Recurrent wheezing in preterm infants: Prevalence and risk factors

Simões, Maria Cristina Ribeiro dos Santos; Inoue, Yuri; Matsunaga, Natasha Yumi; Carvalho, Maria R.V.; Ribeiro, Gisleine L.T.; Morais, Eliane O.; Ribeiro, Miguel; Morcillo, André Moreno; Ribeiro, José Dirceu; Toro, Adyléia Aparecida Dalbo Contrera

doi:10.1016/j.jped.2018.06.007

Cited by 12 publications

(18 citation statements)

References 27 publications

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“…Besides, individuals who had three or more wheezing episodes within 6 months were considered to be wheezing. The clinical presentation of viral infection was characterized by watery nasal secretion, moderate cough, low hyperthermia, and wheezing [ 19 ].…”

Section: Methodsmentioning

confidence: 99%

Identification and seasonality of rhinovirus and respiratory syncytial virus in asthmatic children in tropical climate

Lopes¹,

Amorim²,

Melo

et al. 2020

Bioscience Reports

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Introduction: Asthma is a disease that has been associated with the presence of different genetic and socioenvironmental factors. Objective: To identify and evaluate the seasonality of respiratory syncytial virus (RSV) and human rhinovirus (RV) in asthmatic children and adolescents in tropical climate, as well as to assess the socio-economic and environmental factors involved. Methods: The study was conducted in a referral hospital, where a total of 151 children were recruited with a respiratory infection. The ISAAC protocol and a questionnaire were applied, and a skin prick test was performed. The nasal swab was collected to detect RV and RSV through molecular assay. INMET database was the source of climatic information. Results: The of socio-environmental characterization of asthmatic children showed that the family history of allergy, disturbed sleep at night, dry cough, allergic rhinitis, individuals sensitized to at least one mite. We identified RV in 75% of children with asthma and 66.7% of RSV in children with asthma. There was an association between the presence of RV and the dry season whereas the presence of the RSV was associated with the rainy season. Contributing to these results, a negative correlation was observed between the RSV and the wind speed and the maximum temperature and a positive correlation with precipitation. Conclusions: The results suggest a high prevalence of RV and RSV in asthmatic children and the seasonality of these viruses were present in different climatic periods. This has significant implications for understanding short- and long-term clinical complications in asthmatic patients.

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Section: Methodsmentioning

confidence: 99%

Identification and seasonality of rhinovirus and respiratory syncytial virus in asthmatic children in tropical climate

Lopes¹,

Amorim²,

Melo

et al. 2020

Bioscience Reports

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“…The pathophysiology of asthma in children born preterm may be different from that of full-term children. Lower gestational age (GA), lower birth body weight (BBW), and greater infant weight gain are presumed risk factors for asthma/wheezing in preterm births [ 8 , 9 ]. Preexisting genetic and environmental factors such as maternal infection, multiple pregnancy, tobacco use resulting in premature delivery, and immature lung development and immune system with susceptibility to recurrent pulmonary infections, as well as postnatal lung injuries from barotrauma of the ventilator and oxygen toxicity, all may contribute to impaired lung function in preterm infants [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Early Life Factors Associated with Preschool Wheezing in Preterm Infants

Hsu

Huang

et al. 2021

Children

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Advanced neonatal care has increased the survival of neonates born prematurely, and prematurity is a well-known risk factor for asthma/wheezing disorders. Thus, this prospective study aimed to determine the early life factors associated with preschool wheezing in premature neonates. Preterm neonates born between 2012 and 2017 were recruited, excluding those with bacterial infection within 7 days of life, maternal sepsis, and maternal chorioamnionitis. Birth and admission history, comorbidities, and maternal history were documented. Respiratory problems were followed-up at the neonatal outpatient department. Patients were divided into wheezing and non-wheezing groups. Data were analyzed using the Mann–Whitney test and Fisher’s exact test, and multivariable logistic regression was used to define the risk factors of preschool wheezing/asthma. A total of 125 preterm infants were enrolled, including 19 in the wheezing group and 106 in the non-wheezing group. Patients in the wheezing group had longer duration of intubation (p = 0.025), higher rates for exclusive breast milk feeding (p = 0.012), and higher re-hospitalization rates for respiratory tract infections (p < 0.001), especially for respiratory syncytial virus (RSV) bronchiolitis (p = 0.045). The incidence of allergic rhinitis was also higher in the wheezing group (p = 0.005). After multivariable logistic regression, allergic rhinitis and re-hospitalization for respiratory tract infections were two significant risk factors for preschool wheezing/asthma in premature neonates. Close follow-up of premature infants at high risk for asthma susceptibility is recommended.

