Premium
Influence of host and environmental factors on wheezing severity in infants: findings from the PARIS birth cohort
Author(s) -
Herr M.,
Just J.,
Nikasinovic L.,
Foucault C.,
Marec A.M.,
Giordanella J.P.,
Momas J. I.
Publication year - 2012
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/j.1365-2222.2011.03933.x
Subject(s) - wheeze , medicine , atopy , asthma , pediatrics , cohort , respiratory sounds , cohort study , risk factor
Summary Background Determinants of wheezing severity are poorly documented in infants. Objectives To study the determinants of wheezing severity in infants aged 18 months followed‐up in the PARIS (« Pollution and Asthma Risk : an Infant Study ») birth cohort. Methods Data on wheezing disorders, medical visits and medications, as well as biological markers of atopy, were collected during a medical examination at age 18 months. Severe wheeze was defined as wheeze that required inhaled corticosteroid and/or hospital‐based care. Environmental exposures were assessed prospectively with regular questionnaires. Risk factors for wheeze in the first 18 months of life were assessed by multivariate regression models. Results Participation in the medical examination concerned 48.2% of the original cohort. Prevalence of wheeze was 560/1879 (35.7%) and was influenced by male gender, parental history of asthma, siblings, daycare attendance, heavy parental smoking at home, and carpet covered floor in the child's bedroom. Being overweight increased the risk of wheeze by 62% ( OR = 1.62, 95% CI 1.13–2.32). In addition, trends towards an increased risk of wheeze were found in infants exposed to daily use of cleaning sprays and to renovation activities. Conversely, the presence of a cat reduced the risk of wheeze ( OR = 0.65, 95% CI 0.47–0.89), without any evidence of healthy‐pet keeping effect. Severe wheeze concerned 286 of the wheezers (42.7%). The prevalence of severe wheeze was related to atopy, and risk of severe wheeze was in particular increased in infants having eosinophilia ( OR = 1.76, 95% CI 1.21–2.55) or being sensitized to ≥ 2 allergens ( OR = 1.88, 95% CI 1.13–3.14). Conclusions and Clinical Relevance Whilst risk factors for wheeze before 18 months of age are factors related to infections, indoor air pollution, and being overweight, the severity of wheeze is mainly due to the atopic status of the child. We suggest that atopy should be further considered in the assessment of wheezing severity in infants.