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Introduction: Studies investigating the potential impact of systemic steroid exposure during early infancy on neurological development in full-term infants with normal birth weight are lacking. Methods: This population-based administrative cohort study used data of national health insurance and a health-screening program for infants and children and included full-term infants who were born in Korea between 2008 and 2012 with normal birth weight and did not have any specific perinatal or neurodevelopmental diseases. The prescription of systemic steroids within the first 3 months of age was mainly considered. The neurological development of children was assessed using the Korean Development Screening Test (K-DST) at 6 years of age. To balance the baseline characteristics of the control and exposed groups, stabilized inverse probability of treatment weighting with trimming was performed in the main cohort. Ordinal logistic regression was used to assess the association between systemic steroid exposure and unfavorable results in the K-DST. Results: The control and exposure groups had 246,168 and 5,083 children, respectively. The K-DST suggested unfavorable results in 8.1% and 8.6% children in the control and exposure groups, respectively (weighted odds ratio, 95% confidence interval, 1.03, 0.93–1.14). When each domain of the K-DST was considered separately, the risk of unfavorable results in the exposed group was not significantly different from that in the control group. Conclusions: No significant association was observed between exposure to systemic steroids during early infancy and neurodevelopmental impairment at 6 years of age. [ABSTRACT FROM AUTHOR]

This article examines the incidence of healthcare utilization for allergic and respiratory infectious diseases in children with asthma before and during the COVID-19 pandemic. The study analyzed data from the Korean Childhood Asthma Study (KAS) cohort and the Health Insurance Review and Assessment Service (HIRA) from March 2016 to March 2021. The findings showed significant decreases in hospital visits for allergic and respiratory diseases during the pandemic, with sustained reductions observed for one year. The decline in healthcare utilization may be attributed to factors such as reduced exposure to triggers and apprehension about accessing healthcare services. Further research is needed to explore the long-term effects of the pandemic on healthcare utilization. [Extracted from the article]

Background: The optimal time of starting complementary foods (CFs) in infants remains a subject of debate. This population‐based longitudinal cohort study evaluated the association between early CF introduction and body mass index (BMI) in children aged 5–7 years. Methods: The present study included 917,707 children born in Korea during 2008–2009. Initial timing of CF introduction was obtained by questionnaires administered between 4 and 6 months and 9 and 12 months of age. The cohort consisted of 154,565 eligible individuals who properly completed the screening programme, including structured questionnaires, anthropometric measurements and physical examinations. To balance baseline characteristics, children were subjected to propensity score matching based on 95 covariates, including indicators of baseline health such as perinatal condition, birth weight, economic status, clinical disease and drug exposure. Exposure was defined as introduction to CF at age < 4 months, and outcomes were overweight (BMI z‐score > 85th percentile) and obesity (BMI z‐score > 95th percentile) at ages 5–7 years. Results: Of the 154,565 eligible children in the observed cohort, 10,499 (6.8%) were introduced to CF at age < 4 months and 144,066 (93.2%) at age ≥ 4 months. Propensity score matching yielded 9680 children introduced to CF at age < 4 months and 35,396 at age ≥ 4 months. The risk for being overweight or obese at age 5–7 years was slightly higher among those who started CF at age < 4 months than at age ≥4 months (adjusted relative risk = 1.06; 95% confidence interval = 1.02–1.09). A similar but stronger association was observed for being obese at age 5–7 years (adjusted relative risk = 1.12; 95% confidence interval = 1.05–1.19). Conclusions: Early CF introduction before age 4 months was associated with increased BMI at age 5–7 years. Key points: The optimal time of starting complementary foods (CFs) in infants remains a subject of debate.Early CF introduction before age 4 months was associated with increased body mass index (BMI) at age 5–7 years, which suggest that introducing CFs after 4 months as adherence to current guidelines is desirable regarding children's body mass.Physicians, parents, and caregivers of infants should be aware that early CF introduction is associated with increased childhood BMI. [ABSTRACT FROM AUTHOR]

