Respiratory Disease In Early Childhood Research Articles

Early Childhood Respiratory Morbidity and Health Services Utilization in Children Born Preterm or Small and Large for Gestational Age

IntroductionAlterations in duration of gestation and fetal growth such as preterm birth (PTB) or small and large for gestational age (SGA, LGA) have long-term consequences on respiratory health. The risk of health services use for respiratory conditions in infants born PTB, SGA or LGA in Canada needs to be evaluated.
 Objectives and ApproachWe evaluated the association between PTB, SGA and LGA and health services utilization for respiratory diseases in early childhood. We linked three administrative health databases to identify all singleton live births in Alberta between 2005-2010. We obtained data on the number of hospital admissions and emergency department (ED) visits in the first five years of life for acute upper respiratory infections, acute lower respiratory infections, wheezing disorders, bronchopulmonary dysplasia, and influenza and pneumonia. Odds ratios (OR) of health services use for PTB, SGA, LGA were calculated adjusting for important covariates (e.g., maternal age, sex, socioeconomic status, total antepartum risk score).
 ResultsThe cohort contained 206,994 infants of whom 9.1% were PTB, 8.5% were SGA and 9.4% were LGA. Babies born prematurely (PTB) were more likely to have a respiratory disease in the first five years of life than babies experienced fetal growth alterations (SGA or LGA). PTB increased significantly the odds of acute lower respiratory infections by 30 to 90%, of wheezing disorders by 40 to 70%, of influenza and pneumonia by 30 to 60%, and of acute upper respiratory infections by 10 to 50%. By contrast, SGA increased the odds of bronchopulmonary dysplasia by 3 to 300%, and LGA increased the odds of acute upper respiratory infections by 11 to 18% and of acute lower respiratory infections by 8 to 11%.
 Conclusion/ImplicationsPrematurity and alterations in fetal growth are associated with increased hospital and ED admissions in early childhood. The patterns differ for PTB, SGA, and LGA. Linkage of administrative health data provides useful epidemiological evidence to inform the burden of early childhood respiratory diseases resulting from adverse birth outcomes.

Blood Cadmium and C-Reactive Protein Levels As Risk Factors for Allergic and Respiratory Diseases in Early Childhood: The Mothers and Children's Environmental Health Study

Blood Cadmium and C-Reactive Protein Levels As Risk Factors for Allergic and Respiratory Diseases in Early Childhood: The Mothers and Children's Environmental Health Study

Relationship Between Prenatal and Postnatal Exposures to Folate and Risks of Allergic and Respiratory Diseases in Early Childhood

JH Kim, KS Jeong, EH Ha. Pediatr Pulmonol. 2015;50(2):155–163 To evaluate the relationship between maternal folate exposure and the development of allergic and respiratory disease in early childhood. The study group included 917 pregnant women-child pairs from the Mothers and Children’s Environmental Health study in South Korea. Exclusion criteria included gestational age <37 weeks, pregnancy complications including hypertension, gestational diabetes, intrauterine growth retardation, twins, or congenital anomaly. Maternal dietary intake was assessed by questionnaire. Maternal serum folate levels were prospectively measured during mid- and late pregnancy and categorized as high or low relative a …

Viral etiology of acute respiratory infections among children under 5 years of age in Bulgaria, during the 2013/2014 and 2014/2015 seasons

PURPOSE: A wide range of different viruses cause respiratory tract diseases of varying severity. This study aims to determinate the contribution of nine different viral pathogens in cases of acute respiratory infections (ARI) in children aged less than 5 years, during the 2013/2014 and 2014/2015 winter seasons in Bulgaria. METHODS: A total of 412 nasopharyngeal swabs of children under the age of 5 were tested. Children were either outpatient, or hospitalized for influenza-like illness. The clinical samples were tested for Orthomyxoviruses (influenza A/B), Paramyxoviruses (respiratory-syncytial virus – RSV; human metapneumovirus – HMPV; human parainfluenza viruses – HPIV, type 1/2/3) and human rhinoviruses (HRV) using Real Time RT-PCR reactions based on specific primers/probe. RESULTS: Virus infections were confirmed in 258 (62.6%) samples. In 107 (26%) of samples influenza viruses were detected. All of the 306 influenza virus negative patients were analyzed for Paramyxoand Rhinoviruses. Detection rate for RSV, HMPV, HPIV1/2/3 and HRV was 19%, 5.9%, 2%, 1.3%, 3.3% and 14.1%, respectively. CONCLUSION: The present study is the first one in Bulgaria which analyzes the participation of nine different viral pathogens in the etiology of ARI among children below the age of 5 years. The study reveals the leading role of influenza viruses, RSV and rhinoviruses in the development of serious respiratory diseases in early childhood.

