Format

Send to

Choose Destination
J Pediatr. 2018 Jul;198:201-208.e3. doi: 10.1016/j.jpeds.2018.02.032. Epub 2018 Apr 4.

Maternal Black Race and Persistent Wheezing Illness in Former Extremely Low Gestational Age Newborns: Secondary Analysis of a Randomized Trial.

Collaborators (118)

Strong SH9, Immamura-Ching J9, Orfanos-Villalobos M9, Williams C9, Durand DJ10, Merrill JD10, Horton D10, Pacello L10, Willard A10, Truog WE11, Gauldin C11, Holmes A11, Johnson P11, Meinert K11, Reynolds AM12, Lucie J12, Conway P12, Sacilowski M12, Leadersdorff M12, Orbank P12, Wynn K12, Steinhorn RH13, deUngria M13, Khan JY13, Hamann K13, Schau M13, Hopkins B13, Jenson J13, Garcia C14, Parekh A15, Shariff J15, McGovern R15, Adelman J15, Combs A15, Tjersland M15, Mayock DE16, Howland E16, Walker S16, Longoria J16, Meo H16, Khan A17, McDavid G17, Burson K17, Hinojosa R17, Johnson C17, Martin K17, Martin S17, Rogers S17, Wright S17, Hudak ML18, Barnette K18, Kellum A18, Burcke M18, Hayes C18, Chadwick S18, Howard D18, Kennedy C18, Prince R18, Helderman J19, O'Shea TM19, Stefanescu B19, Warden K19, Brown P19, Griffin J19, Conley L19, Bendel CM20, Georgieff M20, Davern B20, Mills M20, Ritter S20, Wagner C21, Ryan RM21, Fanning D21, Roberson J21, Mammel MC22, Lampland A22, Meyers P22, Brey A22, Bendel-Stenzel EM23, Mulrooney N23, Worwa C23, Dixon P23, Ebert G23, Hejl C23, Maxwell M23, McCullough K23, Dhanireddy R24, El Abiad MT24, Talati A24, Dempsey S24, Gammage K24, Gower G24, James K24, LeNoue P24, McKay VJ25, Bell S25, Bruton D25, Beaulieu M25, Williams R25, Wadhawan R26, Barron-Nelson R26, Taylor S26, Courtney SE27, Sikes C27, Lowe G27, Proffitt B27, Rogers EE28, Chapin C28, Horneman H28, Hamann K28, Kelley S28, Knowles K, Newton N28, Vittinghoff E29, Hietpas J29, Denton L29, Palermo L29, Wu L29.

Author information

1
Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, CA.
2
Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, OH.
3
Department of Pediatrics, UCSF Benioff Children's Hospital, San Francisco, CA; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA.
4
Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA.
5
Department of Pediatrics, UCSF Benioff Children's Hospital, Oakland, CA.
6
Department of Pediatrics, The University of Pennsylvania, Philadelphia, PA.
7
Department of Pediatrics, UCSF Benioff Children's Hospital, San Francisco, CA.
8
Department of Pediatrics, UCSF Benioff Children's Hospital, San Francisco, CA. Electronic address: kellerr@ucsf.edu.
9
UCSF Benioff Children's Hospital, San Francisco, CA.
10
Alta Bates Summit Medical Center, Berkeley, CA; UCSF Benioff Children's Hospital Oakland, Oakland, CA.
11
Children's Mercy Hospital, Kansas City, MO.
12
Women and Children's Hospital of Buffalo, Buffalo, NY.
13
Anne and Robert H. Lurie Children's Hospital/Northwestern University, Chicago, IL.
14
Texas Children's Hospital, Houston, TX.
15
Stony Brook University Hospital, Stony Brook, NY.
16
University of Washington, Seattle, WA.
17
University of Texas Health Science Center, Houston, TX.
18
University of Florida College of Medicine, Jacksonville, UF Health Shands Hospital, Wolfson Children's Hospital, Jacksonville, FL.
19
Wake Forest School of Medicine and Forsyth Medical Center, Winston Salem, NC.
20
University of Minnesota Amplatz Children's Hospital, Minneapolis, MN.
21
Medical University of South Carolina, Charleston, SC.
22
Children's Hospitals and Clinics of Minnesota, St. Paul, MN.
23
Children's Hospitals and Clinics of Minnesota, Minneapolis, MN.
24
University of Tennessee Health Science Center, Memphis, TN.
25
All Children's Hospital, St. Petersburg, FL.
26
Florida Hospital for Children, Orlando, FL.
27
Arkansas Children's Hospital, University of Arkansas Medical Sciences, Little Rock, AK.
28
Clinical Coordinating Center; Department of Pediatrics, University of California San Francisco, San Francisco, CA.
29
Data Coordinating Center; Department of Epidemiology and Biostatistics , University of California San Francisco, San Francisco, CA.

Abstract

OBJECTIVE:

To evaluate the relationship between maternal self-reported race/ethnicity and persistent wheezing illness in former high-risk, extremely low gestational age newborns, and to quantify the contribution of socioeconomic, environmental, and biological factors on this relationship.

STUDY DESIGN:

We assessed persistent wheezing illness determined at 18-24 months corrected (for prematurity) age in survivors of a randomized trial. Parents/caregivers were surveyed for wheeze and inhaled asthma medication use quarterly to 12 months, and at 18 and 24 months. We used multivariable analysis to evaluate the relationship of maternal race to persistent wheezing illness, and identified mediators for this relationship via formal mediation analysis.

RESULTS:

Of 420 infants (25.2 ± 1.2 weeks of gestation and 714 ± 166 g at birth, 57% male, 34% maternal black race), 189 (45%) had persistent wheezing illness. After adjustment for gestational age, birth weight, and sex, infants of black mothers had increased odds of persistent wheeze compared with infants of nonblack mothers (OR = 2.9, 95% CI 1.9, 4.5). Only bronchopulmonary dysplasia, breast milk diet, and public insurance status were identified as mediators. In this model, the direct effect of race accounted for 69% of the relationship between maternal race and persistent wheeze, whereas breast milk diet, public insurance status, and bronchopulmonary dysplasia accounted for 8%, 12%, and 10%, respectively.

CONCLUSIONS:

Among former high-risk extremely low gestational age newborns, infants of black mothers have increased odds of developing persistent wheeze. A substantial proportion of this effect is directly accounted for by race, which may reflect unmeasured environmental influences, and acquired and innate biological differences.

TRIAL REGISTRATION:

ClinicalTrials.gov: NCT01022580.

KEYWORDS:

asthma; prematurity; socioeconomic factors

PMID:
29627188
PMCID:
PMC6019148
DOI:
10.1016/j.jpeds.2018.02.032
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center