Latin American Society for Pediatric Research (LASPR): selected abstracts from the LVII annual meeting

摘要

Background: According to the hypothesis of the Developmental Origin of Health and Disease,scientific evidence suggest that adverse intrauterine conditions impair fetal growth and mayhave long-term consequences facilitating development of chronic non-communicable diseasesin adulthood. These adverse conditions, such as low birth weight (LBW) have been identified asrisk factors for asthma.Objective: Evaluate the association between LBW and the development of asthma in youngadult and estimate the direct and indirect effects.Methods: Cohort study (1978/79) including 1958 young adults aged 23 to 25 years old,from a birth cohort of Ribeir?o Preto in 1978/791. Standardized questionnaires andmethacholine bronchoprovocative test were employed. Outcome variable was asthma andexposure variable birth weight. A directed acyclic graph (DAG) was designed to map causeand effect relationships between variables analyzed; three constructs were created: asthma,birth economic status (Birth SES) and current economic status (Current SES). Asthma constructwas set up for bronchial hyper-reactivity (PCO2 value ≤ 4mg/ml), wheezing in the last12 months and medical diagnosis of asthma. Associations were obtained by StructuralEquations Model (SEM).Results: 14.1% of individuals were diagnosed with asthma. Lower birth weight (CP = ?0.110;p = 0.030) had total effect on asthma and were also indirectly associated with asthma throughhospitalization up 2 years and respiratory infection up to 5 years (CP = ?0.220; p=0.037) andvia current SES and adult smoking (CP = ?0.005; p = 0.037). The exposure variable, birth SES,current SES, maternal smoking, adult smoking, respiratory infection up to 5 years andhospitalization up 2 years also had total direct and indirect effects with asthma.Conclusion: Lower birth weight increase total risk and was indirectly associated with asthmain young adults via hospitalization up 2 years and respiratory infection up to 5 years and viacurrent SES and adult smoking.