Prenatal VOC exposure and redecoration are related to wheezing in early infancy

Redecoration of dwellings is a common behavior of expecting parents. Former studies gave evidence that early childhood exposure to volatile organic compounds (VOC) resulting from renovation activities may increase the risk for wheeze in infants. ObjectivesThe aim of the present study was to evaluate the impact of prenatal exposure on early wheeze and to identify sensitive time windows.Within the LINA birth cohort study data on renovation activities and respiratory outcomes were assessed via questionnaires during pregnancy and at children's age of one. At both timepoints, also indoor VOC concentrations were measured. The associations were studied by logistic regression analysis.Floor covering during pregnancy contributed to an increased risk for physician treated wheeze (adjusted odds ratio OR=5.20, 95% confidence interval 1.8–15.2) during the first 12months after birth in particular in children with an atopic predisposition. Thereby, wall-to-wall-carpets, PVC material, and laminate were the flooring materials which showed the strongest adverse associations. Floor covering was associated with enhanced concentrations of VOCs in the apartments. For the VOCs styrene, ethylbenzene, octane, 1-butanol, tridecane, and o-xylene, a significant association was found to the occurrence of wheezing symptoms. In contrast to pregnancy, exposure during the first 12months after birth showed less detrimental associations. Only the association between wheezing and styrene as well as between wheezing and PVC flooring remained significant for exposure after birth.Redecoration during pregnancy, especially changing floor materials, increases the risk for respiratory diseases in early childhood and should therefore be avoided at least in families with a history of atopic diseases.

Sensitization to food and inhalant allergens in relation to atopic diseases in early childhood: a birth cohort study.

ObjectivesA correct interpretation of sensitization to common allergens is critical in determining susceptibility to allergic diseases. The aim of this study was to investigate the patterns of sensitization to food and inhalant allergens, and their relation to the development of atopic diseases in early childhood.MethodsChildren aged 0 through 4 years from a birth cohort in the Prediction of Allergies in Taiwanese Children (PATCH) study were enrolled. Specific IgE antibody against food and inhalant allergens were measured and their association between total serum IgE levels and atopic diseases were assessed.ResultsA total of 182 children were regular followed up at clinics for a four-year follow-up period. The prevalence of food allergen sensitization increased markedly after 6 months of age, reaching up to 47% at 1.5 years of age and then declined significantly to 10% in parallel with a considerable increase in the prevalence of sensitization to inhalant allergens up to 25% at age 4. Food allergen sensitization appeared to be mainly associated with the elevation of serum total IgE levels before age 2. A combined sensitization to food and inhalant allergens had an additive effect on serum IgE levels after age 2, and was significantly associated with the risk of developing atopic diseases at age 4.ConclusionsSensitization to food occurs early in life, in parallel with the rising prevalence of sensitization to inhalant allergens at older age. A combined sensitization to food and inhalant allergens not only has an additive increase in serum IgE antibody production but also increases the risk of developing allergic respiratory diseases in early childhood.

Relationship between prenatal and postnatal exposures to folate and risks of allergic and respiratory diseases in early childhood

