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Acute bronchiolitis: predisposing factors and characterization of infants at risk
Insights
Infants hospitalized for acute bronchiolitis experienced more respiratory infections and airway obstruction by age two. Early life factors like shorter breastfeeding and crowded homes were associated with increased risk for these children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Respiratory Medicine
Background:
- Acute bronchiolitis is a common respiratory infection in infants.
- Identifying risk factors for severe bronchiolitis is crucial for early intervention.
- Long-term respiratory outcomes in infants hospitalized for bronchiolitis require further investigation.
Purpose of the Study:
- To prospectively follow infants hospitalized with acute bronchiolitis until two years of age.
- To identify risk factors and long-term respiratory sequelae in these children.
- To differentiate hospitalized infants from healthy controls based on early life and clinical factors.
Main Methods:
- Prospective cohort study involving 51 infants with acute bronchiolitis and 24 controls.
- Data collection included initial viral detection, birth season, neonatal complications, feeding practices, home environment, and family history.
- Discriminant analysis was used to classify children based on collected variables.
Main Results:
- Respiratory syncytial virus (RSV) was the most common pathogen identified.
- Index children had shorter breastfeeding durations, more siblings, and lived in more crowded conditions.
- Hospitalized children experienced significantly more respiratory infections and episodes of bronchopulmonary obstruction by age two.
- Discriminant analysis successfully classified most index and control children.
Conclusions:
- Early life factors such as shorter breastfeeding and crowded living conditions are associated with increased risk of acute bronchiolitis hospitalization.
- Infants hospitalized for bronchiolitis are at higher risk for recurrent respiratory infections and bronchopulmonary obstruction in early childhood.
- Discriminant analysis can effectively differentiate infants hospitalized for bronchiolitis from healthy controls based on a combination of factors.
Abstract:
Fifty-one infants hospitalized because of acute bronchiolitis and 24 control children were prospectively followed until 2 years of age. Respiratory syncytial virus was detected initially in 31 index children, parainfluenza virus in two, and rhinovirus in one. More index children were born during the months April through September, and six index children had neonatal respiratory complications. The index children were breast-fed for shorter periods, lived in more crowded homes, and had more siblings. No significant differences were found for atopic background and atopic illness at 2 years of age. The index children had more respiratory infections and episodes of bronchopulmonary obstruction during the follow-up period (60% with three or more episodes). To characterize the hospitalized children, a discriminant analysis was performed. A discriminant function classified 47 of 51 index children as belonging to the index group and 21 of 24 control children to the control group.