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Risk factors for atopic diseases and recurrent respiratory tract infections in children
Hannah M Kansen1,2, Melanie A Lebbink3, Joeri Mul3
1Department of Pediatric Pulmonology and Allergology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
Insights
Risk factors for childhood atopic diseases differ from those for recurrent respiratory tract infections (RRTIs). This suggests their changing prevalence is not due to shared causes, highlighting distinct prevention strategies for allergic conditions and infections.
Area of Science:
- Pediatrics
- Immunology
- Epidemiology
Background:
- Simultaneous increases in atopic diseases and decreases in infectious diseases suggest a potential link.
- Previous research often focused on either atopic diseases or recurrent infections separately.
- Understanding distinct risk factors is crucial for addressing these diverging health trends in children.
Purpose of the Study:
- To investigate whether risk factors for atopic diseases (asthma, allergic rhinitis, atopic dermatitis, food allergy) differ from those for recurrent respiratory tract infections (RRTIs) in children.
- To identify specific risk factors associated with each condition to inform targeted interventions.
Main Methods:
- Utilized cross-sectional data from 5517 children aged 1–18 years (2011–2019).
- Employed univariable and multivariable logistic regression analyses.
- Determined risk factors for any atopic disease and for RRTIs.
Main Results:
- Children aged ≥5 years had higher odds of atopic disease but lower odds of RRTIs compared to younger children.
- Female sex, low birth weight, and dog ownership were associated with reduced odds of atopic disease, but not RRTIs.
- Daycare attendance was linked to RRTIs, while family history strongly predicted the same condition in children.
Conclusions:
- Risk factors for atopic diseases are distinct from those for RRTIs in children.
- The findings suggest that the changing prevalence of these conditions is not driven by shared risk factors.
- Distinct risk profiles imply the need for separate prevention and management strategies.
Introduction:
The simultaneously increased prevalence of atopic diseases and decreased prevalence of infectious diseases might point to a link between the two entities. Past work mainly focused on either atopic diseases or recurrent infections. We aim to investigate whether risk factors for atopic diseases (ie, asthma, allergic rhinitis, atopic dermatitis, and/or food allergy) differ from risk factors for recurrent respiratory tract infections (RRTIs) in children.
Methods:
Cross-sectional data were used from 5517 children aged 1 to 18 years who participated in an Electronic Portal for children between 2011 and 2019. Univariable/multivariable logistic regression analyses were performed to determine risk factors for any atopic disease and RRTIs.
Results:
Children aged ≥5 years were more likely to have any atopic disease (adjusted odds ratio [OR]: 1.50-2.77) and less likely to have RRTIs (OR: 0.68-0.84) compared to children aged less than 5 years. Female sex (OR: 0.72; 95% confidence interval [CI]: 0.63-0.81), low birth weight (OR: 0.74; 95% CI: 0.57-0.97) and dog ownership (OR: 0.79; 95% CI: 0.66-0.95) reduced the odds of any atopic disease, but not of RRTIs. Daycare attendance (OR: 1.22; 95% CI: 1.02-1.47) was associated with RRTIs, but not with atopic diseases. A family history of asthma, allergic rhinitis, atopic dermatitis, and RRTIs was significantly associated with the same entity in children, with OR varying from 1.58 (95% CI: 1.35-1.85) in allergic rhinitis to 2.20 (95% CI: 1.85-2.61) in asthma.
Conclusion:
Risk factors for atopic diseases are distinct from risk factors for RRTIs, suggesting that the changing prevalence of both entities is not related to shared risk factors.
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