It is uncertain whether folate is risk or preventive factor for allergic and respiratory diseases. To determine the relationship between maternal or offspring folate status and subsequent development of allergic and respiratory diseases in early childhood. In total, 917 mother-child pairs from a prospective birth cohort in South Korea were studied. Data regarding the children's allergic and respiratory outcomes were obtained from standardized questionnaires completed by the mothers at postnatal months 6, 12, and 24. Serum folate levels were measured in the mothers at mid- and late-pregnancy, and in their children at 24 months of age. Atopic biomarkers were measured in the cord blood (CB) and at 24 months after birth. Biomarkers and clinical outcomes were analyzed and compared between the mother-child pairs divided into two groups according to median serum folate status at mid- and late-pregnancy. Serum folate levels during mid-pregnancy were inversely associated with CB eosinophil count (adjusted odds ratio [OR] 0.72, 95% confidence interval [CI], 0.54-0.96) and positively associated with CB interleukin-10 levels (1.47, 1.11-1.94). Maternal folate level above the median value (≥9.5 ng/ml) during mid-pregnancy was associated with a decreased risk for the child of lower respiratory tract infections (LRTIs) at 6 months of age (adjusted OR 0.50, 95% CI 0.28-0.91) and atopic dermatitis (AD) at 24 months (adjusted OR 0.52, 95% CI 0.31-0.88), but not with LRTIs and AD at other ages. A relatively high maternal serum folate level in mid-pregnancy was associated with a decreased risk of LRTIs and AD in early childhood.

Relationship Between Maternal Fat During Pregnancy and Risks Of Allergic and Respiratory Diseases In Early Childhood: The Mothers and Children's Environmental Health Study

Relationship Between Maternal Fat During Pregnancy and Risks Of Allergic and Respiratory Diseases In Early Childhood: The Mothers and Children's Environmental Health Study

Relationship Between Maternal Mid Pregnancy Folate Levels and the Risk of Allergic and Respiratory Diseases in Early Childhood: The Mothers and Children's Environmental Health (MOCEH) Study

Relationship Between Maternal Mid Pregnancy Folate Levels and the Risk of Allergic and Respiratory Diseases in Early Childhood: The Mothers and Children's Environmental Health (MOCEH) Study

Occurrence of respiratory symptoms resulting from exposure to house dust mites in early childhood

The aim of the study was to describe the distribution of house dust mite (HDM) allergens within homes of three‐year‐old children, to identify factors responsible for its variation and to test the hypothesis whether the content of HDM allergens exceeding 2 µg/g dust may be regarded as a risk level of sensitization possibly affecting respiratory health in early childhood. House dust samples were collected in 279 dwellings from the mattresses, children’s bedroom and kitchen floors. In the laboratory, dust samples were analyzed for Der f 1 and Der p 1 using monoclonal antibody enzyme‐linked immunosorbent assays. At the time of the house dust collection, interviews with mothers on the household characteristics and child’s respiratory health were performed. Respiratory outcome variables included running or stuffed nose, cough, barking cough, difficult (puffed) breathing and wheezing or whistling in the chest irrespective of respiratory infection. For each of the symptoms the number of the episodes and duration in days over the past six months were recorded in the questionnaire. In the multivariate Poisson regression analysis, a set of potential confounders has been taken into account such as gender of child, season, maternal education, maternal atopy, older siblings and environmental tobacco smoke. The adjusted rate ratio for episodes of running nose among those exposed to higher HDM exposure was 1.09 (95% confidence interval (CI): 0.98–1.20), for episodes of cough 1.11 (95% CI: 0.99–1.24), barking cough 1.44 (95% CI: 0.99–2.09) difficult breathing 1.31 (95% CI: 0.91–1.92) and for wheezing 1.42 (95% CI: 1.00–2.02). In contrast, rate ratios for the duration of all respiratory symptoms were significantly higher in children exposed to higher HDM level. The corresponding rate ratios for duration of symptoms (in days) were 1.10 (95% CI: 1.06–1.14), 1.06 (95% CI: 1.02–1.11), 1.64 (95% CI; 1.42–1.90), 2.05 (95% CI: 1.79–2.35) and 1.40 (95% CI: 1.21–1.62). The children with positive history of maternal atopy showed a higher risk of wheezing than those without the maternal atopy. The rate ratios for number of wheezing episodes in children of mothers without atopy was insignificant 1.11 (95% CI: 0.94–1.30) while in the group with maternal atopy the risk ratio amounted to 1.47 (95% CI: 1.09–1.96); the corresponding rate ratio estimates for the duration of wheezing were 1.12 (95% CI: 1.04–1.20) and 1.46 (95% CI: 1.29–1.66). The data support the view that exposure to higher level of HDM allergens may affect susceptibility of the bronchi to environmental factors and increase the burden of respiratory diseases in early childhood.

