Parental Asthma Research Articles

Association of serum specific IgE levels with asthma in autumn pollen-induced allergic rhinitis: A retrospective analysis

ABSTRACTBackground: Artemisia and Humulus pollen are the two most important aeroallergens of autumn allergies in North China. Cross-sectional data in 2001 have shown that allergic rhinitis often preceded or occurred at the same time as asthma in patients with autumn pollinosis in North China. Objective: We used this cross-sectional data to investigate the association of serum specific IgE (sIgE) levels to Humulus and/or Artemisia pollen with the onset of asthma in patients with autumn pollen-induced allergic rhinitis. Methods: 1096 patients with autumn pollinosis were face-to-face interviewed and underwent sIgE tests to Artemisia and Humulus. The temporal sequence of allergic rhinitis and asthma was documented. 1013 patients were positive to Artemisia and/or Humulus by sIgE. Multinomial logistic regression and survival analysis were used to examine the potential implication of sIgE levels for the progression of asthma in autumn pollen-induced allergic rhinitis. Results: Of the 1013 participants with a positive sIgE test to Artemisia and/or Humulus, 563 (55.6%) had a history of allergic rhinitis which preceded or occurred at the same time as asthma. 450 (44.4%) had allergic rhinitis alone. After controlling of sex, age at onset of allergic rhinitis, and parental asthma, the risk of developing asthma increased with the levels of sIgE to both Artemisia and Humulus (p < 0.05). In Kaplan–Meier analysis, IgE classes 5–6 to Humulus or Artemisia increased the risk of asthma development (p < 0.05). Conclusion: Autumn pollen-induced allergic rhinitis often coexists with seasonal asthma. The incidence of asthma is more pronounced when the sIgE level was higher.

Protective effect of breastfeeding on recurrent cough in adulthood

RationaleBreastfeeding protects from respiratory infections in early life but its relationship to recurrent cough and other respiratory outcomes in adult life is not well established.MethodsInfant feeding practices were assessed prospectively...

Perinatal risk factors for asthma in children with allergic rhinitis and grass pollen sensitization.

Results of epidemiologic studies have determined several risk factors for asthma in school-age children. To examine whether parental and perinatal risk factors, along with infantile feeding patterns, were associated with asthma in children with grass pollen allergy and allergic rhinitis. We retrospectively analyzed the data of our cohort, which consisted of children with allergic rhinitis. Only children with grass pollen sensitization were enrolled. A detailed questionnaire regarding demographic features and perinatal events was given to the parents. A total of 293 children (200 boys [68.3%]; with median age, 10.2 years [interquartile range {IQR}, 7.4-13.0 years]) were included. A total of 109 children (37.2%) had accompanying asthma. The median age of onset of rhinitis symptoms was earlier (5.3 years [IQR, 4.0-8.0 years] versus 7.0 years [IQR, 5.0-10.0 years]; p = 0.001), histories of prematurity (16.7 versus 6.5%; p = 0.006), preeclampsia (5.5 versus 0%; p = 0.001), neonatal intensive care unit admission (15.1 versus 6.0%; p = 0.01), phototherapy (17.9 versus 7.1%; p = 0.004), early formula feeding (58.7 versus 41.2%; p = 0.006), and parental asthma (25.0 versus 11.4%; p = 0.002) were more frequent in children with asthma. Multivariate logistic regression analysis revealed prematurity (odds ratio [OR] 2.78 [95% confidence interval [CI],1.24-6.24]; p = 0.013), history of formula feeding (OR 1.81 [95% CI, 1.09-3.01]; p = 0.022), and parental asthma (OR 2.37 [95% CI, 1.22-4.63]; p = 0.011) were associated with asthma in school-age children with grass pollen-induced allergic rhinitis. Close monitoring of patients with these risk factors may help with an earlier diagnosis of asthma and prompt initiation of therapeutic interventions in children with allergic rhinitis and who were sensitized to grass pollen.

