Risk factors of recurrent wheezing in preschool children

doi:10.3969/j.issn.1674-8115.2022.10.009

Abstract

Abstract:

Objective ·To investigate the potential risk factors of recurrent wheezing in preschool children. Methods ·A case-control study was conducted in 370 children with wheezing admitted to the Department of Respiratory Medicine in a specialized hospital for children in Shanghai from December 2019 to December 2020. The children were preschool children aged 3?6 years. According to the frequency of wheezing, pediatric patients were divided into occasional wheezing group (1?2 attacks per year) and recurrent wheezing group (≥3 attacks per year). The face-to-face questionnaire was performed to the parents responding for basic information and recurrent wheezing risk factors including the children age, gender, gestational age, birth weight, history of eczema, history of allergic rhinitis, history of food allergy, history of inhalational pollen allergy, history of bronchiolitis, maternal age, production mode, feeding pattern, history of parental asthma, resident area (city/village), passive smoking, history of pet contact, seasonal factors, etc. Univariate analysis was used to compare risk factors of recurrent wheezing between the two groups. Logistic regression analysis was used to analyze the independent risk factors associated with recurrent wheezing. Results ·Three hundred and seventy cases were enrolled, including 204 cases (55.14%) in the occasional wheezing group and 166 cases (44.86%) in the recurrent wheezing group. A total of 10 risk factors were determined for recurrent wheezing, which included children's age (χ²=36.608, P=0.000), gender (χ²=4.290, P=0.038), eczema (χ²=6.250, P=0.012), allergic rhinitis (χ²=10.787, P=0.001), inhaling pollen (χ²=8.868, P=0.003), history of bronchiolitis (χ²=27.898, P=0.000), gestational age (χ²=5.141, P=0.023), feeding pattern (χ²=4.316, P=0.038), parental asthma history (χ²=5.050, P=0.025) and resident area (χ²=31.013, P=0.000). The Logistic regression showed that allergic rhinitis (OR=4.759, 95%CI 1.665?13.603), bronchiolitis (OR=12.113, 95%CI 5.686?25.802), premature birth (OR=3.092, 95%CI 1.120?8.539) and living in city (OR=2.395, 95%CI 1.326?4.324) were the independent risk factors of recurrent wheezing. Conclusion ·The independent risk factors for recurrent wheezing in preschoolers include allergic rhinitis, bronchiolitis, premature birth and living in city.

Key words: wheezing, recurrent, risk factor, preschool child

CLC Number:

R725.6

LI Aiqiu, ZHANG Xiaoxiao, JIANG Yunli, XIAO Yanshang, DING Guodong, WU Beirong, DONG Xiaoyan. Risk factors of recurrent wheezing in preschool children[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022, 42(10): 1435-1440.

Figures/Tables 2

TrendMD

References 27

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Factor	State variable	Wheezing <3 times/year （n=204）	Wheezing ≥3 times/year （n=166）	χ² value	P value
Age/month	36‒47	95 （46.6）	52 （31.3）	36.608	0.000
	48‒59	86 （42.1）	51 （30.7）
	60‒72	23 （11.3）	63 （38.0）
Gender	Male	129 （63.2）	122 （73.5）	4.290	0.038
	Female	75 （36.8）	44 （26.5）
Resident area	Living in city	119 （58.3）	141 （84.9）	31.013	0.000
	Living in village	85 （41.7）	25 （15.1）
Production mode	Cesarean	97 （47.5）	75 （45.2）	0.206	0.650
	Eutocia	107 （52.5）	91 （54.8）
Gestational age	Premature delivery	7 （3.4）	15 （9.0）	5.141	0.023
	Term infant	197 （96.6）	151 （91.0）
Feeding pattern	Artificial feeding /mixed feeding	120 （58.8）	115 （69.3）	4.316	0.038
	Breast feeding	84 （41.2）	51 （30.7）
Suffocation	Yes	16 （7.8）	16 （9.6）	0.373	0.541
	No	188 （92.2）	150 （90.4）
Birth weight	Low birth weight	27 （13.2）	25 （15.1）	0.252	0.615
	Normal birth weight	177 （86.8）	141 （84.9）
Maternal age	≥35 years old	11 （5.4）	12 （7.2）	0.530	0.467
	<35 years old	193 （94.6）	154 （92.8）
Parental asthma history	Yes	99 （48.5）	100 （60.2）	5.050	0.025
	No	105 （51.5）	66 （39.8）
Eczema	Yes	140 （68.6）	133 （80.1）	6.250	0.012
	No	64 （31.4）	33 （19.9）
Allergic rhinitis	Yes	111 （54.4）	118 （71.1）	10.787	0.001
	No	93 （45.6）	48 （28.9）
Food allergy	Yes	106 （52.0）	127 （76.5）	3.401	0.065
	No	98 （48.0）	39 （23.5）
Inhaling pollen	Yes	117 （57.4）	120 （72.3）	8.868	0.003
	No	87 （42.6）	46 （27.7）
Bronchiolitis	Yes	60 （29.4）	94 （56.6）	27.898	0.000
	No	144 （70.6）	72 （43.4）
Passive smoking	Yes	110 （53.9）	85 （51.2）	0.271	0.603
	No	94 （46.1）	81 （48.8）
Pet contact	Yes	87 （42.6）	68 （41.0）	0.107	0.744
	No	117 （57.4）	98 （59.0）
Seasonal factor	Winter and spring	110 （53.9）	79 （47.6）	1.468	0.226
	Summer and autumn	94 （46.1）	87 （52.4）

