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The increased purchase of asthma medication for individuals born preterm seems to wane with age: A register-based longitudinal national cohort study

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@article{3e1a8affe8a442d1b2e621ee99f33822,
title = "The increased purchase of asthma medication for individuals born preterm seems to wane with age: A register-based longitudinal national cohort study",
abstract = "INTRODUCTION: Preterm birth is associated with increased risk of respiratory symptoms in childhood, often treated with asthma medication. We designed a follow-up study to previous research and investigated whether the association of gestational age with purchasing asthma medication diminishes in adulthood.METHODS: We conducted a register-based study of a national cohort of all infants born in Denmark in 1980-2009 evaluating longitudinal data on individually prescribed asthma medication (both inhaled {\ss}-2 receptor agonist and different controller treatment over 2-year periods) available from 1995-2011. We analyzed the effect of gestational age considering age, birth year, and perinatal variables using logistic regression with a Generalized Estimating Equations model. All data were unambiguously linked through the Civil Registration System.RESULTS: We included 1,819,743 individuals in our study population. We found an inverse dose-response relationship between gestational age and asthma medication in earlier age-groups with a gradual decrease in odds ratios with increasing age and loss of statistical significance in early adulthood (18-31 years). For our oldest generations, there was a significant effect of gestational age (p-value = 0.04), which became insignificant when adjusting for confounding and mediating factors (p = 0.44). There were significant interactions between gestational age and age (p<0.0001) and gestational age and birth year, but these were most important during childhood (0-11 years) and for our youngest generations (born after 1995).CONCLUSION: The strong association between gestational age and purchase of prescription asthma medication weakens with age into early adulthood, in consistence with the results from our previous study. The risk for purchasing medication to treat asthma-like symptoms was higher in more recent birth years, but the effect of gestational age was small beyond 11 years of age. Gestational age per se did not seem to be significant for the development of asthma-like symptoms: most of its effect could be explained by other perinatal factors.",
keywords = "Adolescent, Adult, Anti-Asthmatic Agents/therapeutic use, Asthma/drug therapy, Child, Child, Preschool, Denmark/epidemiology, Drug Utilization/statistics & numerical data, Female, Follow-Up Studies, Gestational Age, Humans, Infant, Infant, Newborn, Longitudinal Studies, Male, Pregnancy, Premature Birth/physiopathology, Retrospective Studies, Risk Factors, Young Adult",
author = "Damgaard, {Anne Louise de Barros} and Rasmus Gregersen and Theis Lange and Frederik Buchvald and Hansen, {Bo M{\o}lholm} and Gorm Greisen",
year = "2018",
month = jul,
doi = "10.1371/journal.pone.0199884",
language = "English",
volume = "13",
journal = "PLOS ONE",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "7",

}

RIS

TY - JOUR

T1 - The increased purchase of asthma medication for individuals born preterm seems to wane with age

T2 - A register-based longitudinal national cohort study

AU - Damgaard, Anne Louise de Barros

AU - Gregersen, Rasmus

AU - Lange, Theis

AU - Buchvald, Frederik

AU - Hansen, Bo Mølholm

AU - Greisen, Gorm

PY - 2018/7

Y1 - 2018/7

N2 - INTRODUCTION: Preterm birth is associated with increased risk of respiratory symptoms in childhood, often treated with asthma medication. We designed a follow-up study to previous research and investigated whether the association of gestational age with purchasing asthma medication diminishes in adulthood.METHODS: We conducted a register-based study of a national cohort of all infants born in Denmark in 1980-2009 evaluating longitudinal data on individually prescribed asthma medication (both inhaled ß-2 receptor agonist and different controller treatment over 2-year periods) available from 1995-2011. We analyzed the effect of gestational age considering age, birth year, and perinatal variables using logistic regression with a Generalized Estimating Equations model. All data were unambiguously linked through the Civil Registration System.RESULTS: We included 1,819,743 individuals in our study population. We found an inverse dose-response relationship between gestational age and asthma medication in earlier age-groups with a gradual decrease in odds ratios with increasing age and loss of statistical significance in early adulthood (18-31 years). For our oldest generations, there was a significant effect of gestational age (p-value = 0.04), which became insignificant when adjusting for confounding and mediating factors (p = 0.44). There were significant interactions between gestational age and age (p<0.0001) and gestational age and birth year, but these were most important during childhood (0-11 years) and for our youngest generations (born after 1995).CONCLUSION: The strong association between gestational age and purchase of prescription asthma medication weakens with age into early adulthood, in consistence with the results from our previous study. The risk for purchasing medication to treat asthma-like symptoms was higher in more recent birth years, but the effect of gestational age was small beyond 11 years of age. Gestational age per se did not seem to be significant for the development of asthma-like symptoms: most of its effect could be explained by other perinatal factors.

AB - INTRODUCTION: Preterm birth is associated with increased risk of respiratory symptoms in childhood, often treated with asthma medication. We designed a follow-up study to previous research and investigated whether the association of gestational age with purchasing asthma medication diminishes in adulthood.METHODS: We conducted a register-based study of a national cohort of all infants born in Denmark in 1980-2009 evaluating longitudinal data on individually prescribed asthma medication (both inhaled ß-2 receptor agonist and different controller treatment over 2-year periods) available from 1995-2011. We analyzed the effect of gestational age considering age, birth year, and perinatal variables using logistic regression with a Generalized Estimating Equations model. All data were unambiguously linked through the Civil Registration System.RESULTS: We included 1,819,743 individuals in our study population. We found an inverse dose-response relationship between gestational age and asthma medication in earlier age-groups with a gradual decrease in odds ratios with increasing age and loss of statistical significance in early adulthood (18-31 years). For our oldest generations, there was a significant effect of gestational age (p-value = 0.04), which became insignificant when adjusting for confounding and mediating factors (p = 0.44). There were significant interactions between gestational age and age (p<0.0001) and gestational age and birth year, but these were most important during childhood (0-11 years) and for our youngest generations (born after 1995).CONCLUSION: The strong association between gestational age and purchase of prescription asthma medication weakens with age into early adulthood, in consistence with the results from our previous study. The risk for purchasing medication to treat asthma-like symptoms was higher in more recent birth years, but the effect of gestational age was small beyond 11 years of age. Gestational age per se did not seem to be significant for the development of asthma-like symptoms: most of its effect could be explained by other perinatal factors.

KW - Adolescent

KW - Adult

KW - Anti-Asthmatic Agents/therapeutic use

KW - Asthma/drug therapy

KW - Child

KW - Child, Preschool

KW - Denmark/epidemiology

KW - Drug Utilization/statistics & numerical data

KW - Female

KW - Follow-Up Studies

KW - Gestational Age

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Longitudinal Studies

KW - Male

KW - Pregnancy

KW - Premature Birth/physiopathology

KW - Retrospective Studies

KW - Risk Factors

KW - Young Adult

U2 - 10.1371/journal.pone.0199884

DO - 10.1371/journal.pone.0199884

M3 - Journal article

C2 - 29975752

VL - 13

JO - PLOS ONE

JF - PLOS ONE

SN - 1932-6203

IS - 7

M1 - e0199884

ER -

ID: 56218879