NHW) (66.92%), 8,672 non-Hispanic Blacks (NHB) (13.97%), and 21,041 participants (19.11%) categorized as other. NHB children with adverse birth outcomes had higher prevalence of several NDDs compared to NHW children.
Asthma was not shown to be an effect modifier of the association between adverse birth outcomes and NDDs. Nevertheless, these results suggest that NDDs are more prevalent within US children with adverse birth outcomes, with higher rates among NHB compared to NHW children. These findings support screening for NDDs in pediatric health care settings among patients with adverse birth outcomes, particularly among those from ethnic minority backgrounds.
研究哮喘作为不良出生结局与神经发育障碍（NDD）之间的效应修饰物，对于针对不同种族的人群进行有针对性的干预和理解不同人群的不同易感性至关重要。
数据来自全国儿童健康调查。本横断面研究纳入了 131774 名 0 至 17 岁的儿童。研究暴露包括早产和低出生体重等不良出生结局。计算了有无不良出生结局的儿童中 NDD（包括注意缺陷多动障碍、自闭症谱系障碍、脑瘫、癫痫发作等）的加权患病率估计值和比值比（OR）及其 95%置信区间（CI）。对哮喘状况进行分层，并对每个结果进行单独的交互作用评估。
在 131774 名参与者中，10227 名出生体重低（9.12%；95%CI：8.77%至 9.49%），14058 名早产（11.35%；95%CI：10.94%至 11.76%），16166 名患有哮喘（11.97%；95%CI：11.58%至 12.37%）。其中男性 68100 名（51.11%），女性 63674 名（48.89%），非西班牙裔白人（NHW）102061 名（66.92%），非西班牙裔黑人（NHB）8672 名（13.97%），其他种族 21041 名（19.11%）。与 NHW 儿童相比，有不良出生结局的 NHB 儿童 NDD 的患病率更高。
哮喘不是不良出生结局与 NDD 之间关联的效应修饰物。然而，这些结果表明，美国有不良出生结局的儿童 NDD 更为普遍，NHB 儿童的发生率高于 NHW 儿童。这些发现支持在儿科保健环境中对有不良出生结局的患者进行 NDD 筛查，尤其是在少数民族背景的患者中。
