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Risk factors for wheeze in the last 12 months in preschool children
B S Quah1, A R Mazidah, H Simpson
1Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan.
Insights
Family history of asthma, neonatal hospital admission, and parental allergic rhinitis strongly predict wheeze in young children. Environmental factors showed no significant association with preschool wheeze in this study.
Area of Science:
- Pediatrics
- Environmental Health
- Epidemiology
Background:
- Asthma symptoms often begin before age 5, with many preschool children continuing to wheeze.
- Identifying early risk factors for wheezing is crucial for timely intervention.
Purpose of the Study:
- To investigate environmental and family influences on recent wheeze in preschool children.
- To analyze risk factors for wheezing in children aged 1-5 years.
Main Methods:
- A cross-sectional study involving 2,524 preschool children (aged 1-5 years) in Kota Bharu.
- Home-visit questionnaires administered by nurses to parents/carers, collecting data on symptoms, environmental factors, and family history.
- Statistical analysis to identify significant risk factors associated with current wheeze.
Main Results:
- 6.2% of children experienced current wheeze.
- Significant risk factors included family history of asthma (OR=6.36), neonatal hospital admission (OR=2.38), and maternal (OR=2.12) or paternal allergic rhinitis (OR=1.52).
- No environmental factors (household pets, carpeting, smoking, air conditioning, insect repellents) were associated with increased wheeze risk.
Conclusions:
- Family history of asthma is the strongest predictor of current wheeze in preschool children.
- Neonatal hospital admission and parental allergic rhinitis are also significant risk factors.
- Environmental factors examined in this study did not show a relationship with preschool wheeze.
Abstract:
Most children with asthma develop their symptoms before the age of 5 years and many preschool wheezers continue to wheeze in the early school years. It is thus important to investigate the factors that predispose young children to wheeze. The objective of this study was to investigate the relevant environmental and family influences on recent wheeze (wheeze within the last 12 months) in preschool children. A cross-sectional study was conducted in five primary health clinics in the district of Kota Bharu from April to October 1998. Nurses from these clinics distributed Bahasa Malaysia questionnaires containing questions on asthma symptoms, environmental risk factors, family's social status and family history of atopy and wheeze to preschool children aged 1-5 years during their home visits. The respondents were parent(s) or carer(s) of the children. A total of 2,524 (87.7%) complete questionnaires were available for analysis of risk factors. One hundred and fifty six (6.2%) children had current wheeze. Significant risk factors associated with current wheeze were a family history of asthma (O.R. = 6.36, 95% C.I. = 4.45-9.09), neonatal hospital admission (O.R. = 2.38, 95% C.I. = 1.51 - 3.75), and a maternal (O.R. = 2.12, 95% C.I. = 1.31-3.41) or paternal (O.R. = 1.52, 95% C.I. = 0.95-2.43) history of allergic rhinitis. Among environmental factors examined, namely, household pets, carpeting in bedroom, use of fumigation mats, mosquito coils and aerosol insect repellents, maternal and paternal smoking, and air conditioning, none were associated with an increased risk of wheeze. In conclusion, the strongest association with current wheeze was a family history of asthma. Also significant were neonatal hospital admission and a history of allergic rhinitis in either the mother or father. None of the environmental factors studied were related to current wheeze in preschool children.