Childhood predictors of lung function trajectories and future COPD risk: a prospective cohort study from the first to the sixth decade of life

Lifetime lung function is related to quality of life and longevity. Over the lifespan, individuals follow different lung function trajectories. Identification of these trajectories, their determinants, and outcomes is important, but no study has done this beyond the fourth decade. We used six waves of the Tasmanian Longitudinal Health Study (TAHS) to model lung function trajectories measured at 7, 13, 18, 45, 50, and 53 years. We analysed pre-bronchodilator FEV1 z-scores at the six timepoints using group-based trajectory modelling to identify distinct subgroups of individuals whose measurements followed a similar pattern over time. We related the trajectories identified to childhood factors and risk of chronic obstructive pulmonary disease (COPD) using logistic regression, and estimated population-attributable fractions of COPD. Of the 8583 participants in the original cohort, 2438 had at least two waves of lung function data at age 7 years and 53 years and comprised the study population. We identified six trajectories: early below average, accelerated decline (97 [4%] participants); persistently low (136 [6%] participants); early low, accelerated growth, normal decline (196 [8%] participants); persistently high (293 [12%] participants); below average (772 [32%] participants); and average (944 [39%] participants). The three trajectories early below average, accelerated decline; persistently low; and below average had increased risk of COPD at age 53 years compared with the average group (early below average, accelerated decline: odds ratio 35·0, 95% CI 19·5-64·0; persistently low: 9·5, 4·5-20·6; and below average: 3·7, 1·9-6·9). Early-life predictors of the three trajectories included childhood asthma, bronchitis, pneumonia, allergic rhinitis, eczema, parental asthma, and maternal smoking. Personal smoking and active adult asthma increased the impact of maternal smoking and childhood asthma, respectively, on the early below average, accelerated decline trajectory. We identified six potential FEV1 trajectories, two of which were novel. Three trajectories contributed 75% of COPD burden and were associated with modifiable early-life exposures whose impact was aggravated by adult factors. We postulate that reducing maternal smoking, encouraging immunisation, and avoiding personal smoking, especially in those with smoking parents or low childhood lung function, might minimise COPD risk. Clinicians and patients with asthma should be made aware of the potential long-term implications of non-optimal asthma control for lung function trajectory throughout life, and the role and benefit of optimal asthma control on improving lung function should be investigated in future intervention trials. National Health and Medical Research Council of Australia; European Union's Horizon 2020; The University of Melbourne; Clifford Craig Medical Research Trust of Tasmania; The Victorian, Queensland & Tasmanian Asthma Foundations; The Royal Hobart Hospital; Helen MacPherson Smith Trust; and GlaxoSmithKline.

Childhood and Parental Asthma, Future Risk of Bipolar Disorder and Schizophrenia Spectrum Disorders: A Population-Based Cohort Study.

BackgroundMounting evidence implicates early life and prenatal immune disturbances in the etiology of severe mental illnesses. Asthma is a common illness associated with chronic aberrant immune responses. We aimed to determine if asthma in childhood and parents is associated with bipolar and schizophrenia spectrum disorders.MethodsA cohort study including all children born in Sweden 1973–1995 (N > 2 million) assessing associations between childhood hospitalization for asthma, parental asthma during and pre-pregnancy, and subsequent bipolar and schizophrenia spectrum disorders.ResultsChildren with hospitalizations for asthma between 11 and 15 years had increased rates of bipolar (adjusted hazard ratio [aHR] = 1.73, 95% confidence interval [CI] = 1.21–2.47) and schizophrenia spectrum disorders (aHR = 1.62, 95% CI = 1.08–2.42). However, there was no association with asthma before aged 11. These results were supported by an analysis of siblings discordant for asthma. We found an association between both maternal and paternal asthma and bipolar disorder (aHR = 1.60, 95% CI = 1.27–2.02, and aHR = 1.44, 95% CI = 1.08–1.93, respectively), but not between parental asthma and schizophrenia spectrum disorders.ConclusionsAs far as we are aware, this is the first study to find increased risk of bipolar disorder in children of individuals with asthma. Asthma admissions before aged 11 do not appear to be linked to bipolar or schizophrenia spectrum disorders. Taken together, our results do not suggest a straightforward link between asthma and severe mental illness via neurodevelopmental effects of inflammation, but potentially there is shared genetic vulnerability. This finding has implications for understanding the differential pathogenic mechanisms of bipolar and schizophrenia spectrum disorders.

