RESULTS
The cohort included 339 pregnant women/offspring enrolled during
2014-2016. Complete data were available for 307 (91%) dyads, including
44 preschoolers with API+ and 263 with API– at 30 months (Table 1).
There were no significant differences in baseline characteristics
between mothers of API+ and API– children (Table 2). Mothers of API+
toddlers had slightly higher body mass index (BMI), prior contraceptive
use, and higher education level, but these did not achieve statistical
significance.
At the time of birth, API+ and API– children were similar in terms of
most sociodemographic and perinatal characteristics (Table 2); API+
children had slightly higher birth weight and heavier placenta than
API– children, but again the differences did not reach statistical
significance (Table 2).
During the bi-annual follow-up surveys (Table 3), API+ children had a
significantly higher prevalence of symptoms associated with asthma than
API– children, including cough after crying, laughing or agitation; as
well as higher prevalence reported croup, pneumonia, and antibiotics for
respiratory infections. API+ children were also younger at the first
episode of bronchiolitis compared to API– children. The API+ group had
a higher prevalence of reported physician diagnosis of asthma than the
API– group; as well as more frequent oral corticosteroid (OCS) courses,
inhaled corticosteroid (ICS) use, ED visits for wheezing, and
hospitalizations for wheezing (Table 3). There were no consistent
differences between groups in terms of GERD, AOM, paracetamol use, pets
at home, or second-hand tobacco smoking (Table 3).
API+ children also had significantly higher adiponectin in cord blood
and higher IL-10 at 30 months than API– children, but there were no
other significant differences in adipokines or cytokines (Suppl Table
1). The proportion of detectable Phadiatop at 30 months was also similar
between API groups (Suppl Table 1).
In order to test the diagnostic accuracy for the API with the
physician-diagnosed asthma during the first 30 months, the stringent
API+ had sensitivity=48.2%
[95%CI: 46.5-50.0], specificity=92.4% [92.2-92.7], positive
predicted value (PPV)=61.4% [59.2-63.5], negative predictive value
(NPV)=87.78% [87.5-88.0], positive LR=6.4 [3.8-10.9], negative
LR=0.56 [0.4-0.7], overall accuracy=83.6% [0.79-0.88], and
adjusted odds for asthma=11.4 [5.5-23.4].
After adjusting for potential confounders, including history of
bronchiolitis and pneumonia, the API+ was independently associated with
physician-diagnosed asthma at age 30 months (adjOR= 5.7 [2.6-12.3]),
Table 4.