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Growth and respiratory status at 3 years of age after moderate preterm, late preterm and early term births: the Japan Environment and Children’s Study
  1. Katsuya Hirata1,
  2. Kimiko Ueda2,3,
  3. Satoyo Ikehara3,4,
  4. Kanami Tanigawa2,4,
  5. Kazuko Wada1,
  6. Tadashi Kimura5,
  7. Keiichi Ozono6,
  8. Tomotaka Sobue3,4,
  9. Hiroyasu Iso3,7
  10. the Japan Environment and Children’s Study Group
    1. 1 Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
    2. 2 Osaka Maternal and Child Health Information Center, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
    3. 3 Osaka Regional Center for Japan Environment and Children’s Study (JECS), Osaka University, Suita, Osaka, Japan
    4. 4 Department of Social and Environmental Medicine, Osaka University, Suita, Osaka, Japan
    5. 5 Department of Obstetrics and Gynecology, Osaka University School of Medicine Graduate School of Medicine, Suita, Osaka, Japan
    6. 6 Pediatrics, Osaka University School of Medicine Graduate School of Medicine, Suita, Osaka, Japan
    7. 7 National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
    1. Correspondence to Dr Katsuya Hirata; khirata0513{at}gmail.com

    Abstract

    Objective To assess the association between gestational age at birth and the risk of growth failure and respiratory symptoms at 3 years of age.

    Design Cohort study using the Japan Environment and Children’s Study database.

    Patients A total of 86 158 singleton infants born without physical abnormalities at 32–41 weeks of gestation were enrolled between January 2011 and March 2014.

    Main outcome measures Growth failure (weight <10th percentile and height <10th percentile) and respiratory symptoms (asthma and wheezing) at 3 years of age.

    Methods Logistic regression analysis was used to evaluate the risk of growth failure and respiratory symptoms in the moderately preterm, late preterm and early term groups compared with the full-term group after adjusting for socioeconomic and perinatal factors. Multiple imputation was used to reduce the attrition bias related to missing data.

    Results The respective adjusted ORs (95% CI) of growth failure and respiratory symptoms for the moderate preterm, late preterm and early term groups compared with the full-term group were as follows: weight <10th percentile, 2.29 (1.48–3.54), 1.43 (1.24–1.71) and 1.20 (1.12–1.28); height <10th percentile, 2.34 (1.59–3.45), 1.42 (1.25–1.60) and 1.15 (1.09–1.22); asthma, 1.63 (1.06–2.50), 1.21 (1.04–1.41) and 1.16 (1.09–1.23); and wheezing, 1.39 (1.02–1.90), 1.37 (1.25–1.51) and 1.11 (1.06–1.17).

    Conclusion Moderate preterm, late preterm and early term births were associated with a higher risk of growth failure and respiratory symptoms at 3 years of age than full-term births, with an inverse dose-response pattern.

    • Child Development
    • Growth
    • Child Health
    • Epidemiology
    • Respiratory Medicine

    Data availability statement

    No data are available. Data are unsuitable for public deposition due to ethical restrictions and the legal framework of Japan. It is prohibited by the Act on the Protection of Personal Information (Act No. 57 of 30 May 2003, amendment on 9 September 2015) to publicly deposit the data containing personal information. Ethical Guidelines for Medical and Health Research Involving Human Subjects enforced by the Japan Ministry of Education, Culture, Sports, Science and Technology and the Ministry of Health, Labour and Welfare also restricts the open sharing of the epidemiological data. All inquiries about access to data should be sent to: jecs-en@nies.go.jp. The person responsible for handling enquiries sent to this email address is Dr Shoji F Nakayama, JECS Programme Office, National Institute for Environmental Studies.

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    Data availability statement

    No data are available. Data are unsuitable for public deposition due to ethical restrictions and the legal framework of Japan. It is prohibited by the Act on the Protection of Personal Information (Act No. 57 of 30 May 2003, amendment on 9 September 2015) to publicly deposit the data containing personal information. Ethical Guidelines for Medical and Health Research Involving Human Subjects enforced by the Japan Ministry of Education, Culture, Sports, Science and Technology and the Ministry of Health, Labour and Welfare also restricts the open sharing of the epidemiological data. All inquiries about access to data should be sent to: jecs-en@nies.go.jp. The person responsible for handling enquiries sent to this email address is Dr Shoji F Nakayama, JECS Programme Office, National Institute for Environmental Studies.

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    Footnotes

    • Collaborators Members of the JECS Group as of 2023 are Michihiro Kamijima (principal investigator, Nagoya City University, Nagoya, Japan), Shin Yamazaki (National Institute for Environmental Studies, Tsukuba, Japan), Yukihiro Ohya (National Center for Child Health and Development, Tokyo, Japan), Reiko Kishi (Hokkaido University, Sapporo, Japan), Nobuo Yaegashi (Tohoku University, Sendai, Japan), Koichi Hashimoto (Fukushima Medical University, Fukushima, Japan), Chisato Mori (Chiba University, Chiba, Japan), Shuichi Ito (Yokohama City University, Yokohama, Japan), Zentaro Yamagata (University of Yamanashi, Chuo, Japan), Hidekuni Inadera (University of Toyama, Toyama, Japan), Takeo Nakayama (Kyoto University, Kyoto, Japan), Tomotaka Sobue (Osaka University, Suita, Japan), Masayuki Shima (Hyogo Medical University, Nishinomiya, Japan), Seiji Kageyama (Tottori University, Yonago, Japan), Narufumi Suganuma (Kochi University, Nankoku, Japan), Shoichi Ohga (Kyushu University, Fukuoka, Japan), and Takahiko Katoh (Kumamoto University, Kumamoto, Japan).

    • Contributors Conceptualisation: KH. Methodology: KH, KU, SI, TS and HI. Formal analysis: KH. Data curation: KH. Writing of the original draft: KH. Writing of the review and editing: KU, SI, KT, KW, TK, KO, TS and HI. Supervision: TS and HI. Funding acquisition: HI. KH acts as the guarantor.

    • Funding This study was funded by the Ministry of the Environment, Japan.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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