Respiratory morbidity through the first decade of life in a national cohort of children born extremely preterm

BackgroundAdvances in perinatal care have markedly increased the prospects of survival for infants born extremely preterm (EP). The aim of this study was to investigate hospitalisation rates and respiratory morbidity from five to 11 years of age in a prospective national cohort of EP children born in the surfactant era.MethodsThis was a national prospective cohort study of all children born in Norway during 1999 and 2000 with gestational age (GA) < 28 weeks or birth weight < 1000 grams, and of individually matched term-born controls recruited for a regional subsample. Data on hospital admissions, respiratory symptoms, and use of asthma medication was obtained by parental questionnaires at 11 years of age.ResultsQuestionnaires were returned for 232/372 (62%) EP-born and 57/61 (93%) regional term-born controls. Throughout the study period, 67 (29%) EP-born and seven (13%) term-born controls were admitted to hospital (odds ratio (OR) 2.90, 95% confidence interval (CI): 1.25, 6.72). Admissions were mainly due to surgical procedures, with only 12% due to respiratory causes, and were not influenced by neonatal bronchopulmonary dysplasia (BPD) or low GA(≤ 25 weeks). Respiratory symptoms, asthma and use of asthma medication tended to be more common for EP-born, significantly so for medication use and wheeze on exercise. Neonatal BPD was a risk factor for medication use, but not for current wheeze. In multivariate regression models, home oxygen after discharge (OR 4.84, 95% CI: 1.38, 17.06) and parental asthma (OR 4.38, 95% CI: 1.69, 11.38) predicted current asthma, but neither BPD nor low GA were associated with respiratory symptoms at 11 years of age.ConclusionsHospitalisation rates five to 11 years after EP birth were low, but twice those of term-born controls, and unrelated to neonatal BPD and low GA. Respiratory causes were rare. Respiratory complaints were more common in children born EP, but the burden of symptoms had declined since early childhood.

Asthma and Allergic Disorders in Uganda: A Population-Based Study Across Urban and Rural Settings

Allergic diseases are increasing in sub-Saharan Africa, but few studies have characterized the burden among adults. We conducted a study to evaluate the prevalence and risk factors of allergic disorders in urban and rural Uganda. We present a cross-sectional analysis of enrollment data from a population-based cohort study of adults aged ≥35 years in urban and rural Uganda. Sociodemographic and both lifetime and 12-month respiratory symptoms data were collected and spirometry was conducted following standard guidelines. In 1,308 adults (median age 43.8 years and 52.3% female), we found an age-adjusted prevalence of 6.8% for asthma (9.8% urban, 4.3% rural; P < .001), 11.9% for allergic rhinitis (16.4% urban, 7.8% rural; P < .001), and 8.2% for eczema (9.9% urban, 7.8% rural; P= .15). Urbanization was the primary driver of asthma, accounting for 61.4% of cases (95% confidence interval [CI] 22.0% to 83.4%), and was the strongest risk factor for any allergic illness (odds ratio [OR]= 1.87, 95% CI 1.39-2.51). Parental asthma was not associated with allergic illness. Asthma was associated with a lower forced expiratory volume in 1 second (FEV1) by 0.56 z scores (95% CI 0.33-0.80). We found a dose-response association between lower quintiles of the FEV1/forced vital capacity ratio and both hospitalization (OR= 1.77, 95% CI 1.21-2.59) and impairment in daily activities (1.65, 1.20-2.27). Asthma and allergic rhinitis were twice as prevalent in urban settings. Asthma was associated with greater impairment and worse lung function outcomes. We identified a high prevalence of allergic disorders in Uganda, which can be expected to increase due to urbanization and resultant exposures throughout early development.

