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Vol. 89. Núm. 6.
Páginas 559-566 (Novembro - Dezembro 2013)
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Vol. 89. Núm. 6.
Páginas 559-566 (Novembro - Dezembro 2013)
ARTIGO ORIGINAL
Open Access
Risk factors associated with wheezing in infants
Fatores de risco associados à sibilância em lactentes
Visitas
...
Lillian S.L. Moraesa,
Autor para correspondência
lslm44@gmail.com

Corresponding author.
, Olga A. Takanoa, Javier Mallolb, Dirceu Soléc
a Departamento de Pediatria, Universidade Federal de Mato Grosso, Cuiabá, MT, Brasil
b Hospital CRS El Pino, Universidad de Santiago, Santiago, Chile
c Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
Informação do artigo
Abstract
Objective

to identify possible risk factors associated with wheezing in infants (12-15 months-old) in the state of Mato Grosso, Brazil.

Methods

this was a cross-sectional study performed by applying a standardized written questionnaire from the international study on wheezing in infants (Estudio Internacional de Sibilancia en Lactantes - EISL), phase 3. Parents and/or guardians of infants were interviewed at primary health care clinics or at home from August of 2009 to November of 2010. Factors associated to wheezing were studied using bivariate and multivariate analysis (using the Statistical Package for Social Sciences [SPSS] v.18.0), and expressed as odds ratios (OR) and 95% confidence intervals (95% CI).

Results

the written questionnaire was answered by 1,060 parents and/or guardians. The risk factors for wheezing were: history of asthma in the family [mother (OR = 1.62; 95% CI = 1.07-2.43); father (OR = 1.98; 95% CI = 1.22-3.23); siblings (OR = 2.13; 95% CI = 1.18-3.87)]; history of previous pneumonia (OR = 10.80; 95% CI = 4.52-25.77); having had more than six upper respiratory tract infections (URTIs) (OR = 2.95; 95% CI = 2.11-4.14); having had first URTI before the third month of life (OR = 1.50; 95% CI = 1.04-2.17); living in a moderately polluted area (OR = 1.59; 95% CI = 1.08-2.33); paracetamol use for URTI (OR = 2.13; 95% CI = 1.54-2.95); and antibiotic use for skin infection (OR = 2.29; 95% CI = 1.18-4.46).

Conclusions

the study of risk factors for wheezing in the first year of life is important to help physicians identify young children at high risk of developing asthma and to improve public health prevention strategies in order to reduce the morbidity of wheezing in childhood.

Keywords:
Infant
Wheezing
Asthma
Risk factors
Resumo
Objetivo

: identificar possíveis fatores de risco associados à sibilância em lactentes (12 a 15 meses) no estado de Mato Grosso, Brasil.

Métodos

: estudo transversal, utilizando o questionário escrito padronizado do Estudio Internacional de Sibilancia en Lactantes (EISL) – fase 3. Pais e/ou responsáveis pela criança foram entrevistados em Unidades Básicas de Saúde quando as procuravam para imunização de rotina ou durante visitas nos domicílios de crianças matriculadas nos pro- gramas de saúde da família, no período de agosto de 2009 a novembro de 2010. Fatores associados à sibilância foram avaliados utilizando análise bivariada e multivariada e expressos como odds ratio (OR) e intervalo de confiança 95% (IC95%).

Resultados

: ao todo, um mil e sessenta (n = 1.060) pais e/ou responsáveis responderam o questionário escrito. Os fatores de risco para sibilância foram: história familiar de asma [mãe (OR = 1,62; IC95%= 1,07-2,43); pai (OR = 1,98; IC95% = 1,22-3,23); irmãos (OR = 2,13; IC95% = 1,18-3,87)]; história prévia de pneumonia (OR = 10,8; IC 95% = 4,52-25,77); ter mais de seis infecções de vias aéreas superiores (IVAS) (OR = 2,95; IC95% = 2,11-4,14) e a primeira IVAS antes dos três meses de idade (OR = 1,50; IC95% = 1,04-2,17); residir em local com moderada poluição (OR = 1,59; IC95% = 1,08-2,33); uso de paracetamol por IVAS (OR = 2,13; IC95% = 1,54-2,95); e uso de antibiótico por infecção na pele (OR = 2,29; IC 95% = 1,18-4,46).

Conclusões

: o estudo dos fatores de risco para sibilância no primeiro ano de vida é importante para auxiliar na identificação, entre os lactentes sibilantes, aqueles de alto risco para desenvolver asma, e para o desenvolvimento de estratégias de prevenção por políticas pública de saúde visando minimizar a morbidade da sibilância na infância.

