Santos Karoliny Dos, Traebert Jefferson, Piovezan Anna Paula, Silva Jane da
Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Av. Pedra Branca, 25, Cidade Universitária Pedra Branca, 88137-270, Palhoça, Santa Catarina, SC, Brazil.
Department of Internal Medicine and Allergy Clinic of Professor Polydoro Ernani de São Thiago University Hospital, Federal University of Santa Catarina (UFSC), Florianopolis, SC, Brazil.
Allergol Immunopathol (Madr). 2020 May-Jun;48(3):270-280. doi: 10.1016/j.aller.2019.12.007. Epub 2020 Apr 10.
The first thousand days of life are a critical stage for the development of respiratory and immune systems. Many events in this period may be associated with wheezing in childhood.
This study aimed to investigate the association between early life determinants and wheezing in children aged 6-7 years.
Population-based case-control study using early-life related questions. We used the International Study of Asthma and Allergies in Childhood questionnaire to assess wheezing symptoms. Multiple logistic regressions were performed according to a hierarchical framework, considering the complex dynamic of wheezing/asthma and potential interaction between different levels of determination.
A total of 820 children were included, from which 162 reported wheezing symptoms (19.7%). Multivariable analysis identified socioeconomic conditions (OR 2.08, 95% CI 1.08-4.00), family history of asthma (OR 2.28, 95% CI 1.37-3.75), vaginal discharge that required treatment during pregnancy (OR 1.68, 95% CI 1.00-2.83), neonatal hyperbilirubinemia (OR 2.00, 95% CI 1.17-3.42), anemia and intestinal parasitosis in the first two years (OR 2.28, 95% CI 1.22-4.25; OR 1.72, 95% CI 1.02-2.92, respectively) independently associated to wheezing at 6-7 years. Intended pregnancy was associated with reduced wheezing (OR 0.47, 95% CI 0.28-0.77).
Several factors were associated with wheezing in childhood. Considering that intended pregnancy reduced wheezing and other associated exposures are considered modifiable, these findings may guide the planning of strategies to decrease the susceptibility to asthma symptoms in childhood.
生命的最初一千天是呼吸系统和免疫系统发育的关键阶段。这一时期的许多事件可能与儿童喘息有关。
本研究旨在调查6至7岁儿童早期生活决定因素与喘息之间的关联。
基于人群的病例对照研究，采用与早期生活相关的问题。我们使用儿童哮喘和过敏国际研究问卷来评估喘息症状。根据分层框架进行多因素逻辑回归分析，考虑喘息/哮喘的复杂动态以及不同决定水平之间的潜在相互作用。
共纳入820名儿童，其中162名报告有喘息症状（19.7%）。多变量分析确定社会经济状况（比值比2.08，95%置信区间1.08 - 4.00）、哮喘家族史（比值比2.28，95%置信区间1.37 - 3.75）、孕期需要治疗的阴道分泌物（比值比1.68，95%置信区间1.00 - 2.83）、新生儿高胆红素血症（比值比2.00，95%置信区间1.17 - 3.42）、头两年的贫血和肠道寄生虫病（分别为比值比2.28，95%置信区间1.22 - 4.25；比值比1.72，95%置信区间1.02 - 2.92）与6至7岁时的喘息独立相关。计划妊娠与喘息减少相关（比值比0.47，95%置信区间0.28 - 0.77）。
若干因素与儿童喘息有关。鉴于计划妊娠可减少喘息，且其他相关暴露因素被认为是可改变的，这些发现可能为制定降低儿童哮喘症状易感性的策略提供指导。
