Department of Medicine, University of California, San Francisco, CA, United States of America.
Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, United States of America.
PLoS One. 2020 May 5;15(5):e0231782. doi: 10.1371/journal.pone.0231782. eCollection 2020.
Severe early-life respiratory illnesses, particularly those caused by respiratory syncytial virus (RSV) and human rhinovirus (HRV), are strongly associated with the development of asthma in children. Puerto Rican children in particular have a strikingly high asthma burden. However, prior studies of the potential associations between early-life respiratory illnesses and asthma in Puerto Rican and other minority populations have been limited.
We sought to determine whether early-life respiratory illness was associated with asthma in Puerto Rican, Mexican American, and African American children.
Using a logistic regression analysis, we examined the association between early-life respiratory illnesses (report of upper respiratory infection (URI), pneumonia, bronchitis, and bronchiolitis/RSV) within the first two years of life and physician-diagnosed asthma after the age of two in a large cohort of Puerto Rican, Mexican American, and African American children.
While early-life respiratory illnesses were associated with greater asthma odds in Puerto Ricans, Mexican Americans, and African Americans, these associations were stronger among Puerto Rican children. Specifically, in Puerto Ricans, the odds was 6.15 (95% CI: 4.21-9.05) if the child reported at least one of the following respiratory illness: URI, pneumonia, bronchitis or bronchiolitis. The odds were also higher in Puerto Ricans when considering these conditions separately.
We observed population-specific associations between early-life respiratory illnesses and asthma, which were especially significant and stronger in Puerto Ricans. Taken together with the known high burden of RSV in Puerto Rico, our results may help explain the high burden of asthma in Puerto Ricans.
严重的婴幼儿期呼吸道疾病,尤其是由呼吸道合胞病毒(RSV)和人类鼻病毒(HRV)引起的疾病,与儿童哮喘的发生密切相关。波多黎各儿童的哮喘负担尤其沉重。然而,此前关于婴幼儿期呼吸道疾病与波多黎各和其他少数族裔人群哮喘之间潜在关联的研究有限。
我们旨在确定婴幼儿期呼吸道疾病是否与波多黎各、墨西哥裔美国人和非裔美国儿童的哮喘有关。
我们使用逻辑回归分析,在一个大型的波多黎各、墨西哥裔美国人和非裔美国儿童队列中,研究了两岁以内发生的上呼吸道感染(URI)、肺炎、支气管炎和细支气管炎/RSV 等早期呼吸道疾病与两岁后医生诊断的哮喘之间的关联。
虽然婴幼儿期呼吸道疾病与波多黎各、墨西哥裔美国人和非裔美国人的哮喘发病几率增加相关,但这种关联在波多黎各儿童中更强。具体而言,在波多黎各儿童中,如果报告至少有一种以下呼吸道疾病,则哮喘的几率为 6.15(95%CI:4.21-9.05):URI、肺炎、支气管炎或细支气管炎。当分别考虑这些情况时,波多黎各儿童的几率也更高。
我们观察到婴幼儿期呼吸道疾病与哮喘之间存在特定人群的关联,在波多黎各人群中尤为显著且更强。考虑到波多黎各 RSV 的高负担,我们的结果可能有助于解释波多黎各哮喘负担高的原因。