Small-airway dysfunction precedes the development of asthma in children with allergic rhinitis

BackgroundEpidemiological evidence suggests the existence of a direct link between allergic rhinitis (AR) and asthma. Several studies also support the presence of small-airway dysfunction (SAD) in non-asthmatic children with AR. However, it remains unknown whether SAD can predict the progression of AR to asthma. Our objective was to explore the existence of SAD in non-asthmatic children with AR and to assessed its ability to predict the development of asthma. MethodsSeventy-three 6-year-old children with intermittent moderate-severe AR but without asthma symptoms/medication within the last two years, underwent spirometry and measurement of respiratory resistance (Rrs) and reactance (Xrs) before and after bronchodilation (BD) (300mcg salbutamol). Lung function measurements were performed in the absence of nasal symptoms and repeated at AR exacerbation. SAD was defined as >30% decrease in Rrs or >50% increase in Xrs at 6 or 8Hz post-BD. Participants were followed for five years. ResultsTwenty-three children (31.5%) developed asthma; this group presented significant post-BD changes in Rrs and Xrs, but only at AR exacerbation. The ability of these changes to predict the development of asthma was exceptional and superior to that of the spirometric parameters. SAD (22 children, 30.1%), emerged as the single most efficient predictor of asthma, independently of other risk factors such as parental asthma, personal history of eczema and type of allergic sensitisation. ConclusionSAD precedes the development of asthma in children with AR. Changes in respiratory impedance at AR exacerbation may assist in identifying those at risk to progress to asthma.

Asthma predictive index in relation to respiratory mechanics by impulse oscillometry in recurrent wheezers

BackgroundThe identification of children who will have persistent asthma has become a focus of recent research. The aim of this study was to assess whether impulse oscillometry (IOS) has a diagnostic value to predict modified API (asthma predictive index) in pre-schoolers with recurrent wheezing. MethodsPre-school children aged 3–6 years with recurrent wheezing were enrolled. The study population was divided into two groups based on mAPI criteria. Lung function was assessed by IOS. Results115 children were assessed; 75 (65.2%) of them were male. The median age was 39 months (min: 36, max: 68 months). 64 (55.6%) of the children were mAPI positive. The R5-R20% levels of children with positive mAPI were significantly higher compared to negative mAPI. Also, R5-R20% levels of children with parental asthma and R20% pred and resonant frequency (Fres) levels of children with inhalant sensitization were higher than those without. No significant differences were found in IOS indices between groups based on the presence of atopic dermatitis, food sensitization, eosinophilia, inhaled corticosteroid usage or wheezing without colds. R5-R20% and total IgE values were found to be significantly related to positive mAPI (aOR: 1.40, p=0.022 and aOR: 1.02, p=0.001, respectively). In the ROC analysis, R5-R20% levels >14.4 had a sensitivity of 75% and specificity of 53% for predicting a positive mAPI (p=0.003). ConclusionIOS may help clinicians to identify the pre-school wheezers with a high risk of asthma.

Level of knowledge about asthma in parents of asthmatic children attending a specialized outpatient clinic at Yanahuara III Hospital-Arequipa