Childhood Respiratory Disease and the Risk of Anxiety Disorder and Major Depression in Adulthood

To examine the association between early childhood respiratory disease and the risk of anxiety and depression in adulthood. Cohort study. Providence cohort of the National Collaborative Perinatal Project. Offspring of 1062 mothers selected for follow-up from birth through adulthood. Childhood respiratory disease. Odds of developing anxiety and depression by age 34 years. Respiratory disease in childhood was associated with an elevated risk of receiving treatment for anxiety disorders but not mood disorders. Specifically, higher respiratory rate at age 4 months was associated with significantly increased odds of receiving treatment for anxiety by age 34 years (odds ratio, 2.2; 95% confidence interval, 1.1-4.4; P < .05). Respiratory disease at age 1 year was associated with significantly increased odds of receiving treatment for anxiety (odds ratio, 2.8; 95% confidence interval, 1.2-6.5; P = .04). In addition, having respiratory disease at age 1 year only was associated with increased odds of receiving treatment for anxiety (odds ratio, 3.1; 95% confidence interval, 1.1-8.7; P < .05), whereas having both respiratory disease at age 1 year and suspect (parent reported but not physician diagnosed) respiratory disease at age 7 years was associated with the greatest odds of receiving treatment for anxiety (odds ratio, 19.8; 95% confidence interval, 2.8-141.9; P < .05). These results are consistent with and extend previous findings and provide prospective evidence of a link between respiratory disease in early childhood and increased risk of anxiety disorders by age 34 years. These findings may have implications for prevention or early intervention with groups at high risk for anxiety disorders.

Association Between Particulate Air Pollution and First Hospital Admission for Childhood Respiratory Illness in Vancouver, Canada

In this study, the authors assessed the impact of particulate air pollution on first respiratory hospitalization. Study subjects were children less than 3 years of age living in Vancouver, British Columbia, who had their first hospitalization as a result of any respiratory disease (ICD-9 codes 460-519) during the period from June 1, 1995, to March 31, 1999. The authors used logistic regression to estimate the associations between ambient concentrations of particulate matter (PM) and first hospitalization. The adjusted odds ratios for first respiratory hospitalization associated with mean and maximal PM10-2.5 with a lag of 3 days were 1.12 (95% confidence interval: 0.98, 1.28) and 1.13 (1.00, 1.27). After adjustment for gaseous pollutants, the corresponding odds ratios were 1.22 (1.02, 1.48) and 1.14 (0.99, 1.32). The data indicated the possibility of harmful effects from coarse PM on first hospitalization for respiratory disease in early childhood.

Laryngeal Foreign Body in the Differential Diagnosis of Wheeze in Early Childhood

Wheeze is the major clinical sign of asthma. However, wheeze cannot be used as a unique diagnostic sign for asthma in young children. Most respiratory disease in early childhood is obstructive in nature and usually manifests with wheeze. This report presents three wheezy young children diagnosed with asthma and treated with inhaled steroids before the diagnosis of laryngeal foreign body was made. The importance of a carefully taken history and examination of every child presenting with wheeze in early childhood is discussed.

Infections with Legionella pneumophila in children.

To learn the role of Legionella pneumophila, the agent of Legionnaires' disease, in childhood illness, a prospective study was conducted among 52 children younger than four years of age with acute disease of the lower respiratory tract. Viral, mycoplasmal, and bacterial cultures and acute- and convalescent-phase sera were obtained during 64 episodes of acute illness; additional sera were drawn annually for three to five years. On the basis of serologic evidence, none of the acute episodes appeared to be due to L. pneumophila serogroup 1 or 2. However, examination of annual serum specimens showed that 27 (52%) of the children had rises in titer of indirect immunofluorescent antibody (a fourfold or greater rise to a reciprocal titer of ⩾128). Most rises in titer were in response to the serogroup 2 antigen. These results suggest that L. pneumophila is not a common cause of acute respiratory disease in early childhood in the study area but that children are frequently exposed to the organism. Alternatively, the serologic responses might be to unrelated cross-reacting microorganisms.