Risk factors for recurrent wheezing in infants: a case-control study.

Roberta Barros De Sousa,José Ângelo Rizzo,Ana Carolina Dela Bianca,Emanuel Sarinho,Almerinda Rêgo Silva,Décio Medeiros

doi:10.1590/s1518-8787.2016050005100

Roberta Barros De Sousa, José Ângelo Rizzo + Show 4 more

Open Access

https://doi.org/10.1590/s1518-8787.2016050005100

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Abstract

ABSTRACTOBJECTIVE To evaluate the association between recurrent wheezing and atopy, the Asthma Predictive Index, exposure to risk factors, and total serum IgE levels as potential factors to predict recurrent wheezing.METHODS A case-control study with infants aged 6-24 months treated at a specialized outpatient clinic from November 2011 to March 2013. Evaluations included sensitivity to inhalant and food antigens, positive Asthma Predictive Index, and other risk factors for recurrent wheezing (smoking during pregnancy, presence of indoor smoke, viral infections, and total serum IgE levels).RESULTS We evaluated 113 children: 65 infants with recurrent wheezing (63.0% male) with a mean age of 14.8 (SD = 5.2) months and 48 healthy infants (44.0% male) with a mean age of 15.2 (SD = 5.1) months. In the multiple analysis model, antigen sensitivity (OR = 12.45; 95%CI 1.28–19.11), positive Asthma Predictive Index (OR = 5.57; 95%CI 2.23–7.96), and exposure to environmental smoke (OR = 2.63; 95%CI 1.09–6.30) remained as risk factors for wheezing. Eosinophilia ≥ 4.0% e total IgE ≥ 100 UI/mL were more prevalent in the wheezing group, but failed to remain in the model. Smoking during pregnancy was identified in a small number of mothers, and secondhand smoke at home was higher in the control group.CONCLUSIONS Presence of atopy, positive Asthma Predictive Index and exposure to environmental smoke are associated to recurrent wheezing. Identifying these factors enables the adoption of preventive measures, especially for children susceptible to persistent wheezing and future asthma onset.

Highlights

Wheezing resulting from peripheral airway narrowing is a frequent occurrence in the pediatric age group and may be a sign of systemic disease
Presence of atopy, positive Asthma Predictive Index and exposure to environmental smoke are associated to recurrent wheezing
This study showed that some factors, such as early onset and number of viral infections and maternal smoking during pregnancy, had a strong correlation with cases of recurrent wheezing[18]

Summary

Introduction

Wheezing resulting from peripheral airway narrowing is a frequent occurrence in the pediatric age group and may be a sign of systemic disease. Asthma is the main cause of wheezing in infancy, this must always be a diagnosis of exclusion[16]. Many children have recurrent coughing and wheezing episodes early in life, normally during viral respiratory infections[15]. There is a spontaneous remission of wheezing. Approximately 50.0% of infants and pre-school children are still wheezing at the age of six[20]. Wheezing infants are defined as children with a history of three or more wheezing episodes over a six-month period[16]

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