&#x0D; &#x0D; &#x0D; Objetivos: Se trata de un estudio observacional prospectivo cuyo objetivo fue determinar el nivel de conocimientos sobre el asma en los padres de niños asmáticos que acuden a consulta externa del Programa de Asma en el Hospital III Yanahuara.&#x0D; Materiales y métodos: Se encuestó a una muestra representativa de 200 padres de niños con asma, aplicando el cuestionario NAQK (Newcastle Asthma Knowledge Questionnaire). Se muestran resultados mediante estadística descriptiva y se comparan grupos mediante prueba Chi cuadrado, ANOVA y la prueba Post-hoc de Tukey HSD.&#x0D; Resultados: Se encontró que el 62% de los padres tiene un conocimiento regular sobre el asma y bueno en un 27.5%, siendo deficiente en sólo el 10.5% de los casos; dicho resultado es estadísticamente superior en comparación con otros estudios. Respecto al conocimiento del asma en sus aspectos generales, crisis de asma, tratamiento controlador y mitos, los conocimientos fueron todos regulares con un 66.5%, 63.0%, 54.0% y 48.0% respectivamente. Al correlacionar la influencia de algunos factores en el nivel de conocimientos, sólo se encontró que influye el tiempo de permanencia en el programa de asma con diferencia estadística (p=0.01).&#x0D; Conclusiones: El nivel de conocimientos sobre el asma en este estudio fue regular pero superior que en otros estudios y depende predominantemente de su tiempo de permanencia en el programa de asma.&#x0D; &#x0D; &#x0D;

Malatya’da Yaşayan 6-7 Yaş Grubu Çocuklarında Allerjik Hastalıkların Sıklığı ve İlişkili Risk Faktörleri

Oz (Ingilizce):Objective: The prevalence of allergic disease in children has been increasing in the recent years. There is no previous study on the prevalence of allergic disease in Malatya, Turkey. We aimed to investigate the prevalence of allergic disease and related risk factors among children aged 6-7 years in Malatya.Materials and Methods: We administered the questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC) translated into the Turkish language to 480 children aged 6-7 years living in Malatya. The questionnaires were completed by the parents for 413 (86%) of the children.Results: There were 210 (50.8%) males and the overall mean age was 6.6±0.49 years. The lifetime prevalence of wheezing, rhinitis and eczema was 20.3%, 37% and 7.5% respectively and the reported prevalence for the last 12 months was 12.3%, 32% and 6.5% respectively. When the risk factors associated with allergic disease were analyzed; male gender (p=0.001), history of parental asthma (p=0.002), doctor's diagnosis of allergic rhinitis (p=0.025) and having cockroaches at the home (p=0.002) were associated with asthma. A history of doctor's diagnosis of asthma (p<0.001) and atopic eczema (p=0.001) were associated with rhinitis as risk factors. History of parental atopic eczema (p<0.001) and doctor's diagnosis of asthma (p=0.006) were associated with atopic eczema as risk factors.Conclusion: This study is the first to investigate the prevalence of allergic disease in the 6-7 years age group in Malatya using the ISAAC questionnaire. The current study shows the prevalence of allergic diseases is considerable in children living in Malatya.

Combined effects of multiple risk factors on asthma in school-aged children.

Little is known about synergistic effects of several risk factors on asthma. We developed a risk score in Puerto Rican children, and then used this score to estimate the combined effects of multiple risk factors on asthma at school age in Puerto Rican and Swedish children. Case-control study in 609 Puerto Rican children (aged 6-14 years) and longitudinal birth cohort study of 2290 Swedish children followed up to age 12 years (The Children, Allergy, Milieu, Stockholm, Epidemiological Survey [BAMSE] Study). In both cohorts, there was data on parental asthma, sex, obesity, allergic rhinitis, and early-life second-hand smoke (SHS); data on diet and (in children ≥9 years) lifetime exposure to gun violence were also available in the Puerto Rico study. Asthma was defined as physician-diagnosed asthma and ≥1 episode of wheeze in the previous year. In a multivariable analysis in Puerto Rican children, male sex, parental asthma, allergic rhinitis, early-life SHS, an unhealthy diet and (in children ≥9 years) gun violence were each significantly associated with asthma. We next created a risk score using these variables (range, 0 to 5-6 in Puerto Rico and 0 to 4 in BAMSE). Compared with Puerto Rican children without any risk factors (i.e. a score of 0), Puerto Rican children with 2, 3, and at least 4 risk factors had 3.6 times (95% CI=1.4-9.2), 10.4 times (95% CI=4.0-27.0), and 21.6 times (95% CI=7.2-64.9) significantly higher odds of asthma, respectively. In BAMSE, the presence of 2, 3, and at least 4 risk factors was significantly associated with 4.1 times (95% CI=2.3-7.4), 6.3 times (95% CI=3.0-13.3), and 17.2 times (95% CI=4.1-73.2) increased odds of asthma at age 12 years. Our findings emphasize the multifactorial etiology of asthma, and suggest that concurrent eradication or reduction of several modifiable risk factors may better prevent or reduce the burden of childhood asthma.

