Do Risk Factors for Childhood Infections and Malnutrition Protect Against Asthma? A Study of Brazilian Male Adolescents

Lima, Rosângela da Costa; Victora, César G.; Menezes, Ana Maria B.; Barros, Fernando C.

doi:10.2105/ajph.93.11.1858

Cited by 45 publications

(34 citation statements)

References 39 publications

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“…28,29 As to the occurrence of bronchiolitis in the first year of life, which was identified as risk factor for asthma in this same cohort at four years of life (12), was not associated with the outcome in the current study. Respiratory syncytial virus infection (RSV) has been strongly associated with the occurrence of wheezing and asthma in children.…”

Section: Discussionmentioning

confidence: 56%

Prevalência e fatores de risco para asma em escolares de uma coorte no Sul do Brasil

Chatkin¹,

Menezes²

2005

J. Pediatr. (Rio J.)

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Objective: To study the prevalence and risk factors for asthma in a cohort of 494 children born in 1993 and followed up to the age of 6 years in Pelotas, state of Rio Grande do Sul, Brazil.Methods: A standardized and validated asthma questionnaire, based on the International Study of Asthma and Allergies in Childhood (ISAAC), was applied. Other information was also collected about socioeconomic background, genetic, nutritional, gestational and allergic factors, and previous infectious episodes. Results:The prevalence of asthma found in this study was 12.8% (95%CI: 10-15.9%). In the multivariate analysis, risk factors such as non-white skin color (RR = 1.9 95%CI: 1.1-3.3%), family history of asthma (RR = 2.8 95%CI: 1.5-5.1), allergic rhinitis in children (RR = 2.6 95%CI: 1.5-4.4) and maternal smoking during pregnancy (RR = 1.7 95%CI: 1-2.9) were associated with asthma.

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Section: Discussionmentioning

confidence: 56%

Prevalência e fatores de risco para asma em escolares de uma coorte no Sul do Brasil

Chatkin¹,

Menezes²

2005

J. Pediatr. (Rio J.)

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“…In contrast to our findings, a few prospective studies have reported adverse effects of breast-feeding on later wheeze or asthma risk. 7,8 In another study breast-feeding was related to increased risk of asthma in later childhood only among the subgroup of 99 children of asthmatic mothers, 6 whereas breast-feeding was not related to atopy to aeroallergens. For atopy, in unadjusted analyses we found a very slight increased risk of borderline statistical significance for 6 or more months of breast-feeding.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 However, the protective effect of breast-feeding on asthma in later childhood (age 6 years and above) is less evident, 5 and some recent studies suggest that breast-feeding actually increases the risk of asthma, wheeze, or atopy to aeroallergens at older ages. [6][7][8][9][10][11] In one study breast-feeding was associated with increased risk of asthma only in children with a family history of atopic illness. 6 Recent data suggesting that breast-feeding might enhance the risk of asthma phenotypes conflict with public health guidelines encouraging breast-feeding 1 and have raised concern among pregnant women and their physicians.…”

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confidence: 99%

Prospective study of breast-feeding in relation to wheeze, atopy, and bronchial hyperresponsiveness in the Avon Longitudinal Study of Parents and Children (ALSPAC)

Elliott¹,

Henderson²,

Northstone³

et al. 2008

Journal of Allergy and Clinical Immunology

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“…The fact that adolescents breastfed for longer periods presented a lower prevalence of transient wheezing has preventive implications, although some authors have reported that breastfeeding is a risk factor for late-onset wheezing. (19) Another important preventive measure is smoking reduction or cessation during pregnancy. Although there was no statistical significance, the persistent and late-onset patterns were more common in children whose mothers smoked during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Padrões de sibilância respiratória do nascimento até o início da adolescência: coorte de Pelotas (RS) Brasil, 1993-2004

et al. 2008

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Objective: To study the prevalence of wheezing patterns and their associations with independent variables. Methods: Cohort study of live births in 1993 in Pelotas, Brazil. A systematic subsample (20%) of the original cohort was evaluated at 6 months, 12 months and 4 years. At 10-12 years, 87.5% of the original cohort was contacted. Wheezing was categorized: transient, wheezing at 4 years but not at 10-12; persistent, wheezing at all evaluations; late-onset, wheezing at 10-12 years. Independent variables were analyzed: gender; skin color; family income; smoking/asthma during pregnancy; breastfeeding; respiratory infection/diarrhea (during the 1st year); family members with asthma/ allergy (at 4 years and at 10-12); physician-diagnosed rhinitis/eczema (at 10-12 years). Results: The subsample comprised 897 adolescents. Wheezing patterns were expressed as prevalence (95% CI): transient, 43.9% (40.7-47.2); persistent, 6.4% (4.8-8.0); and late-onset, 3.3% (2.2-4.5). The transient pattern was more common in children from low-income families, children breastfed for less time, children with a history of respiratory infections (during the 1st year) and children with asthma in the family (at 4 years). The persistent pattern was almost twice as common in males, in children whose mothers had asthma during pregnancy, in children with respiratory infections (during the 1st year) and in children with asthma in the family (at 4 and 10-12 years). The late-onset pattern was more prevalent among those with asthma in the family (at 10-12 years) and those diagnosed with rhinitis (at 10-12 years), being less prevalent among those reporting respiratory infections (during the 1st year) and those diagnosed with eczema (at 10-12 years). Conclusions: Knowledge of the associations of wheezing patterns allows us to adopt preventive and therapeutic measures.Keywords: Respiratory sounds; Asthma; Epidemiology; Hypersensitivity. ResumoObjetivo: Estudar a prevalência dos padrões de sibilância respiratória e suas associações com variáveis independentes. Métodos: Coorte de nascidos vivos, 1993, Pelotas (RS); subamostra sistemática de 20% da coorte original acompanhada aos 6 e 12 meses e 4 anos; aos 10-12 anos localizou-se 87,5% da coorte original. Definição dos padrões: transitório: chiado até 4 anos e ausência de chiado aos 10-12 anos; persistente: chiado em todos acompanhamentos; início tardio: chiado aos 10-12 anos. Variáveis independentes: gênero; cor da pele; renda familiar; fumo/asma na gravidez; amamentação; infecção respiratória/diarréia (1º ano); alergia e asma na família (4 e 10-12 anos); diagnóstico médico de rinite/eczema (10-12 anos). Resultados: O total da subamostra foi de 897 adolescentes. Prevalência (IC95%) dos padrões de sibilância: transitório 43,9% (40,7-47,2);persistente 6,4% (4,8-8,0); de início tardio 3,3% (2,2-4,5). O transitório foi mais freqüente em crianças de famílias de baixa renda, com menor duração da amamentação, relato de infecções respiratórias (1º ano) e história familiar de asma (4 anos); o persistente f...

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Do Risk Factors for Childhood Infections and Malnutrition Protect Against Asthma? A Study of Brazilian Male Adolescents

Cited by 45 publications

References 39 publications

Prevalência e fatores de risco para asma em escolares de uma coorte no Sul do Brasil

Prevalência e fatores de risco para asma em escolares de uma coorte no Sul do Brasil

Prospective study of breast-feeding in relation to wheeze, atopy, and bronchial hyperresponsiveness in the Avon Longitudinal Study of Parents and Children (ALSPAC)

Padrões de sibilância respiratória do nascimento até o início da adolescência: coorte de Pelotas (RS) Brasil, 1993-2004

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