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[Recurrent asthmatic bronchitis in the first years of life: a 3-year follow-up]
E Brigante1, G Cirillo, G Aurelio
1IV Divisione di Pediatria, Ospedale Materno-Infantile SS. Annunziata, Napoli, Italia.
Insights
Parental smoking is a significant risk factor for childhood asthma, increasing recurrence by 18 times. Early childhood asthmatic bronchitis can develop into chronic asthma, especially with passive smoke exposure.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Epidemiology
Context:
- The natural history and early risk factors for childhood asthma remain incompletely understood.
- Recurrent moderate-to-severe asthmatic bronchitis in early childhood presents a significant clinical challenge.
- Identifying prognostic factors is crucial for managing pediatric respiratory conditions.
Purpose:
- To investigate the evolution of symptomatology in children with recurrent asthmatic bronchitis.
- To identify risk factors influencing the progression of childhood asthma.
- To analyze the long-term outcomes of moderate-to-severe asthmatic bronchitis in early life.
Summary:
- This study followed 100 children with moderate-to-severe recurrent asthmatic bronchitis from infancy.
- After three years, 73.3% of 5-year-old patients still had persistent asthma.
- Key risk factors for poor outcomes included parental smoking (RR=18) and, to a lesser extent, bedroom overcrowding (RR=1.5).
- Passive smoking was identified as a major adverse prognostic factor, potentially leading to chronic asthma.
Impact:
- Findings highlight the critical impact of environmental factors, particularly parental smoking, on childhood asthma development and persistence.
- This research underscores the need for interventions targeting passive smoke exposure to improve long-term respiratory health in children.
- The study provides valuable insights for pediatricians and allergists in predicting and managing pediatric asthma.
- Understanding these risk factors can inform public health strategies aimed at reducing the burden of childhood asthma.
Abstract:
The natural history of asthma is not well known; its origin may go back to just after the birth. The aims of this study are: 1) studying the evolution of the symptomatology of a group of children suffering from recurrent asthmatic bronchitis of a moderate-severe level in the first two years of life; 2) inquiring some risk factors conditioning the evolution of it. One hundred children, aged from 16.6 to 53.4 months, suffering from moderate to severe recurrent asthmatic bronchitis, have been checked at the follow-up at the Broncopneumologic and Allergic Pediatric Unit of the SS Annunziata Hospital (Naples). Among the 100 children checked, 25 have been dropped at the follow-up; the difference between the sample checked and the one dropped at the follow-up is not statistically relevant. Four are variables examined: age, allergic medical history, number of asthma episodes, breast feeding, association or not of atopic dermatitis. The evolution of the symptomatology has not been propitious, as, at the end of three years of analysis, 73.3% of the 5-year-old patients had still persistent asthma. The risk factors of asthma recurrence are: parents smoking habits with a relative risk of 18 times more in patients with disadvantageous evolution (R.R. = 18) and at a less measure the overcrowding of the bedroom (R.R. = 1.5). The age at the onset in of the symptomatology, the positive familiar medical history for allergic illness, the breast feeding and the atopic dermatitis have not resulted statistically different between the group with advantageous evolution and the one with disadvantageous outcome. Passive smoking is a very disadvantageous prognostic factor; it may contribute to the disadvantageous evolution of the moderate to severe asthmatic bronchitis in the early childhood towards the recurrent or chronic bronchial asthma of the late childhood.