Risk and Triggering Factors Associated with Bronchial Asthma Among School-Going Children in an Urban City of Coastal Karnataka

Introduction: Asthma is common in childhood and is a major public health issue. The objectives of this study were to identify risk and triggering factors associated with asthma among school children.Material and Methods: A prospective cross sectional study was conducted among 6-15 years old children, over two months in two private schools at Mangalore city. Trigger factors were assessed as per asthma trigger inventory (ATI). Responses were graded from 0-5 score based on ‘never’,’ rarely’, ‘sometimes’, ‘most of the time’ and ‘always’. A predesigned questionnaire suiting the city environment was prepared and used to assess the risk and triggering factors. Analysis was done using SPSS version 16.Results: Asthma and allergic rhinitis in parents (34.1%,40.7%), smoking at home(24.2%), exclusive breast feeding absence (27.5%),early weaning(24.2%), living in a flat (37.4%) and pets at home(37.4%) were risk factors noted. As per ATI, it was found that ‘having a cold’ was the most frequently selected trigger at 94.5% (47.3% ‘sometimes’, 2.2% ‘always’), followed by ‘running’ at 79.1% (27.5% ‘sometimes’, 13.2% ‘always’), and ‘house dust’ at 69.2% (31.9% ‘sometimes’, 6.6% ‘always’). The highest mean was for infections, (2.228, SD=0.546), followed by physical exercise (2.167, SD=0.331). Animal allergens had lowest mean (1.527, SD=0.104), followed by psychological triggers at second lowest (1.579, SD=0.181). However none of the risk and trigger factors had statistical significance with asthma.Conclusion: Avoiding exposure to probable triggers and identifying risk factors would aid in planning effective strategic measures with better quality of life.

Effect of diet and maternal education on allergies among preschool children: A case-control study

IntroductionThe prevalence of asthma and allergy has increased among children. This increase in prevalence might be related to dietary patterns. AimsThe present epidemiological study investigated the relationship between the consumption of fruit, vegetables, nuts, meat and fish, and the prevalence of wheeze, asthma, and eczema among preschool children. MethodsThis nested case-control study included 1489 children aged 4–6 years and residing in Kaunas city, Lithuania. The subjects were recruited to the KANC newborn cohort study during 2007–2009. Parents’ responses to questionnaires were used to collect information on allergic diseases, diet, and other variables. The association between dietary patterns and children's allergic diseases were tested by using logistic regressions, after adjustment for maternal education level, smoking during pregnancy, parental asthma, children's sex, parity, and antibiotic usage during the first year of life. ResultsIn this study, 83.3% of all children consumed fresh fruit and/or vegetables at least three times per week. A significantly lower adjusted odds ratio (aOR) of wheeze was found among children who ate fruit than among those who did not (aOR: 0.48; 95% CI: 0.22–0.96). The consumption of nuts was also associated with a lower 61% risk of eczema among 4–6 years old children. ConclusionThe results indicated a beneficial effect of a frequent consumption of fresh fruit and nuts on the prevalence of allergies among children. These results might have important implications for children's health.

Associations of caesarean delivery and the occurrence of neurodevelopmental disorders, asthma or obesity in childhood based on Taiwan birth cohort study

ObjectivesWhether birth by caesarean section (CS) increases the occurrence of neurodevelopmental disorders, asthma or obesity in childhood is controversial. We tried to demonstrate the association between children born by CS...

