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Published on: August 7, 2017
Risk factors for asthma after infant bronchiolitis
S Törmänen1, E Lauhkonen1, R Riikonen1
1Center for Child Health Research, Tampere University and University Hospital, Tampere, Finland.
Insights
Infants hospitalized for bronchiolitis have double the risk of developing asthma later in childhood. Maternal asthma is the primary early-life risk factor identified for childhood asthma development.
Area of Science:
- Pediatric Pulmonology
- Epidemiology
- Allergy & Immunology
Background:
- Bronchiolitis in infancy is a significant risk factor for later respiratory issues.
- Previous studies identified several early-life risk factors for asthma post-bronchiolitis.
- This study focuses on the long-term asthma outcomes in children previously hospitalized for bronchiolitis.
Purpose of the Study:
- To evaluate the long-term respiratory health outcomes, specifically doctor-diagnosed asthma, in children up to 11-13 years of age.
- To identify significant early-life risk factors for the development of asthma after infant bronchiolitis.
Main Methods:
- Prospective follow-up of 138 children previously hospitalized for bronchiolitis before 6 months of age.
- Data collection included questionnaires, parental interviews, clinical examinations, and bronchodilation testing at 11-13 years of age.
Main Results:
- Doctor-diagnosed asthma was present in 13% of former bronchiolitis patients at 11-13 years.
- Maternal asthma was the sole significant independent early-life risk factor (aOR 3.45).
- Allergic rhinitis at 5-7 years was also a significant risk factor (aOR 4.06).
Conclusions:
- Children hospitalized for bronchiolitis before 6 months of age have approximately double the risk of developing asthma compared to the general population.
- Maternal asthma is the most critical independently significant early-life predictor of developing asthma by adolescence.
Background:
Five studies carried out after bronchiolitis at less than 24 months of age, with a follow-up of more than 10 years, reported that atopic dermatitis, family asthma, early-life exposure to tobacco smoke and rhinovirus aetiology were early-life risk factors for later asthma. This study evaluated the long-term outcome at 11-13 years of age of children who were hospitalized for bronchiolitis in early infancy.
Methods:
We previously prospectively followed 166 children hospitalized for bronchiolitis at less than 6 months of age until 5-7 years of age. The current study included a structured questionnaire, parental interviews, clinical examinations and bronchodilation test of 138 of those children at 11-13 years of age.
Results:
Respiratory syncytial virus caused 66% of the bronchiolitis cases, and nearly half of the patients were exposed to tobacco smoke in early life. Doctor-diagnosed asthma was present in 13% of the former bronchiolitis patients at 11-13 years of age. Maternal asthma was the only independently significant risk factor in early life (adjusted OR 3.45, 95% CI 1.07-11.74), as was allergic rhinitis at 5-7 years of age (adjusted OR 4.06, 95% CI 1.35-12.25).
Conclusions:
After bronchiolitis at less than 6 months of age, the risk of doctor-diagnosed asthma at 11-13 years was about twice that of the general Finnish population. Maternal asthma was the only independently significant early-life risk factor for current asthma at 11-13 years of age.
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