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“…In our primary model of RSV immunoprophylaxis studies, the mean effect estimate was positive (OR + 1·21), indicating that those not receiving immunoprophylaxis (with presumably greater risk of RSV-LRTI) tended to have higher odds of subsequent wheezing illness, but the 95% CI (0·73–1·99) included the null ( figure 4 ). The mean effect size was slightly larger but remained non-statistically significant when removing two studies 39 , 40 that did not adjust for confounders (OR + 1·38, 95% CI 0·85–2·24). Owing to the small sample size (eight estimates), there was considerable uncertainty around the mean estimate among the two RCTs and no evidence of increased odds of wheezing illness among children who did not receive RSV immunoprophylaxis (OR + 1·24, 0·04–36·27).…”

Section: Resultsmentioning

confidence: 90%

Assessing the strength of evidence for a causal effect of respiratory syncytial virus lower respiratory tract infections on subsequent wheezing illness: a systematic review and meta-analysis

Brunwasser

Snyder

Driscoll

et al. 2020

The Lancet Respiratory Medicine

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Summary Background Although a positive association has been established, it is unclear whether lower respiratory tract infections (LRTIs) with respiratory syncytial virus (RSV) cause chronic wheezing illnesses. If RSV-LRTI were causal, we would expect RSV-LRTI prevention to reduce the incidence of chronic wheezing illnesses in addition to reducing acute disease. We aimed to evaluate the strength of evidence for a causal effect of RSV-LRTI on subsequent chronic wheezing illness to inform public health expectations for RSV vaccines. Methods We did a systematic review and meta-analysis of observational studies evaluating the association between RSV-LRTI and subsequent wheezing illness (exposure studies) and studies evaluating the association between RSV immunoprophylaxis and subsequent wheezing illness (immunoprophylaxis studies). Exposure studies were included if the exposure group members had an LRTI with laboratory-confirmed RSV and if the exposure ascertainment period began before 2 years of age and ended before 5 years of age. We required a wash-out period of more than 30 days between the index RSV-LRTI and the outcome measurement to allow for resolution of the acute illness. Comparisons between RSV-LRTI and non-RSV-LRTI were not included. Immunoprophylaxis studies were included if they measured the association with subsequent wheezing illness relative to a control group, either in a randomised controlled trial (RCT) or an observational design. For the immunoprophylaxis drugs in question, we required evidence of efficacy in targeting RSV-LRTI from at least one RCT to ensure biological plausibility. All variations of wheezing illness were combined into a single outcome that refers broadly to asthma or any other respiratory illness with wheezing symptoms. Ovid MEDLINE and Embase databases were searched from inception up to Aug 28, 2018. We evaluated whether data from exposure studies could provide evidence against the most viable non-causal theory that RSV-LRTI is a marker of respiratory illness susceptibility rather than a causal factor. Additionally, we tested whether RSV immunoprophylaxis reduces the odds of subsequent wheezing illnesses. We used a random-effects modelling framework and, to accommodate studies providing multiple correlated estimates, robust variance estimation meta-regressions. Meta-regression coefficients ( b ) quantify differences between exposure and comparator groups on the log e odds ratio (log e OR) scale. Findings From 14 235 records we identified 57 eligible articles that described 42 studies and provided 153 effect estimates. 35 studies estimated the direct effect of RSV-LRTI on wheezing illnesses (exposure studies) and eight evaluated the effect of RSV immunoprophylaxis (immunoprophylaxis studies). Exposure studies that adjusted for genetic influences yielded a smaller mean adjusted OR estimate (aOR + ...

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Recurrent wheezing in preterm infants: Prevalence and risk factors

Cited by 12 publications

References 27 publications

Identification and seasonality of rhinovirus and respiratory syncytial virus in asthmatic children in tropical climate

Identification and seasonality of rhinovirus and respiratory syncytial virus in asthmatic children in tropical climate

Early Life Factors Associated with Preschool Wheezing in Preterm Infants

Assessing the strength of evidence for a causal effect of respiratory syncytial virus lower respiratory tract infections on subsequent wheezing illness: a systematic review and meta-analysis

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