Factor	State variable	Wheezing <3 times/year （n=204）	Wheezing ≥3 times/year （n=166）	χ² value	P value
Age/month	36‒47	95 （46.6）	52 （31.3）	36.608	0.000
	48‒59	86 （42.1）	51 （30.7）
	60‒72	23 （11.3）	63 （38.0）
Gender	Male	129 （63.2）	122 （73.5）	4.290	0.038
	Female	75 （36.8）	44 （26.5）
Resident area	Living in city	119 （58.3）	141 （84.9）	31.013	0.000
	Living in village	85 （41.7）	25 （15.1）
Production mode	Cesarean	97 （47.5）	75 （45.2）	0.206	0.650
	Eutocia	107 （52.5）	91 （54.8）
Gestational age	Premature delivery	7 （3.4）	15 （9.0）	5.141	0.023
	Term infant	197 （96.6）	151 （91.0）
Feeding pattern	Artificial feeding /mixed feeding	120 （58.8）	115 （69.3）	4.316	0.038
	Breast feeding	84 （41.2）	51 （30.7）
Suffocation	Yes	16 （7.8）	16 （9.6）	0.373	0.541
	No	188 （92.2）	150 （90.4）
Birth weight	Low birth weight	27 （13.2）	25 （15.1）	0.252	0.615
	Normal birth weight	177 （86.8）	141 （84.9）
Maternal age	≥35 years old	11 （5.4）	12 （7.2）	0.530	0.467
	<35 years old	193 （94.6）	154 （92.8）
Parental asthma history	Yes	99 （48.5）	100 （60.2）	5.050	0.025
	No	105 （51.5）	66 （39.8）
Eczema	Yes	140 （68.6）	133 （80.1）	6.250	0.012
	No	64 （31.4）	33 （19.9）
Allergic rhinitis	Yes	111 （54.4）	118 （71.1）	10.787	0.001
	No	93 （45.6）	48 （28.9）
Food allergy	Yes	106 （52.0）	127 （76.5）	3.401	0.065
	No	98 （48.0）	39 （23.5）
Inhaling pollen	Yes	117 （57.4）	120 （72.3）	8.868	0.003
	No	87 （42.6）	46 （27.7）
Bronchiolitis	Yes	60 （29.4）	94 （56.6）	27.898	0.000
	No	144 （70.6）	72 （43.4）
Passive smoking	Yes	110 （53.9）	85 （51.2）	0.271	0.603
	No	94 （46.1）	81 （48.8）
Pet contact	Yes	87 （42.6）	68 （41.0）	0.107	0.744
	No	117 （57.4）	98 （59.0）
Seasonal factor	Winter and spring	110 （53.9）	79 （47.6）	1.468	0.226
	Summer and autumn	94 （46.1）	87 （52.4）

Variable	β	Walds	P value	OR	95%CI
Allergic rhinitis	1.560	8.476	0.004	4.759	1.665‒13.603
Bronchiolitis	2.494	41.795	0.000	12.113	5.686‒25.802
Premature birth	1.129	4.746	0.029	3.092	1.120‒8.539
Urban residence	0.873	8.389	0.004	2.395	1.326‒4.324

Variable	β	Walds	P value	OR	95%CI
Allergic rhinitis	1.560	8.476	0.004	4.759	1.665‒13.603
Bronchiolitis	2.494	41.795	0.000	12.113	5.686‒25.802
Premature birth	1.129	4.746	0.029	3.092	1.120‒8.539
Urban residence	0.873	8.389	0.004	2.395	1.326‒4.324

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