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Published on: August 7, 2017
Prevalence and associated factors of wheeze in early infancy
Shiro Sugiura1,2,3, Yoshimichi Hiramitsu1,4, Masaki Futamura1,5
1Committee for the Prevention of Pediatric Allergic Disease, Nagoya, Japan.
Insights
Maternal smoking and having siblings increase infant wheeze risk. Smoking cessation and improved hand hygiene may reduce early infancy wheeze, a common respiratory issue.
Area of Science:
- Pediatrics
- Epidemiology
- Public Health
Background:
- Wheeze is a common respiratory symptom in early childhood.
- Identifying factors associated with infant wheeze is crucial for developing preventive strategies.
Purpose of the Study:
- To determine the prevalence of wheeze in 4-month-old infants.
- To identify factors associated with wheeze, including hospitalization, to inform future prevention efforts.
Main Methods:
- Cross-sectional analysis of data from the International Study of Asthma and Allergies in Childhood (ISAAC) in Nagoya City, Japan.
- Multivariable, multilevel analysis of questionnaires from parents of 4-month-old infants, adjusted for relevant covariates.
Main Results:
- 7.6% of infants experienced wheeze within 4 months of age.
- Factors significantly associated with wheeze hospitalization included male sex, maternal smoking, and having at least one sibling.
- These associations were consistent across development and validation datasets.
Conclusions:
- Maternal smoking cessation is a key intervention to reduce infant wheeze.
- Promoting improved hand hygiene at home may also decrease the incidence of wheeze in early infancy.
Background:
The aim of this study was to assess the prevalence of wheeze in early childhood and to characterize associated factors for wheeze that could identify potentially feasible interventions for the future prevention of wheeze.
Methods:
We performed a cross-sectional analysis of the data from the International Study of Asthma and Allergies in Childhood (ISAAC)-modified self-administered questionnaire of parents of 4-month-old infants at well-child visits (mandatory health check-ups) in Nagoya City, Japan, between April 2016 and March 2017 (development dataset) and between April 2017 and March 2018 (validation dataset). We used a multivariable, multilevel analysis to identify significant (P < 0.05), associated factors (Bonferroni correction was applied as necessary) after adjustment for local outbreaks of virus-transmitted diseases, access to medical facilities, and socioeconomic status.
Results:
Among the 20 362 questionnaires given to families of infants living in Nagoya City (development dataset), 19 104 questionnaires (93.8%) were analyzed after data cleaning. In all, 1,446 (7.6%) infants experienced wheeze at least once within 4 months of age, 991 (5.2%) visited the clinic/hospital with wheeze, and 244 (1.3%) underwent hospitalization at that time. In the multilevel, multivariable model for hospitalization with wheeze, significant associated factors were male sex (adjusted odds ratio 1.8; 95% confidence interval 1.4-2.3), maternal current smoking (3.3; 2.0-5.5), and having at least one sibling (3.0; 2.2-4.1). These factors were also associated with wheeze and clinic/hospital visit with wheeze, and the results were confirmed in the validation dataset.
Conclusions:
Our study highlights that smoking cessation among mothers and improved hand hygiene at home are two interventions that could potentially decrease wheeze in early infancy.
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