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Published on: August 7, 2017
Rhinovirus bronchiolitis, maternal asthma, and the development of asthma and lung function impairments
Carla R Da Silva Sena1,2, Matthew Morten1, Joseph Meredith1
1University of Newcastle, Callaghan, New South Wales, Australia.
Insights
Infant hospitalization for rhinovirus (RV) bronchiolitis combined with maternal asthma history significantly increases childhood asthma risk. This combined risk factor identifies a high-risk subgroup for asthma development and related treatments.
Area of Science:
- Pediatric Respiratory Medicine
- Epidemiology
- Allergy and Immunology
Background:
- Infant rhinovirus (RV) bronchiolitis hospitalization is a known risk factor for childhood asthma.
- Maternal asthma history may further elevate the risk of asthma development in offspring.
- The combined impact of these factors on asthma incidence requires further investigation.
Purpose of the Study:
- To examine the synergistic effect of infant RV-positive bronchiolitis hospitalization and maternal asthma history on preschool-aged asthma development.
- To quantify the risk of asthma and related symptoms in children with these combined risk factors.
Main Methods:
- Prospective cohort study of 139 preschool-aged children previously hospitalized for bronchiolitis.
- Assessment of doctor-diagnosed asthma, asthma-like symptoms, allergy testing, and lung function (impulse oscillometry).
- Comparison of outcomes between children with RV-positive bronchiolitis and maternal asthma history versus those with fewer risk factors.
Main Results:
- Children with both RV-positive bronchiolitis hospitalization and maternal asthma history showed the highest prevalence of doctor-diagnosed asthma (81.8%) and increased risk ratios for asthma medications.
- This subgroup also exhibited significantly higher abnormal airway resistance and reactance.
- Intermediate asthma risks were observed in children with only one of the two risk factors.
Conclusions:
- Hospitalization for RV-positive bronchiolitis in infancy, coupled with maternal asthma, identifies a high-risk pediatric asthma subgroup.
- This combined exposure significantly elevates the burden of asthma and necessitates targeted monitoring and intervention strategies.
Background:
Children with a history of rhinovirus (RV) positive bronchiolitis have a high risk of developing subsequent asthma. Maternal asthma might also increase this risk. The aim of this study was to investigate the combined effects of hospitalization for RV positive bronchiolitis in infancy and a history of maternal asthma on the development of asthma at preschool age.
Methods:
This is a prospective cohort study of 139 preschool-aged children, with a history of hospital admission for bronchiolitis in infancy, followed-up to ascertain asthma and asthma-like symptoms, skin prick allergy test positivity, and lung function measured pre- and post-bronchodilator using impulse oscillometry.
Results:
Children with a past hospitalization for RV positive bronchiolitis (42.4% of all) and a history of maternal asthma (36.7% of all) had the greatest prevalence and risk ratio (RR) for doctor-diagnosed asthma (prevalence 81.8% and RR 2.10, 95% confidence interval [CI] 1.37-3.19, p = .001), use of inhaled corticosteroids (68.2% and RR 2.17, 95% CI 1.19-3.99, p = .001) and short-acting β-agonists in the last 12 months (95.2% and RR 1.49, 95% CI 1.17-1.89, p = .001), as compared to those with RV negative bronchiolitis and no maternal asthma history. More children in this group had an abnormal airway resistance (33.3% and adjusted risk ratio [aRR] 3.11, 95% CI 1.03-9.47, p = .045) and reactance (27.8% and aRR 2.11, 95% CI 1.06-4.26, p = .035) at 5 Hz, as compared to those with RV negative bronchiolitis and no maternal asthma history.
Conclusion:
Hospitalization for RV positive bronchiolitis in early life combined with a history of maternal asthma identifies a subgroup of children with a high asthma burden while participants with only one of the two risk factors had intermediate risk for asthma.
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