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The association between asthma and type 1 diabetes: a paediatric case-cohort study in Finland, years 1981-2009.

https://arctichealth.org/en/permalink/ahliterature298640
Source
Int J Epidemiol. 2018 04 01; 47(2):409-416
Publication Type
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Date
04-01-2018
Author
Johanna Metsälä
Annamari Lundqvist
Lauri J Virta
Minna Kaila
Mika Gissler
Suvi M Virtanen
Jaakko Nevalainen
Author Affiliation
Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland.
Source
Int J Epidemiol. 2018 04 01; 47(2):409-416
Date
04-01-2018
Language
English
Publication Type
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Asthma - complications - epidemiology
Case-Control Studies
Child
Child, Preschool
Cohort Studies
Diabetes Mellitus, Type 1 - complications - epidemiology
Female
Finland - epidemiology
Humans
Male
Proportional Hazards Models
Registries
Risk factors
Abstract
The association between asthma and type 1 diabetes, two chronic, immune-mediated diseases, has been of longstanding interest, but the evidence is still conflicting. We examined this association in a large, nationwide case-cohort study among Finnish children, using a novel statistical approach.
Among the initial cohort of all children born between 1 January 1981 and 31 December 2008, those who were diagnosed with asthma (n?=?81 473) or type 1 diabetes (n?=?9541) up to age 16 years by the end of 2009 were identified from the Central Drug Register maintained by the Social Insurance Institution of Finland. A 10% random sample from each initial birth year cohort was selected as a reference cohort (n?=?171 138). The association between asthma and type 1 diabetes was studied using a multistate modelling approach to estimate transition rates between healthy and disease states since birth. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to represent the change in the transition rate between the disease states.
After adjusting for sex and birth decade, previous diagnosis of asthma increased the risk of subsequent type 1 diabetes by 41% (95% CI: 1.28, 1.54), whereas previous diagnosis of type 1 diabetes decreased the risk of subsequent asthma by 18% (95% CI: 0.69, 0.98).
The findings of the present study imply that the association between the diseases is more complex than previously thought, and its direction depends on the sequential appearance of the diseases.
PubMed ID
29211844 View in PubMed
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Maternal and perinatal characteristics and the risk of cow's milk allergy in infants up to 2 years of age: a case-control study nested in the Finnish population.

https://arctichealth.org/en/permalink/ahliterature143535
Source
Am J Epidemiol. 2010 Jun 15;171(12):1310-6
Publication Type
Article
Date
Jun-15-2010
Author
Johanna Metsälä
Annamari Lundqvist
Minna Kaila
Mika Gissler
Timo Klaukka
Suvi M Virtanen
Author Affiliation
Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Finland. johanna.metsala@thl.fi
Source
Am J Epidemiol. 2010 Jun 15;171(12):1310-6
Date
Jun-15-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Animals
Case-Control Studies
Cattle
Cesarean Section - statistics & numerical data
Confidence Intervals
Female
Finland - epidemiology
Food Hypersensitivity - epidemiology - etiology
Gestational Age
Humans
Infant
Logistic Models
Male
Maternal Age
Middle Aged
Milk - immunology
Mothers - statistics & numerical data
Odds Ratio
Parity
Pregnancy
Pregnancy, Multiple - statistics & numerical data
Risk factors
Sex Factors
Smoking - adverse effects
Socioeconomic Factors
Young Adult
Abstract
This study examined whether maternal background and perinatal factors were associated with the risk of cow's milk allergy (CMA) in infants up to 2 years of age in a nested case-control study. All children born in 1996-2004 in Finland and diagnosed with CMA by 2006 were identified (n = 16,237). For each case, one matched control was selected. Information on maternal and perinatal factors was derived from the Medical Birth Register. The associations were analyzed by conditional logistic regression. Cesarean section (adjusted odds ratio (OR) = 1.18, 95% confidence interval (CI): 1.10, 1.27) and high maternal age (> or =35 years; adjusted OR = 1.23, 95% CI: 1.11, 1.36) were associated with increased risk, whereas low maternal socioeconomic status (adjusted OR = 0.65, 95% CI: 0.59, 0.71), smoking (adjusted OR = 0.72, 95% CI: 0.67, 0.79), high number of previous deliveries (> or =5; adjusted OR = 0.71, 95% CI: 0.59, 0.86), and multiple pregnancy (adjusted OR = 0.70, 95% CI: 0.60, 0.82) were associated with decreased risk of CMA. In conclusion, maternal background and perinatal factors may play a role in the development of CMA, but further research is needed to clarify these associations and the underpinning biologic mechanisms.
PubMed ID
20472571 View in PubMed
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Mother's and offspring's use of antibiotics and infant allergy to cow's milk.

