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Published on: August 7, 2017
Prevalence and severity of wheezing in the first year of life
Ana Caroline Cavalcanti Dela Bianca1, Gustavo Falbo Wandalsen, Javier Mallol
1Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil.
Insights
Wheezing is common in infants, with nearly half experiencing episodes in their first year. Asthma diagnosis and treatment rates remain low, indicating a gap in pediatric respiratory care.
Area of Science:
- Pediatric Respiratory Medicine
- Epidemiology
- Public Health
Background:
- Wheezing is a common respiratory symptom in infants, impacting their health and healthcare utilization.
- The International Study of Wheezing in Infants (EISL) provides a standardized protocol for assessing infant wheezing.
- Understanding wheezing prevalence and its link to asthma is crucial for early diagnosis and management.
Purpose of the Study:
- To determine the prevalence and severity of infant wheezing using the EISL protocol.
- To investigate the association between infant wheezing and physician-diagnosed asthma in the first year of life.
- To assess the management of wheezing and asthma in this population.
Main Methods:
- A cross-sectional study utilizing the EISL questionnaire administered to parents of 1,014 infants in São Paulo, Brazil.
- Data collection occurred between March 2005 and August 2006 at primary health care clinics.
- Infants were assessed for wheezing episodes, severity, associated symptoms, and physician-diagnosed asthma.
Main Results:
- Nearly half (46.0%) of the infants experienced at least one wheezing episode, with 26.6% having three or more.
- Recurrent wheezing was significantly associated with increased medication use, nocturnal symptoms, breathing difficulties, and hospitalizations.
- Physician-diagnosed asthma (7.5% of wheezing infants) correlated with inhaled corticosteroid use, severe symptoms, and frequent episodes, yet under-treatment was noted.
Conclusions:
- Infant wheezing is highly prevalent with early onset in this Brazilian cohort.
- A significant proportion of infants with wheezing are underdiagnosed or undertreated for asthma.
- There is a need for improved diagnostic and therapeutic strategies for infant wheezing and associated asthma.
Objective:
To determine the prevalence and severity of wheezing in infants, using the standardized protocol devised for the "Estudio Internacional de Sibilancias en Lactantes" (EISL, International Study of Wheezing in Infants), as well as to determine the relationship between such wheezing and physician-diagnosed asthma, in the first year of life.
Methods:
Between March of 2005 and August of 2006, the EISL questionnaire was administered to the parents or legal guardians of infants undergoing routine procedures or immunization at public primary health care clinics in the southern part of the city of São Paulo, Brazil.
Results:
Our sample comprised 1,014 infants (mean age = 5.0 ± 3.0 months), 467 (46.0%) of whom had at least one wheezing episode, 270 (26.6%) having three or more such episodes, in their first year of life. The use of inhaled β2 agonists, inhaled corticosteroids, or antileukotrienes, as well as the occurrence of nocturnal symptoms, difficulty breathing, pneumonia, emergency room visits, and hospitalization due to severe wheezing, was significantly more common among those with recurrent wheezing (p < 0.05). Physician-diagnosed asthma was reported for 35 (7.5%) of the 467 wheezing infants and was found to be associated with the use of inhaled corticosteroids, difficulty breathing during the attacks, and six or more wheezing episodes in the first year of life. However, less than 40% of those infants were treated with inhaled corticosteroids or antileukotrienes.
Conclusions:
In this study, the prevalence of wheezing episodes among infants in their first year of life was high and had an early onset. The proportion of infants diagnosed with and treated for asthma was low.
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