Hospital admission for symptoms exacerbation in 2,075 infants suffering from recurrent asthma-like symptoms: (EISL-3 South America)

• Mallol, Javier ^[8] ; Solé, Dirceu ^[1] ; Aranda, Carolina ^[1] ; Toledo, Eliana C. ^[9] ; Aguirre, Viviana ^[8] ; Urrutia-Pereira, Marilyn ^[2] ; Szulman, Gabriela A. ^[10] ; Rosario, Nelson ^[3] ; Chong, Herberto ^[3] ; Sanchez-Lacerda, Líllian ^[4] ; Niederbacher, Jurg ^[5] ; Pinchak, Catalina ^[6] ; de Olivera, Patricia Polles ^[7] ; Arruda-Chávez, Erika ^[11] ; García-Marcos, Luis ^[12]
  1. [1] Universidade Federal de São Paulo

     Universidade Federal de São Paulo

     Brasil

     
  2. [2] Universidade Federal do Pampa

     Universidade Federal do Pampa

     Brasil

     
  3. [3] Universidade Federal do Paraná

     Universidade Federal do Paraná

     Brasil

     
  4. [4] Universidade Federal de Mato Grosso

     Universidade Federal de Mato Grosso

     Brasil

     
  5. [5] Universidad Industrial de Santander

     Universidad Industrial de Santander

     Colombia

     
  6. [6] Universidad de la República

     Universidad de la República

     Uruguay

     
  7. [7] Universidade Federal de São Carlos

     Universidade Federal de São Carlos

     Brasil

     
  8. [8] Department of Pediatric Respiratory Medicine, Hospital El Pino, University of Santiago de Chile (USACH), Santiago, Chile.
  9. [9] Departamento de Pediatria e Cirurgia Pediátrica, Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, Brazil.
  10. [10] Hospital de Niños “Ricardo Gutiérrez”, Buenos Aires, Argentina.
  11. [11] Section of Allergy and Clinical Immunology, British American Hospital, Lima, Peru.
  12. [12] Pediatric Respiratory and Allergy Units, “Virgen de la Arrixaca” University Children’s Hospital, University of Murcia, Murcia, Spain; IMIB Research Institute, Murcia, Spain.

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• Localización: Allergologia et immunopathologia: International journal for clinical and investigate allergology and clinical immunology, ISSN-e 1578-1267, ISSN 0301-0546, Vol. 49, Nº. 4, 2021, págs. 47-54
• Idioma: inglés
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• Resumen

  • Background: Contrary to what happens in children and adults, the prevalence and the factors related to hospitalisation for asthma/wheezing in infants with recurrent asthma-like symptoms are poorly known.

    Methods: This study is part of the International Study of Wheezing in infants Phase 3; 2,079 infants (aged 12–18 months) with recurrent asthma-like symptoms, from 11 South American centres, were studied to determine the prevalence and the associated factors for wheezing exacerbation admission. Descriptive statistics and multivariate logistic regression were employed for analysis.

    Results: The prevalence of admission for wheezing was 29.7% (95% CI 27.7–31.6) and was significantly associated to severe wheezing episodes (OR: 3.89; 95% CI: 2.93–5.18, p < 0.001), physician-diagnosed asthma (OR: 1.79; 95% CI: 1.33–2.41, p < 0.0001), use of inhaled corticosteroids (OR: 1.78; 95%CI: 1.38–2.29, p < 0.0001), maternal tobacco smoking during pregnancy (OR: 1.69; 95% CI: 1.19–2.39, p = 0.003) and onset of wheezing in the first trimester of life (OR: 1.30; 95% CI: 1.02–1.66, p = 0.038). Breast feeding ≥4 months (OR: 0.72; 95% CI: 0.54–0.96, p = 0.004), maternal high educational level (>12 years) (OR: 0.66; 95% CI: 0.51–0.85, p = 0.001) and total monthly household income ≥US$ 3,000 (OR: 0.34; 95% CI: 0.18–0.67, p = 0.002), were protective factors.

    Conclusions: Infants with recurrent asthma-like symptoms have a high rate of admissions. Tobacco smoking in pregnancy, viral respiratory illness in the first trimester of life and severe progression were risks for admissions. Improving medical management to prevent severe exacerbations, prolonging the postnatal period at home longer than 3 months, favouring breastfeeding and avoiding smoking during pregnancy may have a preventive role for admissions in infants with recurrent asthma-like symptoms.