Chen Po-Sung, Tsai Yi-Fen, Yu Hong-Ren, Hung Chih-Hsing, Chen Wei-Yu, Lin Ching-Wei, Lee Ju, Chen Chih-An, Tsai Hui-Ju, Wang Jiu-Yao
Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan.
Department of Pediatrics, Tainan Sin-Lau Hospital, Tainan, Taiwan.
Asia Pac Allergy. 2023 Mar;13(1):10-14. doi: 10.5415/apallergy.0000000000000002. Epub 2023 Apr 28.
Bronchiolitis is the most common seasonal viral respiratory disorder in infants. However, risk factors for the development of bronchiolitis, particularly during pregnancy, remain unclear.
A questionnaire was administered to the parents of the hospitalized infants with acute bronchiolitis to obtain information regarding patients' medical, family, and prenatal exposure history. Logistic regression with adjustment was performed to evaluate risk factors associated with bronchiolitis in the infants.
Among the enrolled patients, 55 (36.7%) were diagnosed as having bronchiolitis, and the majority (89%) of the patients had moderate-to-severe bronchiolitis. The bronchiolitis group had lower C-reactive protein levels than did the control group. Fewer patients in the bronchiolitis group developed fever. However, hospital stays were longer in the bronchiolitis group than in the control group. Respiratory syncytial virus was the most detected virus (23/26, 88.6%) in the bronchiolitis group. Male sex (odds ratio [OR], 5.71; 95% confidence interval [CI], 2.02-16.12; < 0.001), antibiotic usage during pregnancy (OR, 27.2; 95% CI, 1.12-660.84; = 0.04), and viral infection (OR, 49.3; 95% CI, 9.01-270.26; < 0.001) during the postnatal period were significantly associated with hospitalization for acute bronchiolitis in the infants. By contrast, pet exposure during the perinatal period was significantly and negatively associated with acute bronchiolitis (OR = 0.21, 95% CI = 0.07-0.69, < 0.01).
Environmental exposures during pregnancy may affect respiratory health in offspring, and effective strategies should be developed to prevent bronchiolitis in early life.
细支气管炎是婴儿最常见的季节性病毒性呼吸道疾病。然而,细支气管炎发生的危险因素,尤其是孕期的危险因素仍不明确。
对住院的急性细支气管炎婴儿的父母进行问卷调查,以获取有关患者的医疗、家庭和产前暴露史的信息。进行调整后的逻辑回归分析,以评估与婴儿细支气管炎相关的危险因素。
在纳入的患者中,55例(36.7%)被诊断为细支气管炎,大多数(89%)患者患有中度至重度细支气管炎。细支气管炎组的C反应蛋白水平低于对照组。细支气管炎组发热的患者较少。然而,细支气管炎组的住院时间比对照组更长。呼吸道合胞病毒是细支气管炎组中检测到最多的病毒(23/26,88.6%)。男性(比值比[OR],5.71;95%置信区间[CI],2.02 - 16.12;P < 0.001)、孕期使用抗生素(OR,27.2;95% CI,1.12 - 660.84;P = 0.04)以及出生后病毒感染(OR,49.3;95% CI,9.01 - 270.26;P < 0.001)与婴儿急性细支气管炎住院显著相关。相比之下,围产期接触宠物与急性细支气管炎显著负相关(OR = 0.21,95% CI = 0.07 - 0.69,P < 0.01)。
孕期的环境暴露可能影响后代的呼吸健康,应制定有效的策略来预防早期生活中的细支气管炎。