Effect of helminthic infections together with mite allergen exposure on the risk of wheeze in preschool children.

Although some studies have indicated that helminthic infections and house dust mite exposure may have an alleviating effect on wheeze, an interaction effect of both risk factors has not been examined in Thailand. The objective of this study was to investigate whether exposure to helminthic infections together with house dust mite allergen was associated with wheeze in children aged 18-36 months, living in an area of southern Thailand where helminthic infections are endemic. This study was undertaken as a part of The Prospective Cohort Study of Thai Children which recruited 1,076 children born between December 2000 and November 2001. A home dust sample was collected once when the infants were 12-18 months old to measure house dust mite allergen (Der p1). Questionnaire data on wheeze and a stool specimen for soil-transmitted helminth analysis were collected at age 18-36 months. Prevalence of exposure to house dust mite allergen (Der p1) > 10 μg/g dust was 31.8%. Soil-transmitted helminths were present in 25.0%, predominately Ascaris lumbricoides. Hookworm infection was asso-ciated with a physician’s diagnosis of wheeze (OR 4.20, 95% CI 1.45-12.10) and hospitalized wheeze (OR 5.40, 95% CI 1.26-23.01). Hospitalized wheeze was significantly higher in subjects exposed to Der p1 2-10 μg/g dust. Helminthic infections were not associated with a significant interaction effect with mite allergen against a risk of wheeze. Our survey confirms that hookworm infection and mite allergen exposure are independent risk factors for childhood wheeze and there is no evidence of important interaction between the two.

A population-based cohort study of effect of maternal risk factors on low birthweight in Thailand.

OBJECTIVES: To determine the maternal risk factors of low birthweight (LBW) in Thailand and to address the possible activities to reduce the incidence of LBW. MATERIAL AND METHOD: The data were obtained from the Prospective Cohort Study in Thai Children (PCTC). Three thousand five hundred twenty two pregnancies initiated the follow-up in the year 2000 at four districts across Thailand The birthweight was retrieved from the Delivery Summary Sheet of the hospitals. The babies born in the hospital were weighed within the first day of life. The babies born at home were weighed within 3 days after birth by the research assistants. Only singleton live births were included in the present study. RESULTS: Three thousand three hundred twenty two live births with birthweight data, 8.6% were LBW. Maternal factors affecting LBW with high attributable fraction (AF) and moderate population attributable risk (PAR) were maternal extreme age (AF = 45.96, PAR = 16.24) and weight gain during pregnancy less than 10 kg. (AF = 40.12, PAR = 16.05). The factors with moderate AF and PAR were first and more than two parities (AF = 21.9, PAR = 15.51) and less consultation to health personnel (AF = 20.96, PAR = 16.98). CONCLUSIONS: Improving nutritional status of pregnant women is a potential activity to reduce the incidence of LBW. Pregnant women with extreme age, first and more than parity two and less consultation to health personnel should also be closely followed-up.

Differences in socio-economic status, service utilization, and pregnancy outcomes between teenage and adult mothers.

BACKGROUND: Teenage pregnancies put mothers at high-risks to many health-related complications and newborn infants to poor birth-outcomes. OBJECTIVE: The present study aimed to explore the relationship of socio-economic status, service utilization, and pregnancy outcomes between teenage and adult mothers. MATERIAL AND METHOD: The study design was a population-based prospective cohort study conducted in four districts located in different geographical areas of Thailand All pregnancies occurring within one year, in each of the selected districts as of October 2000, were identified and recruited as the study's cohorts. Data was collected by interviewing cohort-respondents and through reviewing medical records. RESULTS: The present study showed that teenage pregnancies accounted for 13.3% of all pregnancies in the study area. Approximately two thirds of the teenage cohort (i.e. 68.8%) were 18-19 years of age, while the remaining cohort members were 14-17 years of age (i.e. 26.1% aged 16-17 years, and 5.1% aged 14-15 years). The percentage of low-birth weights for teenage and adult mothers were 15.1% and 8.8% respectively. A higher percentage of teenage mothers enrolled in or completed secondary or higher levels of education has had more abnormal deliveries in comparison with adult mothers. In comparison with the non-teenage mothers, a greater proportion of teenage mothers had insufficient income, did not own their homes/houses, were single parents, had fewer consultations with health personnel, did not plan their pregnancy, were pregnant for the first time, and delivered infants with low-birth weights. CONCLUSION: The prevalence of teenage pregnancies in Thailand remains high. Most teenage mothers and their newborn infants are vulnerable to a variety of potentially serious health problems, and accordingly need appropriate help and support.