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Socioeconomic Status, Smoke Exposure, and Health Outcomes in Young Children With Cystic Fibrosis

Pediatrics (Evanston), 2017-02, Vol.139 (2), p.1 [Peer Reviewed Journal]

Copyright © 2017 by the American Academy of Pediatrics. ;Copyright American Academy of Pediatrics Feb 2017 ;Copyright © 2017 by the American Academy of Pediatrics 2017 ;ISSN: 0031-4005 ;EISSN: 1098-4275 ;DOI: 10.1542/peds.2016-2730 ;PMID: 28093464 ;CODEN: PEDIAU

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Title:
Socioeconomic Status, Smoke Exposure, and Health Outcomes in Young Children With Cystic Fibrosis
Author: Ong, Thida ; Schechter, Michael ; Yang, Jing ; Peng, Limin ; Emerson, Julia ; Gibson, Ronald L ; Morgan, Wayne ; Rosenfeld, Margaret
Subjects: Analysis ; Body Weight ; Care and treatment ; Child ; Child, Preschool ; Children & youth ; Cohort Studies ; Cystic fibrosis ; Cystic Fibrosis - diagnosis ; Cystic Fibrosis - epidemiology ; Female ; Follow-Up Studies ; Forced Expiratory Volume ; Health aspects ; Humans ; Infant ; Infant, Newborn ; Longitudinal Studies ; Male ; Nutrition ; Pediatrics ; Respiratory Sounds ; Risk factors ; Smoking ; Smoking and youth ; Social economics ; Socioeconomic Factors ; Socioeconomics ; Tobacco Smoke Pollution - adverse effects ; Tobacco Smoke Pollution - statistics & numerical data ; Youth smoking
Is Part Of: Pediatrics (Evanston), 2017-02, Vol.139 (2), p.1
Description: Lower socioeconomic status (SES) and environmental tobacco smoke (ETS) exposure are both associated with poorer disease outcomes in cystic fibrosis (CF), and children with low SES are disproportionately exposed to ETS. We analyzed a large cohort of young children with CF to distinguish the impact of SES and ETS on clinical outcomes. The Early Pseudomonas Infection Control Observational study enrolled Pseudomonas-negative young children with CF <13 years of age. An enrollment survey assessed SES and ETS exposures. Forced expiratory volume in 1 second (FEV ), crackles and wheezes, and weight-for-age percentile were assessed at each clinical encounter over at least 4 years. Repeated measures analyses estimated the association of SES and ETS exposures with longitudinal clinical outcomes, adjusting for confounders. Of 1797 participants, 1375 were eligible for analysis. Maternal education was high school or less in 28.1%, 26.8% had household income <$40 000, and 43.8% had Medicaid or no insurance. Maternal smoking after birth was present in 24.8%, more prevalent in household with low SES. In separate models, lower SES and ETS exposure were significantly associated with lower FEV % predicted, presence of crackles or wheezes, and lower weight percentile. In combined models, effect estimates for SES changed minimally after adjustment for ETS exposures, whereas estimates for ETS exposures were attenuated after adjusting for SES. ETS exposure was disproportionately high in low SES families in this cohort of children with CF. Lower SES and ETS exposure had independent adverse effects on pulmonary and nutritional outcomes. Estimated effect of SES on FEV decreased minimally after ETS adjustment, suggesting health disparity risks independent of ETS exposure.
Publisher: United States: American Academy of Pediatrics
Language: English
Identifier: ISSN: 0031-4005
EISSN: 1098-4275
DOI: 10.1542/peds.2016-2730
PMID: 28093464
CODEN: PEDIAU
Source: MEDLINE
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Socioeconomic Status, Smoke Exposure, and Health Outcomes in Young Children With Cystic Fibrosis

Copyright © 2017 by the American Academy of Pediatrics. ;Copyright American Academy of Pediatrics Feb 2017 ;Copyright © 2017 by the American Academy of Pediatrics 2017 ;ISSN: 0031-4005 ;EISSN: 1098-4275 ;DOI: 10.1542/peds.2016-2730 ;PMID: 28093464 ;CODEN: PEDIAU

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