Prevalence and associated factors of wheeze in early infancy

Abstract

Background The aim of this study was to assess the prevalence of wheeze in early childhood and to characterize associated factors for wheeze that could identify potentially feasible interventions for the future prevention of wheeze. Methods We performed a cross‐sectional analysis of the data from the International Study of Asthma and Allergies in Childhood (ISAAC)‐modified self‐administered questionnaire of parents of 4‐month‐old infants at well‐child visits (mandatory health check‐ups) in Nagoya City, Japan, between April 2016 and March 2017 (development dataset) and between April 2017 and March 2018 (validation dataset). We used a multivariable, multilevel analysis to identify significant (P < 0.05), associated factors (Bonferroni correction was applied as necessary) after adjustment for local outbreaks of virus‐transmitted diseases, access to medical facilities, and socioeconomic status. Results Among the 20 362 questionnaires given to families of infants living in Nagoya City (development dataset), 19 104 questionnaires (93.8%) were analyzed after data cleaning. In all, 1,446 (7.6%) infants experienced wheeze at least once within 4 months of age, 991 (5.2%) visited the clinic/hospital with wheeze, and 244 (1.3%) underwent hospitalization at that time. In the multilevel, multivariable model for hospitalization with wheeze, significant associated factors were male sex (adjusted odds ratio 1.8; 95% confidence interval 1.4–2.3), maternal current smoking (3.3; 2.0–5.5), and having at least one sibling (3.0; 2.2–4.1). These factors were also associated with wheeze and clinic/hospital visit with wheeze, and the results were confirmed in the validation dataset. Conclusions Our study highlights that smoking cessation among mothers and improved hand hygiene at home are two interventions that could potentially decrease wheeze in early infancy.

Clinical risk factors at 3 months of age for the development of bronchial asthma at 36 months of age

“…It is therefore important to identify 3‐month‐old infants at high risk of developing bronchial asthma to assist in the provision of appropriate health‐care guidance. In a study conducted in Nagoya city, 10 we used a self‐administered questionnaire to determine that having at least one sibling, current maternal smoking, and male sex were all associated with severe wheezing requiring hospital administration in infants less than 3 months of age. Our findings might have value insofar as informing health guidance provided to pregnant women.…”