Preconception exposure to over-the-counter medications and antibiotics and the risk of childhood asthma in Lebanon: A cross-sectional study

Malaeb, Diana; Hallit, Souheil; Sacre, Hala; Clara, Rahme; Malaeb, Bassem; Hallit, Rabih; Salameh, Pascale

doi:10.15586/aei.v49i2.46

Cited by 6 publications

(10 citation statements)

References 52 publications

(70 reference statements)

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“…This inadequate control of the illness is associated with disease progression and poor QoL (19). In Lebanon, several studies were conducted on asthmatic patients that tackled the preschool asthma risk factor scale, evaluated association between different factors and both wheezing and asthma development, assessed asthma control, and evaluated the influence of diet and obesity on asthma (20)(21)(22)(23)(24)(25). However, data on patients' QoL is still scarce, particularly among adults (26).…”

Section: Introductionmentioning

confidence: 99%

An Assessment of Quality of Life in Patients With Asthma Through Physical, Emotional, Social, and Occupational Aspects. A Cross-Sectional Study

Kharaba

Feghali

Husseini

et al. 2022

Front. Public Health

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BackgroundAsthma is a prevalent hyperactive airway disease with physical and emotional impact. Severe asthma is associated with considerable health-related quality of life (HRQoL). The aim of this study is to assess the quality of life through physical, emotional, social and occupational aspects and evaluate the factors affecting HRQoL in patients with asthma.MethodsThis is a cross-sectional multicenter study conducted on adult asthmatic patients enrolled from community pharmacies across different Lebanese geographic areas.ResultsHaving wheezing sometimes and most of the time (Beta = −0.144 and −0.552), experiencing anxiety sometimes and most of the time (Beta = −0.205 and −0.573), encountering sleep problems sometimes and most of the time (Beta = −0.270 and −0.553), having previous chest discomfort sometimes and most of the time (Beta = −0.421 and −0.713), and having depression most of the times (Beta = −0.415) were associated with higher lower quality of life scores. On the other side, holding a secondary level of education was associated with a higher quality of life score (Beta = 0.192).ConclusionThis study highlights that asthma affects adults' quality of life through social, emotional, physical, and occupational impacts. Improved follow-up and patient education may be essential in the future to stop disease progression and achieve ideal therapeutic outcomes.

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Section: Introductionmentioning

confidence: 99%

An Assessment of Quality of Life in Patients With Asthma Through Physical, Emotional, Social, and Occupational Aspects. A Cross-Sectional Study

Kharaba

Feghali

Husseini

et al. 2022

Front. Public Health

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“…The data from the remaining 3 studies is presented in Table 3. For prenatal exposure, the ORs from the study by Malaeb et al 54 was 4.66 (1.92–11.30). Piler et al 55 found no association with prenatal and combined exposures while a mild association was seen with infant exposure on the outcome of pediatrician diagnosed asthma at 11 years of age.…”

Section: Resultsmentioning

confidence: 93%

Paracetamol exposure and asthma: What does the evidence say? An overview of systematic reviews

Singh

Varukolu²,

Chauhan

et al. 2021

Pediatric Pulmonology

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Objective To conduct an umbrella review collating the existing evidence to determine whether there is an association between exposure of Paracetamol in‐utero or in infancy and the development of childhood Asthma. Methods In this review, systematic reviews with or without meta‐analysis that reported the association between paracetamol and asthma in children were included. To identify relevant reviews, a search was performed in the electronic databases PubMed, the Cochrane Library, and Ovid MEDLINE. The protocol was registered in PROSPERO CRD42020156023. A separate search was conducted for primary studies from the last 5 years not yet included in systematic reviews reporting the association from January 2016 to March 2021. Results The electronic searches identified 1966 review titles. After the removal of 493 duplicates, 1475 titles and abstracts were screened against the eligibility criteria. Full‐text screening yielded six systematic reviews to be included in this review. The search for primary studies in the last 5 years yielded 1214 hits, out of which 5 studies were found suitable for inclusion. Three of them, that were not included in the systematic reviews, and have been summarised in this paper. The odds ratios (ORs) for the outcome of asthma in offspring of mothers with prenatal paracetamol consumption in any trimester were 1.28 (1.13–1.39) and 1.21 (1.02–1.44). For first trimester exposures, they were 1.12 (0.99–1.27), 1.39 (1.01–1.91), and 1.21 (1.14–1.28), for the second or third trimester, they were 1.49 (1.37–1.63) and 1.13 (1.04–1.23). For the third trimester only, the figure was 1.17 (1.04–1.31). Of the six reviews included, 1 had a low risk of bias, 2 had an unclear risk while 3 had a high risk of bias assessed using the ROBIS tool. There was no significant increased risk of asthma with early infancy exposure. The inter‐study heterogeneity varied from I2 = 41% to I2 = 76% across reviews. In the primary studies, the OR for prenatal exposure ranged from 1.12 (0.25–4.98) to 4.66 (1.92–11.3) and for infancy exposure was 1.56 (1.06–2.30). All three included primary studies were adjudged to be of high quality using the Newcastle Ottawa scale. Conclusions There is a modest association between paracetamol exposure in‐utero and the future development of asthma. Exposure in infancy has a less consistant association. All the studies done thus far are observational in nature, with their inherent biases. Further research, preferably randomized controlled trials are recommended to answer this pertinent question.

