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Hospital admission for symptoms exacerbation in 2,075 infants suffering from recurrent asthma-like symptoms: (EISL-3
Javier Mallol1, Dirceu Solé2, Carolina Aranda2
1Department of Pediatric Respiratory Medicine, Hospital El Pino, University of Santiago de Chile (USACH), Santiago, Chile; javier.mallol@usach.cl.
Insights
Infants with recurrent asthma-like symptoms are frequently hospitalized. Maternal smoking during pregnancy and early wheezing onset increase admission risk, while breastfeeding and higher socioeconomic status offer protection.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Epidemiology
Background:
- The prevalence and risk factors for infant hospitalization due to asthma/wheezing are not well-understood.
- This knowledge gap contrasts with existing data for older children and adults.
Purpose of the Study:
- To determine the prevalence of hospital admissions for wheezing exacerbations in infants with recurrent asthma-like symptoms.
- To identify factors associated with these hospitalizations.
Main Methods:
- A cohort of 2,079 infants (12-18 months) with recurrent asthma-like symptoms was studied across 11 South American centers.
- Data were analyzed using descriptive statistics and multivariate logistic regression.
Main Results:
- The prevalence of hospital admission for wheezing was 29.7%.
- Risk factors included severe wheezing episodes, physician-diagnosed asthma, inhaled corticosteroid use, maternal smoking during pregnancy, and early wheezing onset (first trimester).
- Protective factors included breastfeeding for at least 4 months, higher maternal education, and higher household income.
Conclusions:
- Infants with recurrent asthma-like symptoms experience high hospitalization rates.
- Maternal smoking, early-life viral respiratory illness, and disease severity are key risk factors.
- Preventive strategies should focus on managing exacerbations, promoting breastfeeding, and avoiding smoking during pregnancy.
Background:
Contrary to what happens in children and adults, the prevalence and the factors related to hospitalisation for asthma/wheezing in infants with recurrent asthma-like symptoms are poorly known.
Methods:
This study is part of the International Study of Wheezing in infants Phase 3; 2,079 infants (aged 12-18 months) with recurrent asthma-like symptoms, from 11 South American centres, were studied to determine the prevalence and the associated factors for wheezing exacerbation admission. Descriptive statistics and multivariate logistic regression were employed for analysis.
Results:
The prevalence of admission for wheezing was 29.7% (95% CI 27.7-31.6) and was significantly associated to severe wheezing episodes (OR: 3.89; 95% CI: 2.93-5.18, p < 0.001), physician-diagnosed asthma (OR: 1.79; 95% CI: 1.33-2.41, p < 0.0001), use of inhaled corticosteroids (OR: 1.78; 95%CI: 1.38-2.29, p < 0.0001), maternal tobacco smoking during pregnancy (OR: 1.69; 95% CI: 1.19-2.39, p = 0.003) and onset of wheezing in the first trimester of life (OR: 1.30; 95% CI: 1.02-1.66, p = 0.038). Breast feeding ≥4 months (OR: 0.72; 95% CI: 0.54-0.96, p = 0.004), maternal high educational level (>12 years) (OR: 0.66; 95% CI: 0.51-0.85, p = 0.001) and total monthly household income ≥US$ 3,000 (OR: 0.34; 95% CI: 0.18-0.67, p = 0.002), were protective factors.
Conclusions:
Infants with recurrent asthma-like symptoms have a high rate of admissions. Tobacco smoking in pregnancy, viral respiratory illness in the first trimester of life and severe progression were risks for admissions. Improving medical management to prevent severe exacerbations, prolonging the postnatal period at home longer than 3 months, favouring breastfeeding and avoiding smoking during pregnancy may have a preventive role for admissions in infants with recurrent asthma-like symptoms.
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