Aranda Carolina Sanchez, Wandalsen Gustavo Falbo, Bianca Ana Caroline Cavalcanti Dela, Dantas Ellen de Oliveira, Mallol Javier, Solé Dirceu
Universidade Federal de São Paulo, São Paulo, SP, Brasil.
Universidade de Santiago, Santiago, Chile.
Rev Paul Pediatr. 2018 Oct-Dec;36(4):445-450. doi: 10.1590/1984-0462/;2018;36;4;00016.
To assess the prevalence and severity of wheezing in the first year of life of infants, using the standardized protocol of the Estudio Internacional de Sibilancias en Lactantes- phase 3, and compare the values obtained with those found in phase 1, conducted at the same center.
Between 2009 and 2010, parents and guardians of infants answered the written questionnaire of the Estudio Internacional de Sibilancias en Lactantes - phase 3, and its results were compared to those of phase 1, performed between 2005 and 2006. We divided the infants into wheezing and non-wheezing. The wheezing group was stratified according to the frequency of episodes: occasional wheezing - less than three -, and recurrent wheezing - three or more.
Wheezing prevalence was similar in both phases (44.6 versus 46%). Regarding frequency, the prevalence of occasional wheezing increased (19.4 versus 23%; p=0.03) and recurrent wheezing decreased (26.7 versus 21.6%; p=0.005). Also, diagnosis of asthma (7.5 versus 21.8%), use of inhaled corticosteroids (11.7 versus35%), and hospitalization for wheezing (19.7 versus 32.6%) grew significantly in phase 3. This period coincides with the Influenza A (H1N1) pandemic, which could have contributed to this outcome.
Wheezing prevalence in the first year of life remains high. Despite the temporal assessment showing a decrease in the prevalence of recurrent wheezing, a significant increase in its morbidity was identified due to the higher number of hospitalizations. In addition, there were signs of improvement in the wheezing management of infants, reflected by an increase in the diagnosis of asthma and a greater indication of preventive treatments.
采用国际婴幼儿喘息研究-3期的标准化方案,评估婴儿出生后第一年喘息的患病率和严重程度,并将所得结果与在同一中心进行的1期研究结果进行比较。
2009年至2010年期间,婴儿的父母和监护人回答了国际婴幼儿喘息研究-3期的书面问卷,并将其结果与2005年至2006年进行的1期研究结果进行比较。我们将婴儿分为喘息组和非喘息组。喘息组根据发作频率分层:偶尔喘息(少于3次)和反复喘息(3次或更多)。
两个阶段的喘息患病率相似(44.6%对46%)。在发作频率方面,偶尔喘息的患病率增加(19.4%对23%;p=0.03),反复喘息的患病率下降(26.7%对21.6%;p=0.005)。此外,3期哮喘诊断率(7.5%对21.8%)、吸入性糖皮质激素使用率(11.7%对35%)和喘息住院率(19.7%对32.6%)显著上升。这一时期恰逢甲型H1N1流感大流行,这可能是导致这一结果的原因。
婴儿出生后第一年的喘息患病率仍然很高。尽管时间评估显示反复喘息的患病率有所下降,但由于住院人数增加,其发病率显著上升。此外,婴儿喘息管理有改善迹象,表现为哮喘诊断率增加和预防性治疗指征增多。