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“…Our results are consistent with those of a study showing that asthma is associated with exposure to the respiratory syncytial virus during infancy. 37 Studies have also shown that viral infections of the lower respiratory tract alter the development of the respiratory/ immune system, increasing the likelihood of developing asthma, specifically in predisposed children. 49,50 As for the hygiene hypothesis, to the best of our knowledge, this study is the first to use a validated scale to assess the association between the hygiene hypothesis theory and asthma in preschool children.…”

Section: Discussionmentioning

confidence: 99%

“…The third section included questions related to factors generally associated with asthma, namely parental asthma 36 ; prenatal exposure to medications (antibiotics, paracetamol) 36,37 ; alcohol use 38 and smoking 39,40 during pregnancy; preterm delivery 41 ; passive smoking and environmental exposure to toxicants 39,40 ; number of older siblings; medication or alcohol intake during breastfeeding; reflux; atopy; exposure to pesticides (occupational, regional, local, and domestic) 39,40 ; and the use of cleaning products at home. 42 The exposure to pesticides was recorded using the following questions: ''Have you ever used pesticides in your work?…”

Section: Hygiene Measures and Asthmamentioning

confidence: 99%

Hygiene hypothesis: association between hygiene and asthma among preschool children in Lebanon

Hallit

Sacre²,

Kheir³

et al. 2021

aei

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Objectives: To validate a scale to assess the hygiene hypothesis and the association between hygiene and asthma among Lebanese preschool children aged 3–5 years. Methods: This cross-sectional study, conducted between November 2018 and March 2019, enrolled 515 preschool children. Asthma and potential risk factors, including hygiene, were assessed using a standardized questionnaire. A specific hygiene hypothesis scale has been gen-erated and validated for this purpose. Results: The hygiene hypothesis scale items converged over a solution of nine factors that had an Eigenvalue over 1, explaining a total of 65.86% of the variance. An acceptable Cronbach’s alpha value was recorded for the hygiene hypothesis scale (0.696). Variables correlated with higher odds of asthma were male gender (ORa = 0.41 for females), living near a prairie sprayed with pesticides (ORa = 3.09), having a heating system in the bedroom compared to the sitting room (ORa = 9.97), attending kindergarten (ORa = 2.80), having a mother who smokes water-pipe compared to not smoking (ORa = 3.34), having a mother with a history of asthma (ORa = 5.50), and having respiratory infections (ORa = 14.72). However, the hygiene hypothesis score was not associated with higher odds of asthma (p = 0.881). Conclusions: The current results suggested that neither home cleaning nor personal cleanliness was correlated with asthma in preschool children. Larger prospective studies that measure the intensity and duration of exposure to each toxicant are suggested to better assess the hygiene hypothesis items and their association with asthma.

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Preconception exposure to over-the-counter medications and antibiotics and the risk of childhood asthma in Lebanon: A cross-sectional study

Cited by 6 publications

References 52 publications

An Assessment of Quality of Life in Patients With Asthma Through Physical, Emotional, Social, and Occupational Aspects. A Cross-Sectional Study

An Assessment of Quality of Life in Patients With Asthma Through Physical, Emotional, Social, and Occupational Aspects. A Cross-Sectional Study

Paracetamol exposure and asthma: What does the evidence say? An overview of systematic reviews

Hygiene hypothesis: association between hygiene and asthma among preschool children in Lebanon

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