Palavras-chave:
Lactente
Sibilos
Asma
Fatores de risco
O texto completo está disponível em PDF
Referências
[1]
L. Garcia-Marcos, J. Mallol, D. Solé, P.L. Brand.
EISL group International study of wheezing in infants: risk factors in affluent and non-affluent countries during the first year of life.
Pediatr Allergy Immunol., 21 (2010), pp. 878-888
[2]
F.D. Martinez, A.L. Wright, L.M. Taussig, C.J. Holberg, M. Halonen, W.J. Morgan.
Asthma and wheezing in the first six years of life.
N Engl J Med., 332 (1995), pp. 133-138
[3]
L.B. Bacharier, T.W. Guilbert.
Diagnosis and management of early asthma in preschool-aged children.
J Allergy Clin Immunol., 130 (2012), pp. 287-296
[4]
T.W. Guilbert, W.J. Morgan, R.S. Zeiger, L.B. Bacharier, S.J. Boehmer, M. Krawiec, et al.
Atopic characteristics of children with recurrent wheezing at high risk for the development of childhood asthma.
J Allergy Clin Immunol., 114 (2004), pp. 1282-1287
[5]
A. Muiño, A.M. Menezes, F.F. Reichert, R.P. Duquia, M. Chatkin.
Padrões de sibilância respiratória do nascimento até o início da adolescência: coorte de Pelotas (RS) Brasil, 1993-2004.
J Bras Pneumol., 34 (2008), pp. 347-355
[6]
M. Herr, J. Just, L. Nikasinovic, C. Foucault, A.M. Le Marec, J.P. Giordanella, et al.
Risk factors and characteristics of respiratory and allergic phenotypes in early childhood.
J Allergy Clin Immunol., 130 (2012), pp. 389-396
[7]
H. Burke, J. Leonardi-Bee, A. Hashim, H. Pine-Abata, Y. Chen, D.G. Cook, et al.
Prenatal and passive smoke exposure and incidence of asthma and wheeze: systematic review and meta-analysis.
Pediatrics., 129 (2012), pp. 735-744
[8]
M.M. Kusel, N.H. de Klerk, T. Kebadze, V. Vohma, P.G. Holt, S.L. Johnston, et al.
Early-life respiratory viral infections, atopic sensitization, and risk of subsequent development of persistent asthma.
J Allergy Clin Immunol., 119 (2007), pp. 1105-1110
[9]
D.J. Jackson, R.E. Gangnon, M.D. Evans, K.A. Roberg, E.L. Anderson, T.E. Pappas, et al.
Wheezing rhinovirus illnesses in early life predict asthma development in high-risk children.
Am J Respir Crit Care Med., 178 (2008), pp. 667-672
[10]
D. Caudri, A. Wijga, S. Scholtens, M. Kerkhof, J. Gerritsen, J.M. Ruskamp, et al.
Early daycare is associated with an increase in airway symptoms in early childhood but is no protection against asthma or atopy at 8 years.
Am J Respir Crit Care Med., 180 (2009), pp. 491-498
[11]
F. Rusconi, L. Gagliard, C. Galassi, F. Forastiere, L. Brunetti, S. La Gruta, et al.
Paracetamol and antibiotics in childhood and subsequent development of wheezing/asthma: association or causation?.
Int J Epidemiol., 40 (2011), pp. 662-667
[12]
K.R. Risnes, K. Belanger, W. Murk, M.B. Bracken.
Antibiotic exposure by 6 months and asthma and allergy at 6 years: findings in a cohort of 1,401 US children.
Am J Epidemiol., 173 (2011), pp. 310-318
[13]
H.J. Chong Neto, N.A. Rosário.
Sibilância no lactente: epidemiologia, investigação e tratamento.
J Pediatr (Rio J)., 86 (2010), pp. 171-178
[14]
H.J. Chong Neto, N. Rosario, A.C. Dela Bianca, D. Solé, J. Mallol.
Validation of a questionnaire for epidemiologic studies of wheezing in infants.
Pediatr Allergy Immunol., 18 (2007), pp. 86-87
[15]
M.I. Asher, U. Keil, H.R. Anderson, R. Beasley, J. Crane, F. Martinez, et al.
International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods.
Eur Respir J., 8 (1995), pp. 483-491
[16]
H.J. Chong Neto, N.A. Rosário, E.I.S.L. Grupo.
Curitiba (Estudio Internacional de Sibilancias en Lactantes) Risk factors for wheezing in the first year of life.
J Pediatr (Rio J)., 84 (2008), pp. 495-502
[17]
J.A. Lima, G.B. Fisher, E.E. Sarria, R. Matiello, D. Solé.
Prevalência e fatores de risco para sibilância no primeiro ano de vida.
J Bras Pneumol., 36 (2010), pp. 525-531
[18]
