Relevance of the first thousand days of life to the development of wheezing in children aged 6-7 years

• Published in: Allergologia et immunopathologia Vol. 48; no. 3; p. 270
• Main Authors: Santos, Karoliny Dos, Traebert, Jefferson, Piovezan, Anna Paula, Silva, Jane da
• Format: Journal Article
• Language: English
• Published: Spain 01.05.2020
• Subjects: Asthma - epidemiology; Brazil - epidemiology; Case-Control Studies; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Medical History Taking; Population Groups; Pregnancy; Pregnancy Complications - epidemiology; Respiratory Sounds; Socioeconomic Factors; Brazil; Epidemiologic factors; Odds ratio; Child development; Child health; Asthma
• ISSN: 1578-1267
• DOI: 10.1016/j.aller.2019.12.007

The first thousand days of life are a critical stage for the development of respiratory and immune systems. Many events in this period may be associated with wheezing in childhood. This study aimed to investigate the association between early life determinants and wheezing in children aged 6-7 years. Population-based case-control study using early-life related questions. We used the International Study of Asthma and Allergies in Childhood questionnaire to assess wheezing symptoms. Multiple logistic regressions were performed according to a hierarchical framework, considering the complex dynamic of wheezing/asthma and potential interaction between different levels of determination. A total of 820 children were included, from which 162 reported wheezing symptoms (19.7%). Multivariable analysis identified socioeconomic conditions (OR 2.08, 95% CI 1.08-4.00), family history of asthma (OR 2.28, 95% CI 1.37-3.75), vaginal discharge that required treatment during pregnancy (OR 1.68, 95% CI 1.00-2.83), neonatal hyperbilirubinemia (OR 2.00, 95% CI 1.17-3.42), anemia and intestinal parasitosis in the first two years (OR 2.28, 95% CI 1.22-4.25; OR 1.72, 95% CI 1.02-2.92, respectively) independently associated to wheezing at 6-7 years. Intended pregnancy was associated with reduced wheezing (OR 0.47, 95% CI 0.28-0.77). Several factors were associated with wheezing in childhood. Considering that intended pregnancy reduced wheezing and other associated exposures are considered modifiable, these findings may guide the planning of strategies to decrease the susceptibility to asthma symptoms in childhood.