Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016:50:15.
doi: 10.1590/S1518-8787.2016050005100. Epub 2016 May 3.

Risk factors for recurrent wheezing in infants: a case-control study

[Article in English, Portuguese]
Roberta Barros de Sousa  1 , Décio Medeiros  2 , Emanuel Sarinho  2 , José Ângelo Rizzo  3 , Almerinda Rêgo Silva  2 , Ana Carolina Dela Bianca  2
Affiliations

Risk factors for recurrent wheezing in infants: a case-control study

[Article in English, Portuguese]
Roberta Barros de Sousa et al. Rev Saude Publica. 2016.

Abstract
in English, Portuguese

Objective: To evaluate the association between recurrent wheezing and atopy, the Asthma Predictive Index, exposure to risk factors, and total serum IgE levels as potential factors to predict recurrent wheezing.

Methods: A case-control study with infants aged 6-24 months treated at a specialized outpatient clinic from November 2011 to March 2013. Evaluations included sensitivity to inhalant and food antigens, positive Asthma Predictive Index, and other risk factors for recurrent wheezing (smoking during pregnancy, presence of indoor smoke, viral infections, and total serum IgE levels).

Results: We evaluated 113 children: 65 infants with recurrent wheezing (63.0% male) with a mean age of 14.8 (SD = 5.2) months and 48 healthy infants (44.0% male) with a mean age of 15.2 (SD = 5.1) months. In the multiple analysis model, antigen sensitivity (OR = 12.45; 95%CI 1.28-19.11), positive Asthma Predictive Index (OR = 5.57; 95%CI 2.23-7.96), and exposure to environmental smoke (OR = 2.63; 95%CI 1.09-6.30) remained as risk factors for wheezing. Eosinophilia ≥ 4.0% e total IgE ≥ 100 UI/mL were more prevalent in the wheezing group, but failed to remain in the model. Smoking during pregnancy was identified in a small number of mothers, and secondhand smoke at home was higher in the control group.

Conclusions: Presence of atopy, positive Asthma Predictive Index and exposure to environmental smoke are associated to recurrent wheezing. Identifying these factors enables the adoption of preventive measures, especially for children susceptible to persistent wheezing and future asthma onset.

OBJETIVO: Avaliar a associação entre a sibilância recorrente e atopia, o Índice Preditivo para Asma, exposição a fatores de risco e dosagem de IgE sérica total como possíveis fatores preditores de sibilância recorrente.

MÉTODOS: Estudo caso-controle com crianças de seis a 24 meses de idade atendidas em ambulatório especializado entre novembro de 2011 e março de 2013. Foram avaliados a sensibilização a antígenos inaláveis e alimentares, positividade para o Índice Preditivo para Asma e outros fatores de risco para sibilância recorrente (tabagismo durante a gravidez, presença de fumaça na residência, infecções virais e dosagem de IgE total).

RESULTADOS: Foram avaliadas 113 crianças, sendo 65 lactentes sibilantes recorrentes (63,0% do sexo masculino) com média de idade de 14,8 (DP = 5,2) meses e 48 lactentes saudáveis (44,0% do sexo masculino) com média de idade de 15,2 (DP = 5,1) meses. No modelo de análise múltipla, a sensibilização a antígenos (OR = 12,45; IC95% 1,28–19,11), Índice Preditivo para Asma positivo (OR = 5,57; IC95% 2,23–7,96) e exposição à fumaça ambiental (OR = 2,63; IC95% 1,09–6,30) permaneceram como fatores de risco para sibilância. Eosinofilia ≥ 4,0% e IgE total ≥ 100 UI/mL foram mais prevalentes no grupo sibilante, mas não permaneceram no modelo. O tabagismo na gestação foi identificado em pequeno número de mães e o tabagismo domiciliar foi maior no grupo controle.

CONCLUSÕES: A presença de atopia, a positividade ao Índice Preditivo para Asma e a exposição à fumaça ambiental estão associadas à sibilância recorrente. A identificação desses fatores permite a adoção de medidas preventivas, especialmente nas crianças susceptíveis à persistência de sibilância e ao surgimento de asma no futuro.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: The authors declare no conflict of interest.

References

    1. Alcântara-Neves NM, Britto GSG, Veiga RV, Figueiredo CA, Fiaccone RL, Conceição JS, et al. Effects of helminth co-infections on atopy, asthma and cytokine production in children living in a poor urban area in Latin America. 10.1186/1756-0500-7-817BMC Research Notes. 2014;7(817) - PMC - PubMed
    1. Almqvist C, Li Q, Britton WJ, Kemp AS, Xuan W, Tovey ER, et al. Early predictors for developing allergic disease and asthma: examining separate steps in the ‘allergic march’. 10.1111/j.1365-2222.2007.02796.xClin Exp Allergy. 2007;37(9):1296–1302. - PubMed
    1. Bacharier LB, Boner A, Carlsen KH, Eigenmann PA, Frischer T, Gotz M, et al. Diagnosis and treatment of asthma in childhood: a PRACTALL consensus report. 10.1111/j.1398-9995.2007.01586.xAllergy. 2008;63(1):5–34. - PubMed
    1. Bacharier LB. Evaluation of the child with recurrent wheezing. 10.1016/j.jaci.2011.07.034J Allergy Clin Immunol. 2011;128(3):690e1–690e5. - PubMed
    1. Bousquet J, Heinzerling L, Bachert C, Papadopoulos NG, Bousquet PJ, Burney PG, et al. Practical guide to skin prick tests in allergy to aeroallergens. 10.1111/j.1398-9995.2011.02728.xAllergy. 2012;67:18–24. - PubMed