Risk Factors of Transient Early Wheezing in Infants below 2 years in Fayoum City

Abstract

The three different phenotypes of wheezing in infants and children are transient early wheezing, non-atopic preschool wheezing and atopic or asthmatic wheezing. Early transient wheezers suffer from wheezing only during the first two years of life due to small airways caliber being more likely to narrow and obstruct. The main phenomena are the absence of personal history and/or family of atopy, so they are born with lung deficiency. Transient early wheezing to represent about 60% among children. There are many risk factors, which predispose to transient early wheezing such as: maternal complications during pregnancy, type of delivery, type of feeding during infancy, overweight infants, passive smoking and day care attendance during infancy. The previous risk factors were studied well in many developed countries but not in our communities including Egypt. Study these risk factors among infants between two months and two years of age and this is the first study done for this common problem among Egyptian children. The study included 160 infants between 2 months and two years, 80 of them were diagnosed as TEW (group 1) and another 80 healthy infants as a control group. Infants were subjected to the following: Detailed history with special emphasize on gestational age -infant gender-infant weight-prenatal and natal history- history of smoking in family- type of delivery -type of feeding. History of recurrent wheezing, need for hospitalization. Full Clinical Examination 3-Investigations: chest x ray and Laboratory tests: Full picture analysis and IgE total enzyme assay. The study revealed that TEW was encountered with large percentage among infants with history of: maternal disease during pregnancy (diabetes, hypertension and urinary tract infection), caesarian section delivery, over weight infants, family history of smoking, artificial feeding, consuming cow milk during first year of life and attendance to daycare during infancy. Overweight is a new risk factor that was observed in our study. Most of the noted risk factors are similar to that reported in studies done in developed countries in addition to overweight infants are associated.