Association of birthweight with lung function and respiratory diseases: results from the GEIRD study

Abstract Background Early life conditions are associated with lung function and the development of respiratory and non-respiratory illnesses. The relationship with birthweight (BW) is however conflicting. We examined associations of BW with lung function and respiratory diseases within the GEIRD (Gene-Environment Interaction in Respiratory Diseases) study. Methods GEIRD is an Italian multi-centre, multi-case control study of people aged 20-84 from the general population conducted from 2008 to 2014. The study included cases of COPD, asthma, allergic rhinitis and controls. Multinomial logistic regression was performed with case/control status (control/COPD/asthma/allergic rhinitis) as response variable, and BW as main determinant adjusting for sex, age and smoking status. Results Of 2,287 reporting BW, 6.4 % (n = 147) had low BW (<2500 gr), and this proportion was greater in women than men (7.8% vs. 5.1%; p = 0.006). Lung volumes were significantly lower in individuals with low than normal BW. Median FEV1 was 3.01 L (p25-p75=2.60-3.45 L) versus 3.16 L (2.65-3.86 L) (p = 0.019) and median FVC was 3.68 L (3.19-4.34 L) versus 3.91 (3.34-4.81 L) (p = 0.003). However, FEV1 and FVC were not affected by BW when expressed as percent predicted. Of note, both men and women with low BW were shorter than those with normal BW (mean±SD: 160.2±5.5 vs. 162.6±6.5 cm in women, p = 0.009; 172.4±6.1 vs. 174.8±7.2 cm in men, p < 0.001). FEV1/FVC expressed as absolute ratio or as percent predicted, was not affected by BW. In multinomial analysis, BW was not associated with respiratory diseases in adulthood. However, those with low BW had a higher risk of self-reported hospitalisation for lung disease before age 2 (10.3% vs. 4.1%) and severe respiratory infection before age 5 (16.9% vs. 8.8%) (p = 0.003). Conclusions BW was not associated with lung function in adulthood, when controlling for sex and height. Low BW was a risk factor for respiratory diseases in childhood, not in adulthood. Key messages • Low birthweight was associated with respiratory diseases in childhood but not in adulthood. • Although spirometrically-assessed lung volumes were lower in adults with low birthweight, this is likely explained by associations of low birthweight with sex and height.


Background:
Despite declines in cardiovascular disease mortality, evidence suggests women have a higher mortality and worse prognosis after ischemic events compared with men.This work investigates to what extent clinical recommendations made by cardiovascular guidelines might include sex and gender biases.

Methods:
We reviewed the primary literature base underlying the 2019 European Society of Cardiology guidelines' recommendations on chronic coronary syndromes focusing on sex and gender sensitivity aspects pertaining to ischemic heart diseases.We applied an adapted Cochrane Collaboration appraisal checklist and only included recommendations with direct citation to literature evidence.We used beta regression to model the association between the proportion of female participants within the study population and the year of publication (modeled as cubic polynomial), impact factor, and sex of the first/last author.

Results:
In the 20 recommendations that quoted the literature, gendersensitive propositions were fully absent, while 4 included sexsensitive statements.Sex-or gender-specific study design or a priori statistical considerations were largely absent in the included publications.The term ''gender'' was used exclusively to denote biological sex.The included studies published between 1991 and 2019 comprised of more than 2.1 million individuals (29% female).Representation of women as study participants undulated over time.Female sex of first (OR = 1.84, 95%CI = 1.30-2.60)or last (OR = 2.27, 95%CI = 1.31-3.92)author were statistically significantly associated with the probability of having more female study participants.

Conclusions:
Methodological sex-and gender-sensitive considerations are largely missing in the evidence base used to guide cardiovascular care decision-making in Europe.Women remain underrepresented in the studies from which the guidelines are derived.Studies with female first or last authors were more likely to have better representation of women.

Background:
Early life conditions are associated with lung function and the development of respiratory and non-respiratory illnesses.The relationship with birthweight (BW) is however conflicting.We examined associations of BW with lung function and respiratory diseases within the GEIRD (Gene-Environment Interaction in Respiratory Diseases) study.

Methods:
GEIRD is an Italian multi-centre, multi-case control study of people aged 20-84 from the general population conducted from 2008 to 2014.The study included cases of COPD, asthma, allergic rhinitis and controls.Multinomial logistic regression was performed with case/control status (control/ COPD/asthma/allergic rhinitis) as response variable, and BW as main determinant adjusting for sex, age and smoking status.

Results:
Of 2,287 reporting BW, 6.4 % (n = 147) had low BW (<2500 gr), and this proportion was greater in women than men (7.8% vs. 5.1%; p = 0.006).Lung volumes were significantly lower in individuals with low than normal BW.

Background:
Italy was the first western country severely affected by the Covid-19 pandemic attesting more than 16 million cases since the outbreak began.Po Valley regions have been most afflicted, with Piedmont ranking sixth at 25,899 cases/100,000 inhabitants.Within this area, air dispersion is hampered making Po Valley a recognised air pollution hotspot.We aimed to explore the potential association between the environment and Covid-19 incidence.

Conclusions:
Results from ecological studies may support researchers' preliminary understanding of the interplay between environment and Public Health issues, including pandemics.A

Background:
Air pollution (AP) contributes to a large disease burden and some populations are disproportionately exposed.It is unclear to what extent AP exposure differs across ethnic groups in the Netherlands and how this intersects with socioeconomic position (SEP).First, we identified differences in AP exposures between ethnic groups in the Netherlands.Second, we examined the interrelationships between ethnicity and SEP in relation to AP exposures.

Methods:
We assessed AP exposures for residents of the Netherlands in 2019 (N = 17,251,511).Home address AP levels were estimated by dispersion models of the National Institute of Public Health and the Environment (RIVM).We linked exposure estimations of particulate matter <10 or < 2.5 mm (PM10, PM2.5), nitrogen dioxide (NO2), and elemental carbon (EC) to demographic data gathered by Statistics Netherlands.Absolute and relative differences in AP levels across ethnic groups were assessed.We conducted multivariable linear regression analyses and estimated marginal mean exposures to evaluate differences by ethnicity, SEP, age and sex within urban and rural areas.We tested for interactions and stratified accordingly.