Children at the Risk of Recurrent Wheezing: A Matched Case-Control Study in a Tertiary Care Center.

Abstract

Introduction Wheezing is a common symptom in early childhood. Recurrent wheezing is defined as more than three episodes of wheezing in the past year. Many studies have been conducted to delineate the risk factors for recurrent wheezing and to predict which of these children will progress to asthma. Most studies about risk factors and the clinicodemographic profile of children with recurrent wheeze have been carried out in developed nations. Data in developing countries may differ. This study was carried out to identify risk factors associated with recurrent wheezing in children in a tertiary care center. Materials and methods It was a retrospective, matched case-control study conducted over a period of two years (July 2019 to July 2021). Records of children aged one month to 12 years who came to pediatric OPD or were admitted to a pediatric ward with a history of recurrent wheezing were included in the study. Cases with uncontrolled recurrent wheezing diagnosed by examination with an unreliable history and those with a global developmental delay were excluded from the study. The study involved the hospital records of 60 children. Of these, 30 were recurrent wheezers, and 30 were non-wheezers (controls). Data were collected with detailed proformas from case histories and examination sheets. The proforma had several known and suspected risk factors associated with wheezes. Each risk factor was studied and compared with the control group. The risk factors included in this study were male gender, not exclusively breastfed, history of bottle feeding, exposure to vehicles; exposure to pollen; exposure to animals; using an agarbatti or dhoop, passive smoking, or playing with a soft toy. Data were entered in an Excel sheet, and appropriate statistical analyses were done. Results The male-to-female ratio was 2:1. Out of the number of cases, 73.33% were younger than six years; 56.66% of cases were not exclusively breastfed, and 43.33% were exclusively breastfed for six months; 20% of the cases were bottle-fed, and 40% of the controls were bottle-fed. The percentage of cases exposed to vehicle smoke was 26.66%, while 20% of cases had exposure to pollen and 16% of controls were exposed to pollen. 30% of cases were exposed to animals, and 23% of controls were exposed to animals. With regard to passive smoking, 16.66% of cases were exposed to passive smoking, and 20% of controls were not exposed to passive smoking. Out of the study group, 26.66% of the children played with soft toys. Of all these risk factors, a significant difference between cases and controls was found in only one factor: not being exclusively breastfed for six months. All other risk factors showed no significant difference between cases and controls. Conclusion The present study concluded that the significant risk factor that was associated with recurrent wheezing was "not exclusively breastfeeding." The other factors studied that were suspected to be associated with recurrent wheezing cannot be ruled out entirely due to the relatively small size of the sample and the need to be studied further in detail.