Emma Goksör

Early introduction of fish decreases the risk of eczema in infants

Background: Atopic eczema in infants has increased in western societies. Environmental factors and the introduction of food may affect the risk of eczema. Aims: To investigate the prevalence of eczema among infants in western Sweden, describe patterns of food introduction and assess risk factors for eczema at 1 year of age. Methods: Data were obtained from a prospective, longitudinal cohort study of infants born in western Sweden in 2003; 8176 families were randomly selected and, 6 months after the infant’s birth, were invited to participate and received questionnaires. A second questionnaire was sent out when the infants were 12 months old. Both questionnaires were completed and medical birth register data were obtained for 4921 infants (60.2% of the selected population). Results: At 1 year of age, 20.9% of the infants had previous or current eczema. Median age at onset was 4 months. In multivariable analysis, familial occurrence of eczema, especially in siblings (OR 1.87; 95% confidence interval (CI) 1.50 to 2.33) or the mother (OR 1.54; 95% CI 1.30 to 1.84), remained an independent risk factor. Introducing fish before 9 months of age (OR 0.76; 95% CI 0.62 to 0.94) and having a bird in the home (OR 0.35; 95% CI 0.17 to 0.75) were beneficial. Conclusions: One in five infants suffer from eczema during the first year of life. Familial eczema increased the risk, while early fish introduction and bird keeping decreased it. Breast feeding and time of milk and egg introduction did not affect the risk.

The impact of pre- and post-natal smoke exposure on future asthma and bronchial hyper-responsiveness

Aim: To analyse the impact of pre‐ and post‐natal smoke exposure on asthma presence, bronchial hyper‐responsiveness, airway function and active smoking in early adulthood.

Asthma symptoms in early childhood--what happens then?

AIM To study the outcome in early adulthood for children with early asthma symptoms and to analyse the factors associated with current asthma. METHODS In a prospective study, we have re-investigated 89/101 children who were hospitalized before the age of two years due to wheezing. The children were investigated using a questionnaire and allergy and bronchial hyper-responsiveness tests at the age of 17-20 years and compared with age-matched controls. RESULTS In the cohort, 43% had had asthma symptoms in the preceding 12 months compared with 15% in the control group. The strongest risk factors for asthma were current allergy, bronchial hyper-responsiveness and female gender. Female gender and passive smoking in infancy were independent infantile risk factors. In addition to female gender, two pathways led to current asthma: an allergic pathway from family atopy via the development of allergy and another pathway from early passive smoking via hyper-responsiveness and active smoking. CONCLUSION In children with early wheezing disorder, current allergy, bronchial hyper-responsiveness and female gender were the strongest risk factors for asthma in early adulthood, while female gender and passive smoking in infancy were independent infantile risk factors. The effects of early passive smoking persist longer than previously reported.

Early protective and risk factors for allergic rhinitis at age 4½ yr.

To cite this article: Alm B, Goksör E, Thengilsdottir H, Pettersson R, Möllborg P, Norvenius G, Erdes L, Åberg N, Wennergren G. Early protective and risk factors for allergic rhinitis at age 4½ years. Pediatr Allergy Immunol 2011; 22: 398–404.

Bradycardic response during submersion in infant swimming.

The diving response involves reflex bradycardia, apnoea and peripheral vasoconstriction and is known to exist in human infants. The response diminishes with increasing age and has been reported to disappear by the age of 6 mo. This study was performed to analyse the physiological events during natural diving of full‐term healthy infants and describe how these events alter with maturation. Thirty‐six infants were studied during diving exercises in infant swimming. All of the infants who participated showed an immediate decrease in heart rate when submerged. On average, the heart rate decreased by 25% (range –5.0% to –50.7%, p < 0.0001). The bradycardia was sustained during the dive and for some seconds afterwards. The response was often followed by a tachycardia as the bradycardia ceased. A decline of reflex bradycardia was observed with increasing age (p= 0.03), but the response was still clearly evident in infants over the age of 6 mo.

Preschool wheeze - impact of early fish introduction and neonatal antibiotics.

Aim:  The aim of this study was to analyse the risk factors for preschool wheeze with special reference to the early introduction of fish and early antibiotic treatment. To avoid reverse causation regarding antibiotics, we focused on the influence of broad‐spectrum antibiotics given during the first week of life.

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

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.

Prenatal paracetamol exposure and risk of wheeze at preschool age

Aim:  To analyse the association between prenatal paracetamol exposure and preschool wheeze.

Reduced airway function in early adulthood among subjects with wheezing disorder before two years of age

To compare airway function in early adulthood in subjects with wheezing in infancy with age‐matched controls and to analyze what accounts for a possible difference.

Antibiotics in the first week of life is a risk factor for allergic rhinitis at school age

Heredity as well as external factors influences the development of allergic rhinitis. The aim of this study was to analyse early risk factors and protective factors for allergic rhinitis at school age.