. 2017 Nov 8;7(11):e017936.

doi: 10.1136/bmjopen-2017-017936.

Association between respiratory syncytial viral disease and the subsequent risk of the first episode of severe asthma in different subgroups of high-risk Australian children: a whole-of-population-based cohort study

Nusrat Homaira^{1

2}, Nancy Briggs³, Christopher Pardy³, Mark Hanly⁴, Ju-Lee Oei^{1

5}, Lisa Hilder^{1

4}, Barbara Bajuk⁶, Kei Lui^{1

5}, William Rawlinson^{7

8

9}, Tom Snelling^{10

11

12}, Adam Jaffe^{1

2}

Affiliations

¹ Department of Paediatrics, Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
² Respiratory Department, Sydney Children's Hospital, Sydney, Australia.
³ Stats Central, Mark Wainwright Analytical Centre, University of New South Wales, Sydney, New South Wales, Australia.
⁴ Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia.
⁵ Department of Newborn Care, Royal Hospital for Women, Sydney, Australia.
⁶ NSW Pregnancy and Newborn Services Network, Sydney Children's Hospitals Network, Randwick, New South Wales, Australia.
⁷ Serology and Virology Division, SEALS Microbiology, Prince of Wales Hospital, Randwick, New South Wales, Australia.
⁸ School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia.
⁹ School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia.
¹⁰ Princess Margaret Hospital for Children, Perth, Australia.
¹¹ Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Australia.
¹² Menzies School of Health Research, Charles Darwin University, Darwin, Australia.

PMID: 29122797
PMCID: PMC5695308
DOI: 10.1136/bmjopen-2017-017936

Association between respiratory syncytial viral disease and the subsequent risk of the first episode of severe asthma in different subgroups of high-risk Australian children: a whole-of-population-based cohort study

Nusrat Homaira et al. BMJ Open. 2017.

. 2017 Nov 8;7(11):e017936.

doi: 10.1136/bmjopen-2017-017936.

Authors

Affiliations

¹ Department of Paediatrics, Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
² Respiratory Department, Sydney Children's Hospital, Sydney, Australia.
³ Stats Central, Mark Wainwright Analytical Centre, University of New South Wales, Sydney, New South Wales, Australia.
⁴ Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia.
⁵ Department of Newborn Care, Royal Hospital for Women, Sydney, Australia.
⁶ NSW Pregnancy and Newborn Services Network, Sydney Children's Hospitals Network, Randwick, New South Wales, Australia.
⁷ Serology and Virology Division, SEALS Microbiology, Prince of Wales Hospital, Randwick, New South Wales, Australia.
⁸ School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia.
⁹ School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia.
¹⁰ Princess Margaret Hospital for Children, Perth, Australia.
¹¹ Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Australia.
¹² Menzies School of Health Research, Charles Darwin University, Darwin, Australia.

PMID: 29122797
PMCID: PMC5695308
DOI: 10.1136/bmjopen-2017-017936

Abstract

Objective: To determine the contribution of respiratory syncytial virus (RSV) to the subsequent development of severe asthma in different subgroups of children at risk of severe RSV disease.

Settings: The study was conducted in New South Wales (NSW), Australia.

Participants: The study comprised all children born in NSW between 2000 and 2010 with complete follow-up till 31 December 2011. The cohort was divided into three subgroups: (1) non-Indigenous high-risk children: non-Indigenous children born preterm or born with a low birth weight; (2) Indigenous children: children of mothers whose Indigenous status was recorded as Aboriginal and/or Torres Strait Islander and (3) non-Indigenous standard risk children: all other non-Indigenous term children.

Primary outcome measure: Risk of development of severe asthma in different subgroups of children who had RSV hospitalisation in the first 2 years of life compared with those who did not.

Design: We performed a retrospective cohort analysis using population-based linked administrative data. Extended Cox model was used to determine HR and 95% CI around the HR for first asthma hospitalisation in different subgroups of children.

Results: The cohort comprised 847 516 children born between 2000 and 2010. In the adjusted Cox model, the HR of first asthma hospitalisation was higher and comparable across all subgroups of children who had RSV hospitalisation compared with those who did not. The HR (95% CI) was highest in children aged 2-3 years; 4.3 (95% CI 3.8 to 4.9) for high-risk, 4.0 (95% CI 3.3 to 4.8) for Indigenous and 3.9 (95% CI 3.7 to 4.1) for non-Indigenous standard risk children. This risk persisted beyond 7 years of age.

Conclusion: This large study confirms a comparable increased risk of first asthma hospitalisation following RSV disease in the first 2 years of life across different subgroups children at risk.

Keywords: asthma; community child health; respiratory infections.

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Conflict of interest statement

Competing interests: None declared.

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Association between respiratory syncytial viral disease and the subsequent risk of the first episode of severe asthma in different subgroups of high-risk Australian children: a whole-of-population-based cohort study

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Association between respiratory syncytial viral disease and the subsequent risk of the first episode of severe asthma in different subgroups of high-risk Australian children: a whole-of-population-based cohort study

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