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- Publisher Website: 10.1001/archpedi.154.7.657
- Scopus: eid_2-s2.0-0033937688
- PMID: 10891016
- WOS: WOS:000088075100003
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Article: A randomized clinical trial on the effectiveness of a multifaceted intervention measures in the primary prevention of asthma in high-risk infants
Title | A randomized clinical trial on the effectiveness of a multifaceted intervention measures in the primary prevention of asthma in high-risk infants |
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Authors | |
Issue Date | 2000 |
Publisher | American Medical Association. The Journal's web site is located at http://www.archpediatrics.com |
Citation | Archives of Pediatrics & Adolescent Medicine, 2000, v. 154 n. 7, p. 657-663 How to Cite? |
Abstract | BACKGROUND:
The prevalence of asthma has increased in developed countries in the past 2 decades. The effectiveness of intervention measures on the primary prevention of asthma has not been well studied.
OBJECTIVE:
To assess the effectiveness of a multifaceted intervention program in the primary prevention of asthma in high-risk infants (in this study, infants are defined as persons from birth to the age of 1 year).
DESIGN:
Prospective, prenatally randomized, controlled study with follow-up through the age of 1 year.
SETTING:
University hospital-based settings at 2 Canadian centers: Vancouver, British Columbia, and Winnipeg, Manitoba.
PARTICIPANTS:
A total of 545 high-risk infants (at least 1 first-degree relative with asthma or 2 first-degree relatives with other IgE-mediated allergic diseases) identified before birth.
INTERVENTIONS:
Avoidance of house dust mite and pet allergens and environmental tobacco smoke, encouragement of breastfeeding, and supplementation with a partially hydrolyzed formula.
MAIN OUTCOME MEASURES:
Probable or possible asthma, rhinitis without apparent colds, and a prick skin test result positive for common inhalant allergens.
RESULTS:
Thirty-eight (15.1%) of the 251 infants available for assessment in the intervention group and 49 (20.2%) of the 242 infants available for assessment in the control group fulfilled the criteria for possible or probable asthma (adjusted relative risk, 0.66; 90% confidence interval, 0.44-0.98). Also, 16.7% of the infants in the intervention group and 27.3% of the infants in the control group developed rhinitis without colds (adjusted relative risk, 0.51; 90% confidence interval, 0.35-0.74). The incidence of positive skin test results to 1 or more inhalant allergens was similar in both groups (4.4% in the intervention group and 4.6% in the control group).
CONCLUSIONS:
Our multifaceted intervention program resulted in a modest but significant (P= .04) reduction in the risk of possible or probable asthma and rhinitis without apparent colds at the age of 12 months in high-risk infants. In the absence of a validated definition of asthma at the age of 12 months, follow-up studies are needed to determine the effectiveness of the intervention program in the primary prevention of asthma in high-risk infants. |
Persistent Identifier | http://hdl.handle.net/10722/210263 |
ISSN | 2014 Impact Factor: 5.731 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Chan-Yeung, M | - |
dc.contributor.author | Manfreda, J | - |
dc.contributor.author | Dimich-Ward, H | - |
dc.contributor.author | Ferguson, A | - |
dc.contributor.author | Watson, W | - |
dc.contributor.author | Becker, A | - |
dc.date.accessioned | 2015-06-02T08:48:41Z | - |
dc.date.available | 2015-06-02T08:48:41Z | - |
dc.date.issued | 2000 | - |
dc.identifier.citation | Archives of Pediatrics & Adolescent Medicine, 2000, v. 154 n. 7, p. 657-663 | - |
dc.identifier.issn | 1072-4710 | - |
dc.identifier.uri | http://hdl.handle.net/10722/210263 | - |
dc.description.abstract | BACKGROUND: The prevalence of asthma has increased in developed countries in the past 2 decades. The effectiveness of intervention measures on the primary prevention of asthma has not been well studied. OBJECTIVE: To assess the effectiveness of a multifaceted intervention program in the primary prevention of asthma in high-risk infants (in this study, infants are defined as persons from birth to the age of 1 year). DESIGN: Prospective, prenatally randomized, controlled study with follow-up through the age of 1 year. SETTING: University hospital-based settings at 2 Canadian centers: Vancouver, British Columbia, and Winnipeg, Manitoba. PARTICIPANTS: A total of 545 high-risk infants (at least 1 first-degree relative with asthma or 2 first-degree relatives with other IgE-mediated allergic diseases) identified before birth. INTERVENTIONS: Avoidance of house dust mite and pet allergens and environmental tobacco smoke, encouragement of breastfeeding, and supplementation with a partially hydrolyzed formula. MAIN OUTCOME MEASURES: Probable or possible asthma, rhinitis without apparent colds, and a prick skin test result positive for common inhalant allergens. RESULTS: Thirty-eight (15.1%) of the 251 infants available for assessment in the intervention group and 49 (20.2%) of the 242 infants available for assessment in the control group fulfilled the criteria for possible or probable asthma (adjusted relative risk, 0.66; 90% confidence interval, 0.44-0.98). Also, 16.7% of the infants in the intervention group and 27.3% of the infants in the control group developed rhinitis without colds (adjusted relative risk, 0.51; 90% confidence interval, 0.35-0.74). The incidence of positive skin test results to 1 or more inhalant allergens was similar in both groups (4.4% in the intervention group and 4.6% in the control group). CONCLUSIONS: Our multifaceted intervention program resulted in a modest but significant (P= .04) reduction in the risk of possible or probable asthma and rhinitis without apparent colds at the age of 12 months in high-risk infants. In the absence of a validated definition of asthma at the age of 12 months, follow-up studies are needed to determine the effectiveness of the intervention program in the primary prevention of asthma in high-risk infants. | - |
dc.language | eng | - |
dc.publisher | American Medical Association. The Journal's web site is located at http://www.archpediatrics.com | - |
dc.relation.ispartof | Archives of Pediatrics & Adolescent Medicine | - |
dc.subject.mesh | Asthma - genetics - prevention & control | - |
dc.subject.mesh | Follow-Up Studies | - |
dc.subject.mesh | Genetic Predisposition to Disease - genetics | - |
dc.subject.mesh | Immunoglobulin E-blood | - |
dc.subject.mesh | Respiratory Hypersensitivity - genetics - prevention & control | - |
dc.title | A randomized clinical trial on the effectiveness of a multifaceted intervention measures in the primary prevention of asthma in high-risk infants | - |
dc.type | Article | - |
dc.identifier.email | Chan-Yeung, M: mmwchan@hku.hk | - |
dc.identifier.doi | 10.1001/archpedi.154.7.657 | - |
dc.identifier.pmid | 10891016 | - |
dc.identifier.scopus | eid_2-s2.0-0033937688 | - |
dc.identifier.hkuros | 52980 | - |
dc.identifier.volume | 154 | - |
dc.identifier.issue | 7 | - |
dc.identifier.spage | 657 | - |
dc.identifier.epage | 663 | - |
dc.identifier.isi | WOS:000088075100003 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 1072-4710 | - |