Alfonso Julia, Pérez Santiago, Bou Ricardo, Amat Ana, Ruiz Irene, Mora Amparo, Escolano Silvia, Chofre Laura
Pediatric Pneumology and Allergy Unit, La Ribera University Hospital, Alzira, Valencia, Spain.
Division of Neonatology, La Fe University and Polytechnic Hospital, Valencia, Spain.
Allergol Immunopathol (Madr). 2020 May-Jun;48(3):223-231. doi: 10.1016/j.aller.2019.06.003. Epub 2019 Nov 17.
To analyze the incidence of wheezing in the first six years of life; the prevalence of asthma at six years of age; and the associated risk factors, in a population from Valencia, Spain.
A prospective longitudinal study was made of a cohort of 636 newborn infants, with follow-up of the clinical records and the completion of questionnaires up to the age of six years.
The prevalence of asthma at six years of age was 12.8%. Up until that age, 63% of the study population had experienced at least one episode of wheezing, and 35% had suffered recurrent wheezing (three or more episodes). Admission due to wheezing was associated to school asthma. The following risk factors were identified: atopic dermatitis (OR: 2.1; 95%CI: 1.2-3.5), the presence of at least one episode of wheezing in the first year (OR: 1.8; 95%CI: 1.1-2.9), prematurity (OR: 2.5; 95%CI: 1.2-5.1), and a family history of asthma (OR: 2.2; 95%CI: 1.2-4.1).
The prevalence of asthma at six years of age in our population is similar to that described in other longitudinal studies. An important increase is observed in the cumulative incidence of wheezing and of recurrent wheezing up to three years of age, followed by stabilization. The most relevant risk factors for developing asthma at six years were atopic dermatitis, wheezing during the first year, prematurity, and a family history of asthma. Full-term pregnancy and the minimization of respiratory infections at an early age could reduce the prevalence of asthma at six years of age in our population.
分析西班牙巴伦西亚人群6岁前喘息的发病率、6岁时哮喘的患病率及其相关危险因素。
对636名新生儿进行前瞻性纵向研究,随访临床记录并完成至6岁的问卷调查。
6岁时哮喘患病率为12.8%。截至该年龄,63%的研究人群至少经历过一次喘息发作,35%曾反复喘息(三次或更多次发作)。因喘息住院与学龄期哮喘相关。确定了以下危险因素:特应性皮炎(比值比:2.1;95%置信区间:1.2 - 3.5)、第一年至少有一次喘息发作(比值比:1.8;95%置信区间:1.1 - 2.9)、早产(比值比:2.5;95%置信区间:1.2 - 5.1)以及哮喘家族史(比值比:2.2;95%置信区间:1.2 - 4.1)。
我们人群中6岁时哮喘的患病率与其他纵向研究中描述的相似。观察到至3岁时喘息和反复喘息的累积发病率显著增加,随后趋于稳定。6岁时患哮喘最相关的危险因素是特应性皮炎、第一年喘息、早产以及哮喘家族史。足月妊娠和尽早减少呼吸道感染可降低我们人群中6岁时哮喘的患病率。