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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Early Probiotic Supplementation for Eczema and Asthma Prevention: A Randomized Controlled Trial

Michael D. Cabana, Michelle McKean, Aaron B. Caughey, Lawrence Fong, Susan Lynch, Angela Wong, Russell Leong, Homer A. Boushey and Joan F. Hilton
Pediatrics September 2017, 140 (3) e20163000; DOI: https://doi.org/10.1542/peds.2016-3000
Michael D. Cabana
aDepartments of Pediatrics,
bEpidemiology and Biostatistics,
cPhilip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California;
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Michelle McKean
aDepartments of Pediatrics,
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Aaron B. Caughey
dDepartment of Obstetrics and Gynecology, Oregon Health & Sciences University, Portland, Oregon;
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Lawrence Fong
eMedicine, and
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Susan Lynch
eMedicine, and
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Angela Wong
fDepartment of Pediatrics, Kaiser Permanente, San Francisco, California; and
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Russell Leong
gDepartment of Pediatrics, California Pacific Medical Center, San Francisco, California
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Homer A. Boushey
eMedicine, and
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Joan F. Hilton
bEpidemiology and Biostatistics,
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  • FIGURE 1
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    FIGURE 1

    Cumulative incidence of eczema by the Kaplan-Meier method. At 2 years of age, the estimated cumulative incidence of eczema was 30.9% (95% CI, 21.4%–40.4%) for the control arm and 28.7% (95% CI, 19.4–38.0%) for the LGG arm, for an HR of 0.95 (95% CI, 0.59–1.53) (log-rank P = .83).

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    FIGURE 2

    Cumulative incidence of asthma by the Kaplan-Meier method. At 5 years of age, the cumulative incidence of asthma was 17.4% (95% CI, 7.6%–27.1%) in the control arm and 9.7% (95% CI, 2.7%–16.6%) in the LGG arm, for an HR of 0.88 (95% CI, 0.41–1.87) (log-rank P = .25).

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    TABLE 1

    Infant Participant Characteristics by Study Arm

    Control (n = 92)Probiotic (n = 92)
    Boys48 (52%)44 (48%)
    Racea
     White77 (85%)72 (78%)
     African American10 (11%)14 (15%)
     American Indian, Alaskan Native12 (13%)10 (11%)
     Asian19 (21%)22 (24%)
     Pacific Islander4 (4%)3 (3%)
     Other8 (32%)18 (20%)
    Hispanic ethnicity19 (21%)27 (29%)
    Gestational age, wk (SD)38.9 (1.3)39.0 (1.4)
    Birth weight, g (SD)3440 (442)3427 (506)
    Cesarean delivery21 (23%)27 (29%)
    Mean number of months breastfeeding in first year of life (SD)7.5 (5.1)7.7 (4.9)
    Breastfeeding exposure
     None20 (22%)16 (17%)
     <12 mo31 (34%)29 (32%)
     ≥12 mo41 (45%)47 (51%)
    • ↵a The percentage of infants in each race category is >100%. Fifty-nine (32%) parents of these infants selected more than 1 race when describing their infants.

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    TABLE 2

    Parental and Household Characteristics

    Control (n = 92)Probiotic (n = 92)
    Paternal historya
     Mean age at delivery, y34.9 (5.7)34.6 (6.9)
     History of asthma35 (40%)42 (47%)
     History of rhinitis29 (33%)30 (34%)
     History of eczema15 (17%)22 (25%)
    Maternal history
     Mean age at delivery, y33.0 (5.2)32.6 (5.8)
     History of asthma68 (74%)68 (74%)
     History of rhinitis41 (45%)41 (45%)
     History of eczema34 (37%)25 (27%)
    Maternal educationb
     Up to high school, vocational school8 (9%)11 (12%)
     Some college17 (18%)14 (15%)
     College graduate29 (32%)31 (34%)
     Graduate school38 (41%)36 (39%)
    Household income per y, $
     <10 0005 (6%)8 (9%)
     10 001–50 00013 (15%)12 (14%)
     50 001–100 00016 (18%)18 (21%)
     100 001–150 00024 (27%)19 (22%)
     150 001–200 00020 (23%)19 (22%)
     >200 00011 (12%)12 (14%)
    Household insurance
     Self-pay00
     Private insurance74 (81.5%)69 (75.0%)
     Medicaid, SCHIP, HFP17 (18.5%)22 (23.9%)
     Military or other01 (1.1%)
    • HFP, Healthy Families Program; SCHIP, State Children’s Health Insurance Program.

    • ↵a Data missing from 9 fathers.

    • ↵b Data missing from 1 mother.

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Pediatrics
Vol. 140, Issue 3
1 Sep 2017
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Early Probiotic Supplementation for Eczema and Asthma Prevention: A Randomized Controlled Trial
Michael D. Cabana, Michelle McKean, Aaron B. Caughey, Lawrence Fong, Susan Lynch, Angela Wong, Russell Leong, Homer A. Boushey, Joan F. Hilton
Pediatrics Sep 2017, 140 (3) e20163000; DOI: 10.1542/peds.2016-3000

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Early Probiotic Supplementation for Eczema and Asthma Prevention: A Randomized Controlled Trial
Michael D. Cabana, Michelle McKean, Aaron B. Caughey, Lawrence Fong, Susan Lynch, Angela Wong, Russell Leong, Homer A. Boushey, Joan F. Hilton
Pediatrics Sep 2017, 140 (3) e20163000; DOI: 10.1542/peds.2016-3000
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