Association of infant and child health characteristics with the hazard of any medical condition or disability in Australian children.

Kabir Ahmad, Syed Afroz Keramat, Nusrat Jahan Sathi, Enamul Kabir, Rasheda Khanam
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Abstract

Background: 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.

Objectives: 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.

Methods: 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.

Results: 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..

Conclusions: 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.

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婴儿和儿童健康特征与澳大利亚儿童的任何医疗状况或残疾危险之间的联系。
背景:近几十年来,澳大利亚儿童中任何医疗状况(例如,视力、听力和语言问题、昏迷、慢性疼痛等)或残疾(例如,限制使用手臂或手指、腿和脚,或其他限制日常活动的身体长期健康状况等)的发生率一直在增加。目的:本研究评估婴儿或儿童健康特征是否可以预测儿童在生命的前15年的后续医疗状况或残疾。方法:使用从澳大利亚儿童纵向研究的出生队列中获得的5107名儿童的时间事件数据,研究使用生存分析技术估计任何医疗状况或残疾的发生率。本研究随访了从出生到14或15岁(2004-2018)的儿童,并使用随机效应参数生存回归模型评估了婴儿和儿童健康特征(出生体重、胎龄、新生儿期重症监护病房或呼吸机的使用情况以及肥胖)与任何医疗状况或残疾风险的关系。在儿童0/1岁时,在第1波测量婴儿特征,在14/15岁之前的所有波中纵向测量肥胖特征。结果:在澳大利亚儿童中,所有参与者的任何医疗状况或残疾的危险率为每1000人年26.13人。低出生体重儿的危险发生率(39.07)高于正常出生体重儿(24.89)。肥胖儿童(34.37)的危险率高于正常体重儿童(24.82),接受过产后通气或重症监护病房急救服务的儿童(36.87)的危险率高于未接受过这些服务的儿童(24.20)。参数面板回归模型还表明,低出生体重儿童出现任何疾病或残疾的可能性是正常出生体重儿童的1.43倍(风险比:1.43,95%可信区间:1.05-1.94)。事件时间分析还显示,接受出生后紧急情况(HR: 1.47, 95% CI: 1.23-1.75)、男性儿童(HR: 1.30, 95% CI: 1.14-1.48)或肥胖(HR: 1.38, 95% CI: 1.07-1.79)显著增加了儿童发生医疗状况或残疾的可能性。根据儿童和母亲的社会人口学特征对回归模型进行了调整。结论:研究结果表明,低出生体重婴儿、医院急诊服务使用和肥胖儿童将受益于额外的卫生保健监测,以尽量减少任何医疗状况或残疾的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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