Risk Factors of Recurrent Wheeze in Infancy

Background: Recurrent wheeze in infancy is a common clinical problem and one of the most important causes of health facility visits in Bangladesh. Recurrent wheeze is an important manifestation of bronchiolitis, pneumonia and asthma.Objectives: The study was conducted to identify the risk factors associated with recurrent wheeze in infancy.Methods: This case control study was conducted at Dhaka Shishu Hospital and Dhaka Medical College Hospital (DMCH) during August 2008- June 2009 including 50 infants (1- 12 months of age) with recurrent (3 or more) wheeze or wheeze persisting for more than one month during first year of life as study group and 50 children (12 months to 24 months of age) who had no wheeze during first year of life as control groupResults: The study group comprised of 34 (68.0%) male and 16(32.0%) female infants and control group included 31(62.0%) male and 19 (38.0 %) female children. The mean age of study group was 9 months and that of the control group was 18 months. The median age of first attack of wheeze was 4 months. Twenty one (42.0%) infants in study group and 29 (58.0%) in control group were exclusively breastfed. On the other hand, 29 (58.0%) studied cases and 21(42.0%) controls were mixed fed (formula, cow’s milk, suji along with breast milk).The study children who were exclusively breastfed had lesser incidence of recurrent wheeze than those who were mixed fed but the difference was not significant (P&gt; 0.05). There was past history of bronchiolitis in 45 (90.0%) cases of study group in comparison to only 3 (6.0%) cases of control group (p &lt;0.05). Past history of pneumonia was present in 15 (30.0%) cases of study group compared to only 3 (6.0%) cases of control group (P &lt;0.05). There was history of mother’s asthma among 14 (28.0%) infants of study group versus only 1 (2.0%) mother of control group (P &lt;0.05). There was history of father’s asthma in 8 (16.0%) cases of study group in comparison to none of control group (P&lt;0.05). In this study we observed that 11 (22.0%) infants of study group had sibs suffering from wheeze compared to only 3 (6.0%) children of control group (&lt;0.05). Sixteen (32.0%) infants of study group versus only 6 (12.0%) children of control group had atopic dermatitis and 33 (66.0%) cases of study group had suffered from allergic rhinitis whereas only 10 (20.0%) children had allergic rhinitis in control group (P&lt;0.05). Atopic dermatitis and allergic rhinitis among study children were significantly associated with recurrent wheeze during infancy. Twenty (40.0%) study cases had exposure to tobacco smoke compared to 22 (44.0%) cases of control group. Exposure to tobacco smoke was not found to be associated with recurrent wheeze (P &gt;0.05)Conclusion: The risk factors of recurrent wheeze in infancy identified in this study were past history of bronchiolitis , past history of pneumonia, asthma in parents (father and mother), wheeze in other sibs and atopic condition in children (atopic dermatitis, allergic rhinitis). Exclusively breastfed children had lesser incidence of recurrent wheeze than those who were mixed fed but the difference was not significant and exposure to tobacco smoke was not associated with recurrent wheeze in infancy in the present study.Bangladesh J Child Health 2017; VOL 41 (1) :9-14

Variations in the prevalence of childhood asthma and wheeze in MeDALL cohorts in Europe.

