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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

TitleA randomized clinical trial on the effectiveness of a multifaceted intervention measures in the primary prevention of asthma in high-risk infants
Authors
Issue Date2000
PublisherAmerican 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?
AbstractBACKGROUND: 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 Identifierhttp://hdl.handle.net/10722/210263
ISSN
2014 Impact Factor: 5.731

 

DC FieldValueLanguage
dc.contributor.authorChan-Yeung, M-
dc.contributor.authorManfreda, J-
dc.contributor.authorDimich-Ward, H-
dc.contributor.authorFerguson, A-
dc.contributor.authorWatson, W-
dc.contributor.authorBecker, A-
dc.date.accessioned2015-06-02T08:48:41Z-
dc.date.available2015-06-02T08:48:41Z-
dc.date.issued2000-
dc.identifier.citationArchives of Pediatrics & Adolescent Medicine, 2000, v. 154 n. 7, p. 657-663-
dc.identifier.issn1072-4710-
dc.identifier.urihttp://hdl.handle.net/10722/210263-
dc.description.abstractBACKGROUND: 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.languageeng-
dc.publisherAmerican Medical Association. The Journal's web site is located at http://www.archpediatrics.com-
dc.relation.ispartofArchives of Pediatrics & Adolescent Medicine-
dc.subject.meshAsthma - genetics - prevention & control-
dc.subject.meshFollow-Up Studies-
dc.subject.meshGenetic Predisposition to Disease - genetics-
dc.subject.meshImmunoglobulin E-blood-
dc.subject.meshRespiratory Hypersensitivity - genetics - prevention & control-
dc.titleA randomized clinical trial on the effectiveness of a multifaceted intervention measures in the primary prevention of asthma in high-risk infants-
dc.typeArticle-
dc.identifier.emailChan-Yeung, M: mmwchan@hku.hk-
dc.identifier.doi10.1001/archpedi.154.7.657-
dc.identifier.pmid10891016-
dc.identifier.hkuros52980-
dc.identifier.volume154-
dc.identifier.issue7-
dc.identifier.spage657-
dc.identifier.epage663-
dc.publisher.placeUnited States-

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