D. Medeiros, A.R. Silva, J.A. Rizzo, E. Sarinho, J. Mallol, D. Solé.
Prevalência de sibilância e fatores de risco associados em crianças no primeiro ano de vida, residentes no município de Recife.
Pernambuco, Brasil. Cad Saude Publica., 27 (2011), pp. 1551-1559
[19]
J.A. Castro-Rodriguez, C.J. Holberg, A.L. Wright, F.D. Martinez.
A clinical index to define risk of asthma in young children with recurrent wheezing.
Am J Respir Crit Care Med., 162 (2000), pp. 1403-1406
[20]
P.G. Holt, P.D. Sly.
Viral infections and atopy in asthma pathogenesis: new rationales for asthma prevention and treatment.
Nat Med., 18 (2012), pp. 726-735
[21]
M. Mommers, C. Thijs, F. Stelma, F. Penders, J. Reimerink, R. van Ree, et al.
Timing of infection and development of wheeze, eczema, and sensitization during the first 2 yr of life: the KOALA Birth Cohort Study.
Pediatr Allergy Immunol., 21 (2010), pp. 983-989
[22]
P.G. Holt, J. Rowe, M. Kusel, F. Parsons, E.M. Hollams, A. Bosco, et al.
Toward improved prediction of risk for atopy and asthma among preschoolers: a prospective cohort study.
J Allergy Clin Immunol., 125 (2010), pp. 653-659
[23]
J. Mallol, R. Andrade, F. Auger, J. Rodriguez, R. Alvarado, L. Figueroa.
Wheezing during the first year of life in infants from low- income population: a descriptive study.
Allergol Immunopathol (Madr)., 33 (2005), pp. 257-263
[24]
A.C. Dela Bianca, G.F. Wandalsen, J. Mallol, D. Solé.
Risk factors for wheezing disorders in infants in the first year of life living in São Paulo.
Brazil. J Trop Pediatr., 58 (2012), pp. 501-504
[25]
J. Pellegrini-Belinchón, G. Miguel-Miguel, B. De Dios-Martin, E. Vicente-Galindo, F. Lorente-Toledano, L. Garcia-Marcos.
Study of wheezing and its risk factors in the first year of life in the Province of Salamanca.
Spain. The EISL Study. Allergol Immunopathol (Madr)., 40 (2012), pp. 164-171
[26]
A. Bueso, M. Figueroa, L. Cousin, W. Hoyos, A.E. Martinez-Torres, J. Mallol, et al.
Poverty-associated risk factors for wheezing in the first year of life in Honduras and El Salvador.
Allergol Immunopathol (Madr)., 38 (2010), pp. 203-212
[27]
E. Nordling, N. Berglind, E. Melen, G. Emenius, J. Hallberg, F. Nyberg, et al.
Traffic-related air pollution and childhood respiratory symptoms, function and allergies.
Epidemiology., 19 (2008), pp. 401-408
[28]
A.J. Lowe, J.B. Carlin, C. Bennet, C.S. Hosking, K.J. Allen, C.F. Robertson, et al.
Paracetamol use in early life and asthma: prospective birth cohort study.
BMJ., 341 (2010), pp. c4616
[29]
E. Bakkeheim, P. Mowinckel, K.H. Carlsen, G. Håland, K.C. Carlsen.
Paracetamol in early infancy: the risk of childhood allergy and asthma.
Acta Paediatr., 100 (2011), pp. 90-96
[30]
M.S. Perzanowski, R.L. Miller, D. Tang, D. Ali, R.S. Garfinkel, G.L. Chew, et al.
Prenatal acetaminophen exposure and risk of wheeze at age 5 years in a urban low-income cohort.
Thorax., 65 (2010), pp. 118-123
[31]
D.P. Strachan.
Hay fever, hygiene, and household size.
BMJ., 299 (1989), pp. 1259-1260
[32]
F. Marra, L. Lynd, M. Coombes, K. Richardson, M. Legal, J.M. FitzGerald, et al.
Does antibiotic exposure during infancy lead to development of asthma?.: A systematic review and metaanalysis.
Chest., 129 (2006), pp. 610-618
[33]
F. Marra, C.A. Marra, K. Richardson, L.D. Lynd, A. Kozyrskyj, D.M. Patrick, et al.
Antibiotic use in children is associated with increased risk of asthma.
Pediatrics., 123 (2009), pp. 1003-1010
[34]
W. Murk, K.R. Risnes, M.B. Bracken.
Prenatal or early-life exposure to antibiotics and risk of childhood asthma: a systematic review.
Pediatrics., 127 (2011), pp. 1125-1138

Como citar este artigo: Moraes LS, Takano OA, Mallol J, Solé D. Risk factors associated with wheezing in infants. J Pediatr (Rio J). 2013:89;559-66.

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