While there is evidence for variations in prevalence rates of childhood wheeze and asthma between countries, longitudinal, individual-level data are needed to understand these differences. The aim of this study was to examine variations in prevalence rates of childhood asthma, wheeze and wheeze with asthma in Europe.We analysed datasets from 10 MeDALL (Mechanisms of the Development of ALLergy) cohorts in eight countries, representing 26 663 children, to calculate prevalence rates of wheeze and asthma by child age and wheeze with asthma at age 4 years. Harmonised variables included outcomes parent-reported wheeze and parent-reported doctor-diagnosed asthma, and covariates maternal education, parental smoking, pets, parental asthma, doctor-diagnosed allergic rhinitis, doctor-diagnosed eczema and wheeze severity.At age 4 years, asthma prevalence varied from 1.72% in Germany to 13.48% in England and the prevalence of wheeze varied from 9.82% in Greece to 55.37% in Spain. Adjusted estimates of the proportion of 4-year-old children with wheeze diagnosed with asthma remained highest in England (38.14%, 95% CI 31.38–44.90%) and lowest in Spain (15.94%, 95% CI 6.16–25.71%).The large differences in prevalence rates of asthma, wheeze and wheeze with asthma at age 4 years between European cohorts may indicate that childhood asthma is more readily diagnosed in some countries while going unrecognised elsewhere.

Does atopy affect the course of viral pneumonia?

BackgroundThe presence of atopy is considered as a risk factor for severe respiratory symptoms in children. The objective of this study was to examine the effect of atopy on the course of disease in children hospitalised with viral pneumonia. MethodsChildren between the ages of 1 and 6 years hospitalised due to viral pneumonia between the years of 2013 and 2016 were included to this multicentre study. Patients were classified into two groups as mild–moderate and severe according to the course of pneumonia. Presence of atopy was evaluated with skin prick tests. Groups were compared to evaluate the risk factors associated with severe viral pneumonia. ResultsA total of 280 patients from nine centres were included in the study. Of these patients, 163 (58.2%) were male. Respiratory syncytial virus (29.7%), Influenza A (20.5%), rhinovirus (18.9%), adenovirus (10%), human metapneumovirus (8%), parainfluenza (5.2%), coronavirus (6%), and bocavirus (1.6%) were isolated from respiratory samples. Eighty-five (30.4%) children had severe pneumonia. Atopic sensitisation was found in 21.4% of the patients. Ever wheezing (RR: 1.6, 95% CI: 1.1–2.4), parental asthma (RR: 1.5, 95% CI: 1.1–2.2), other allergic diseases in the family (RR: 1.8, 95% CI: 1.2–2.9) and environmental tobacco smoke (RR: 1.6, 95% CI: 1.1–3.5) were more common in the severe pneumonia group. ConclusionsWhen patients with mild–moderate pneumonia were compared to patients with severe pneumonia, frequency of atopy was not different between the two groups. However, parental asthma, ever wheezing and environmental tobacco smoke exposure are risk factors for severe viral pneumonia in children.

Parental antibiotics and childhood asthma—a population-based study

In this population-based study on antibiotic treatment before, during, and after pregnancy, using paternal exposure as negative control, we confirm that associations between maternal antibiotic exp ...

Early menarche and new onset of asthma: Results from the SAPALDIA cohort study

RationaleThe association between early menarche and new onset of asthma warrants further investigation in those aged >30 years. ObjectivesUsing data from the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA), we investigated whether early menarche was associated with new onset of asthma in women aged 18–60 years at baseline. MethodsOur analysis included 2492 women with information on age at menarche and doctor-diagnosed asthma, who had been asthma free at the time of menarche and had complete covariate information. New onset of asthma was defined as newly reported doctor-diagnosed asthma which occurred at least one year after menarche. Asthma incidence and its association with early menarche was analysed using logistic regression, adjusting for age, atopy, smoking, BMI, parental asthma, urbanity, education and study area, and additionally stratifying by atopy and BMI. ResultsAfter adjustment of relevant confounders, women with early menarche did not have a significantly higher risk of onset of asthma than women without early menarche (OR 1.23, 95% CI 0.85–1.80). Young atopic women with early menarche appeared to have an increased risk of asthma compared with non-atopic women (OR 2.21, 95% CI 0.90–5.43); however, our results did not reach statistical significance. ConclusionWe could not substantiate an association of early menarche with new onset of asthma in this Swiss population-based cohort aged 18–60 years at baseline. Future studies may need to prospectively assess age of menarche to investigate the association with new onset of asthma in those aged >30 years.