Background: There is a lack of longitudinal studies of associations between growth from infancy to childhood and asthma development. Objective: The objective of the study was to investigate the effects of weight change during infancy, body mass index (BMI) and the interaction of these factors on the risk of childhood asthma. Methods: We enrolled children born in 2008 and 2009 at full‐term and with normal birth weight. The weight change in infancy was grouped into slow, on‐track and rapid. BMI status in childhood was stratified into low, normal and high groups and used as a time‐varying variable. The outcome was asthma, defined as two or more diagnoses of asthma separated by at least 1 year after 2 years of age. The risk of asthma was assessed using Cox proportional hazard regression, with adjustment for sex, residence area at birth, economic status and feeding types in infancy. Results: Of 917,707 children born in Korea in 2008 and 2009, 271,871 were eligible for analysis. The risk of asthma was greater in groups with low birth weight (aHR 1.06, 95% CI 1.04 to 1.08), rapid body weight change during early infancy (aHR 1.08, 95% CI 1.07 to 1.10) and high BMI during childhood (aHR 1.06, 95% CI 1.04–1.08). The interaction of weight change during early infancy with BMI during childhood was significant for asthma (p <.01). Rapid weight gain in infancy was associated with lower risk of asthma in those with low BMI during childhood; had no association with asthma in those with normal BMI during childhood; and was associated increased asthma risk in those with high BMI during childhood—aHR 1.26 (95% CI 1.19 to 1.33) and aHR 1.33 (95% CI 1.12 to 1.56) compared with on‐track and slow infant weight gain, respectively. Conclusion: Low birth weight, high BMI during childhood and, in those with high childhood BMI, rapid weight gain during early infancy are associated with increased risk of childhood asthma. [ABSTRACT FROM AUTHOR]

Background: The association between dyslipidemia and atopic dermatitis in children is unclear. This study investigated the association between dyslipidemia and atopic dermatitis in children by analysis of disease onset, risk factors, and disease severity. Methods: Subset I examined 7‐year‐old children in elementary school (n = 248), and Subset II was a retrospective long‐term follow‐up hospital‐based study (n = 52 725) conducted from 1986 to 2016 that used propensity score matching. In the Subset I study, total cholesterol (TC), high‐density lipoprotein cholesterol (HDL‐C), low‐density lipoprotein cholesterol (LDL‐C), and triglycerides (TG) were determined, and the SCORing Atopic Dermatitis (SCORAD) index was determined. In the Subset II study, the time of atopic dermatitis onset was determined for asymptomatic subjects whose TC levels were below or above 170 mg/dL. Results: Our Subset I study indicated that children with atopic dermatitis (n = 69, 27.8%) had significantly higher levels of TC and TG, and that the SCORAD index had significant associations with high levels of TC and TG, and a low level of HDL‐C. Our Subset II study (1722 with high TC and 6735 with normal TC after propensity score matching) indicated the high TC group had a greater hazard ratio (HR) for the onset of atopic dermatitis (consensus‐based HR: 2.47; 95% CI: 1.23, 5.06, P =.012) during 5 years. Conclusion: An abnormal blood lipid profile in children is associated with the presence of atopic dermatitis and the SCORAD index. The risk of atopic dermatitis onset was significantly greater with high levels of TC. [ABSTRACT FROM AUTHOR]

Objective: Various numerical asthma control tools have been developed to distinguish different levels of symptom control. We aimed to examine whether the asthma control test (ACT) is reflective of objective findings such as lung function, fractional exhaled nitric oxide (FeNO) and laboratory data in patients with stable asthma. Methods: We included patients who were enrolled in the Korean Childhood Asthma Study. ACT, spirometry, blood tests and FeNO were performed in patients after stabilization of their asthma. We examined differences among spirometry parameters, blood tests and FeNO according to control status as determined by ACT and investigated for any significant correlations. Results: The study population consisted of 441 subjects. Spirometry showed that forced expiratory volume in one second (FEV1), forced expiratory flow between 25% and 75% of forced vital capacity and FEV1/forced vital capacity were all significantly higher in the controlled asthma group. Likewise, FeNO and percent-change in FEV1 were both significantly lower in the controlled asthma group. In blood tests, the eosinophil fraction was significantly lower in the controlled asthma group while white blood cell count was significantly higher in the controlled asthma group. Lastly, among the various factors analyzed, only provocative concentration of methacholine causing a 20% fall in FEV1 significantly correlated with ACT score. Conclusion: ACT is useful as part of the routine evaluation of asthmatic children and should be used as a complement to existing tools such as spirometry and FeNO measurement. [ABSTRACT FROM AUTHOR]