Department of Paediatrics, Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
Respiratory Department, Sydney Children's Hospital, Sydney, Australia.
BMJ Open. 2017 Nov 8;7(11):e017936. doi: 10.1136/bmjopen-2017-017936.
To determine the contribution of respiratory syncytial virus (RSV) to the subsequent development of severe asthma in different subgroups of children at risk of severe RSV disease.
The study was conducted in New South Wales (NSW), Australia.
The study comprised all children born in NSW between 2000 and 2010 with complete follow-up till 31 December 2011. The cohort was divided into three subgroups: (1) non-Indigenous high-risk children: non-Indigenous children born preterm or born with a low birth weight; (2) Indigenous children: children of mothers whose Indigenous status was recorded as Aboriginal and/or Torres Strait Islander and (3) non-Indigenous standard risk children: all other non-Indigenous term children.
Risk of development of severe asthma in different subgroups of children who had RSV hospitalisation in the first 2 years of life compared with those who did not.
We performed a retrospective cohort analysis using population-based linked administrative data. Extended Cox model was used to determine HR and 95% CI around the HR for first asthma hospitalisation in different subgroups of children.
The cohort comprised 847 516 children born between 2000 and 2010. In the adjusted Cox model, the HR of first asthma hospitalisation was higher and comparable across all subgroups of children who had RSV hospitalisation compared with those who did not. The HR (95% CI) was highest in children aged 2-3 years; 4.3 (95% CI 3.8 to 4.9) for high-risk, 4.0 (95% CI 3.3 to 4.8) for Indigenous and 3.9 (95% CI 3.7 to 4.1) for non-Indigenous standard risk children. This risk persisted beyond 7 years of age.
This large study confirms a comparable increased risk of first asthma hospitalisation following RSV disease in the first 2 years of life across different subgroups children at risk.
确定呼吸道合胞病毒（RSV）在有发生严重 RSV 疾病风险的不同亚组儿童中对随后发生严重哮喘的影响。
本研究在澳大利亚新南威尔士州（NSW）进行。
本研究包括 2000 年至 2010 年间在 NSW 出生且截至 2011 年 12 月 31 日随访完整的所有儿童。队列分为三组：（1）非土著高危儿童：非土著早产或出生体重低的儿童；（2）土著儿童：母亲的土著身份被记录为原住民和/或托雷斯海峡岛民的儿童；（3）非土著标准风险儿童：所有其他非土著足月儿童。
与未发生 RSV 住院的儿童相比，2 岁内发生 RSV 住院的不同亚组儿童发展为严重哮喘的风险。
我们使用基于人群的链接行政数据进行了回顾性队列分析。扩展 Cox 模型用于确定不同亚组儿童首次哮喘住院的 HR 及其 95%CI。
队列包括 2000 年至 2010 年期间出生的 847516 名儿童。在调整后的 Cox 模型中，与未发生 RSV 住院的儿童相比，所有发生 RSV 住院的儿童亚组的首次哮喘住院 HR 更高且相似。风险最高的是 2-3 岁的儿童；高危组为 4.3（95%CI 3.8 至 4.9），土著组为 4.0（95%CI 3.3 至 4.8），非土著标准风险组为 3.9（95%CI 3.7 至 4.1）。这种风险持续到 7 岁以上。
这项大型研究证实，在有发生严重 RSV 疾病风险的不同亚组儿童中，2 岁内发生 RSV 疾病后，首次哮喘住院的风险相当增加。
