title: Inequality in infant morbidity: causes and consequences in England in the 1990s. ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood.
abstract: OBJECTIVE
  To examine the effect of deprivation, crowding, maternal smoking, and breast feeding on morbidity from wheeze and diarrhoea in the first six months after birth.
  
  
  METHODS
  A geographically located population survey using maternal responses on self completion questionnaires.
  
  
  METHODS
  The three health districts of Bristol.
  
  
  METHODS
  8501 infants from the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC) in which all women expecting a baby between April 1991 and December 1992 in Bristol were invited to participate.
  
  
  METHODS
  The prevalence and severity of wheeze at six months after birth. The prevalence of diarrhoea and the duration of the worst bout at six months after birth.
  
  
  RESULTS
  Logistic regression analyses using a conceptual hierarchical framework showed that wheeze was significantly more likely to be reported for infants if they lived in rented accommodation (OR = 1.20, 95% CI = 1.04, 1.39), if they lived in crowded housing conditions (OR = 1.26, 95% CI = 1.06, 1.49), if they were one of a number of siblings (OR = 1.78, 95% CI = 1.52, 2.07), and if their mothers smoked (OR = 1.38, 95% CI = 1.21, 1.58). They were significantly less likely to have wheeze if they were breast fed (OR = 0.68, 95% CI = 0.59, 0.79). Each of these factors was independently related to the prevalence of wheeze. For infants with wheeze those who were breast fed for three or more months were significantly less likely to have three or more episodes in the first six months after birth (OR = 0.76, 95% CI = 0.58, 0.99). A higher prevalence of diarrhoea in infancy was associated with living in rented accommodation (OR = 1.25, 95% CI = 1.10, 1.41) and lower maternal education (OR = 0.76, 95% CI = 0.69, 0.84) and a lower prevalence with breast feeding (OR = 0.42, 95% CI = 0.37, 0.48). An episode of diarrhoea was significantly less likely to last for six or more days if an infant lived in mortgaged accommodation (OR = 1.34 95% CI = 1.03, 1.75) and was breast fed for three or more months (OR = 1.34 95% CI = 1.03, 1.75).
  
  
  CONCLUSIONS
  Deprivation was associated with heightened morbidity from common conditions such as wheeze and diarrhoea for this geographical cohort of infants in England in the 1990s. Results supported evidence suggesting that breast feeding is protective against such conditions and is particularly associated with reduced severity and duration. Implications for future research and policy are discussed.
authors.affiliation: Department of Child Health, University of Bristol.
authors.forename: D
authors.initials: D
authors.lastname: Baker
authors.forename: H
authors.initials: H
authors.lastname: Taylor
authors.forename: J
authors.initials: J
authors.lastname: Henderson
mesh_terms: D001942:Breast Feeding; D003441:Crowding; D003967:Diarrhea / Q000453:epidemiology* / Q000517:prevention & control; D004739:England / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D009017:Morbidity; D011203:Poverty; D015995:Prevalence; D012044:Regression Analysis; D012135:Respiratory Sounds; D014028:Tobacco Smoke Pollution
chemical_list: D014028:Tobacco Smoke Pollution