BACKGROUND: Prenatal alcohol exposure leads to a myriad of health outcomes that are known as Fetal Alcohol Spectrum Disorders (FASDs). In animal models, in utero ethanol exposure has been shown to be associated with diminished lung size and function as well as reduced immune strength. The current study attempts to provide further understanding of the relationship between prenatal alcohol exposure and lung development by hypothesizing that there is an association between having been diagnosed with FASD and having been diagnosed asthma.
METHODS: Information on asthma diagnoses in 619 children between the ages of 1 and 15 with a diagnosis of FASD and who attend the Emory Neurodevelopmental Exposure Clinic (ENEC) was compared with similar information collected about 708 children subjects who attend ENEC, but who do not have a diagnosis FASD and 23,889 children for whom information on asthma diagnoses was obtained through the National Health and Nutrition Examination Survey (NHANES). Logistic regression models were run to examine the association between FASD diagnosis and the cumulative incidence of asthma.
RESULTS: A similar proportion of children with FASD and those attending ENEC for other reasons had been diagnosed with asthma, even after adjusting for potential confounding factors (ORadj = 0.96, 95% CI = 0.71, 1.29). In contrast, compared to participants in NHANES, children with FASD were 30% more likely to have been diagnosed with asthma (ORadj= 1.29; 95% CI 1.03 to 1.61).
CONCLUSIONS: Depending on the comparison group, children with FASD were more likely than expected to have been diagnosed with asthma. However, there is significant concern about selection bias, residual confounding and differential misclassification, and these biases are likely to affect the two comparison groups differently. Therefore, there is insufficient evidence to support an association between FASD-exposure and asthma diagnosis. Future, prospective study that properly controls for confounding by several factors is needed.
Table of Contents
Table of Contents
BACKGROUND AND LITERATURE REVIEW 2
Fetal Alcohol Spectrum Disorders 2
In Utero Alcohol Exposure and Fetal Development 4
Childhood Asthma 8
Study Question 11
Study Design 11
Variable and Data Measures 14
Analytic Methods 17
Univariate Analyses of Covariates 19
Bivariate Analyses 20
Logistic Regression 20
Interpretation of Results 22
Strengths and Limitations 22
Limitations & Sensitivity Analyses 24
FUTURE DIRECTIONS AND CONCLUSIONS 33
Suggestions for Future Research 33
About this Master's Thesis
|Committee Chair / Thesis Advisor|
|Association between Fetal Alcohol Spectrum Disorders and Asthma Diagnosis in Children ()||2018-08-28||