International study of wheezing in infants: risk factors in affluent and non-affluent countries during the first year of life

International study of wheezing in infants: risk factors in affluent and non-affluent countries during the first year of life

Author Garcia-Marcos, Luis Google Scholar
Mallol, Javier Google Scholar
Sole, Dirceu Autor UNIFESP Google Scholar
Brand, Paul L. P. Autor UNIFESP Google Scholar
Eisl Study Grp Google Scholar
Institution Univ Murcia
CIBER Epidemiol
Publ Hlth CIBERSP
Univ Santiago Chile USACH
Universidade Federal de São Paulo (UNIFESP)
Isala Clin
Abstract Risk factors for wheezing during the first year of life (a major cause of respiratory morbidity worldwide) are poorly known in non-affluent countries. We studied and compared risk factors in infants living in affluent and non-affluent areas of the world. A population-based study was carried out in random samples of infants from centres in Latin America (LA) and Europe (EU). Parents answered validated questionnaires referring to the first year of their infant's life during routine health visits. Wheezing was stratified into occasional (1-2 episodes, OW) and recurrent (3 + episodes, RW). Among the 28687 infants included, the most important independent risk factors for OW and RW (both in LA and in EU) were having a cold during the first 3 months of life [OR for RW 3.12 (2.60-3.78) and 3.15 (2.51-3.97); population attributable fraction (PAF) 25.0% and 23.7%]; and attending nursery school [OR for RW 2.50 (2.04-3.08) and 3.09 (2.04-4.67); PAF 7.4% and 20.3%]. Other risk factors were as follows: male gender, smoking during pregnancy, family history of asthma/rhinitis, and infant eczema. Breast feeding for > 3 months protected from RW [OR 0.8 (0.71-0.89) in LA and 0.77 (0.63-0.93) in EU]. University studies of mother protected only in LA [OR for OW 0.85 (0.76-0.95) and for RW 0.80 (0.70-0.90)]. Although most risk factors for wheezing are common in LA and EU; their public health impact may be quite different. Avoiding nursery schools and smoking in pregnancy, breastfeeding babies > 3 months, and improving mother's education would have a substantial impact in lowering its prevalence worldwide.
Keywords wheezing
asthma
infants
epidemiology
estudio internacional de sibilancias en lactantes
Language English
Date 2010-08-01
Published in Pediatric Allergy and Immunology. Malden: Wiley-Blackwell, v. 21, n. 5, p. 878-888, 2010.
ISSN 0905-6157 (Sherpa/Romeo, impact factor)
Publisher Wiley-Blackwell
Extent 878-888
Origin http://dx.doi.org/10.1111/j.1399-3038.2010.01035.x
Access rights Closed access
Type Article
Web of Science ID WOS:000280200000011
URI http://repositorio.unifesp.br/handle/11600/32802

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