https://arctichealth.org/en/permalink/ahliterature116921
Source
Epidemiology. 2013 Mar;24(2):303-9
Publication Type
Article
Date
Mar-2013
Author
Johanna Metsälä
Annamari Lundqvist
Lauri J Virta
Minna Kaila
Mika Gissler
Suvi M Virtanen
Author Affiliation
Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland. johanna.metsala@thl.fi
Source
Epidemiology. 2013 Mar;24(2):303-9
Date
Mar-2013
Language
English
Publication Type
Article
Keywords
Adult
Animals
Anti-Bacterial Agents - adverse effects - immunology
Case-Control Studies
Female
Finland
Humans
Infant
Infant Formula
Male
Maternal Exposure - adverse effects
Milk Hypersensitivity - diagnosis - etiology - immunology
Mothers
Pregnancy
Registries
Risk
Abstract
Evidence on the association between antibiotics and the risk of food allergies is limited. We explored the associations between mother's and offspring's use of antibiotics and the risk of cow's milk allergy in infancy.
We used a national registry to identify all children who were born in 1996-2004 in Finland and diagnosed with cow's milk allergy after 1 month of age by November 2005 (n = 15,672). For each case, we selected one control matched for birth date, sex, and hospital district. Information on antibiotic purchases and putative confounders was obtained from registries. The associations were analyzed using conditional logistic regression.
Maternal use of antibiotics before and during pregnancy was associated with an increased risk of cow's milk allergy in the offspring (odds ratio = 1.26 [95% confidence interval = 1.20-1.33] and 1.21 [1.14-1.28], respectively, adjusting for putative confounders). The risk of cow's milk allergy increased with increasing number of child's antibiotics used from birth to diagnosis (test for trend P
PubMed ID
23348066 View in PubMed
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Perinatal factors and the risk of asthma in childhood--a population-based register study in Finland.

https://arctichealth.org/en/permalink/ahliterature156966
Source
Am J Epidemiol. 2008 Jul 15;168(2):170-8
Publication Type
Article
Date
Jul-15-2008
Author
Johanna Metsälä
Annamari Kilkkinen
Minna Kaila
Heli Tapanainen
Timo Klaukka
Mika Gissler
Suvi M Virtanen
Author Affiliation
Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute, Helsinki, Finland. johanna.metsala@ktl.fi
Source
Am J Epidemiol. 2008 Jul 15;168(2):170-8
Date
Jul-15-2008
Language
English
Publication Type
Article
Keywords
Adult
Anti-Asthmatic Agents - therapeutic use
Apgar score
Asthma - epidemiology
Birth weight
Case-Control Studies
Child
Child, Preschool
Delivery, Obstetric - methods
Female
Finland - epidemiology
Humans
Infant
Infant, Newborn
Infant, Premature
Infant, Small for Gestational Age
Male
Maternal Age
Multivariate Analysis
Parity
Pregnancy
Prenatal Exposure Delayed Effects
Risk factors
Smoking - adverse effects
Statistics, nonparametric
Abstract
The aim of the study was to assess whether perinatal factors are associated with the risk of asthma in childhood in a register-based, nested case-control study in Finland. All children born between January 1, 1996, and April 30, 2004, who were entitled to a special reimbursement for antiasthmatic drugs (i.e., had diagnosed asthma by 2006 and had purchased inhaled corticosteroids or montelukast at least once), were identified (n = 21,038). For each case, one matched control child was selected. The associations between perinatal factors, derived from the Finnish Medical Birth Register, and the risk of asthma were analyzed by conditional logistic regression. In the final multivariate model, maternal asthma, young age, smoking, previous miscarriages, and a high number of previous deliveries, as well as cesarean section, low gestational age, and low ponderal index, were associated with an increased risk of asthma in children diagnosed before the age of 3 years. Among children diagnosed at the age of 3 years or later, maternal asthma, low gestational age, and low ponderal index were associated with an increased risk, and a high number of previous deliveries was associated with a decreased risk of asthma. In conclusion, perinatal factors play a role in the development of asthma in childhood, but the etiology may differ in early and late-onset asthma.
PubMed ID
18511427 View in PubMed
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