gms | German Medical Science

MAINZ//2011: 56. GMDS-Jahrestagung und 6. DGEpi-Jahrestagung

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V.
Deutsche Gesellschaft für Epidemiologie e. V.

26. - 29.09.2011 in Mainz

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Early life manifest infections and risk of asthma and wheezing disorders in preschool children: Prospective birth cohort study

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  • Heny Ghizibel - The German Cancer Research Center, Heidelberg
  • Melanie Weck - The German Cancer Research Center, Heidelberg
  • Hermann Brenner - The German Cancer Research Center, Heidelberg
  • Jon Genuneit - Institute of Epidemiology and Medical Biometry, Ulm
  • Dietrich Rothenbacher - Institute of Epidemiology and Medical Biometry, Ulm

Mainz//2011. 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi). Mainz, 26.-29.09.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11gmds395

doi: 10.3205/11gmds395, urn:nbn:de:0183-11gmds3955

Published: September 20, 2011

© 2011 Ghizibel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Background: Early life markers of infection and subclinical exposure to microbes are associated with decreased risk of allergic diseases. Data on the influence of clinical infections on asthma and allergy risk have been inconsistent. We aimed to assess whether the frequencies of fever episodes and manifest infections in the first year of life are associated with the later risk of physician reported asthma and parent reported wheezing.

Methods: We used data of a prospective birth cohort study. All women who came to the University Clinics of Ulm between 11/2000 and 11/2001 for delivery were recruited for the study. The childrens’ parents and their primary care pediatricians were contacted, separately, 1, 2, 3 and 4 years after the baseline examination. Six years after baseline only the parents were contacted. We used multivariate logistic regression to estimate adjusted odds ratios (OR) for the association of infectious diseases in the first year of life with lifetime prevalence of physician reported asthma at 4 years of age, annual prevalence of parent reported wheezing at 6 years of age and early persistent wheezing.

Results: We included 623 children (58% of the baseline population) whose parents and physicians participated at each follow up. At least one fever episode within the first year of life was reported for 69.1% of the children by the physicians and for 81.6% by the parents. The number of physician reported fever episodes was associated with an increased risk of both early persistent wheezing (p trend=0.009) and physician reported asthma (p trend<0.001), whereas the number of parental reported fever episodes was associated only with asthma (p trend<0.001). The number of upper respiratory infections (URI) was associated with increased risk of asthma (p trend<0.001), and the number of lower respiratory infections (LRI) with increased risk of asthma and persistent wheezing (both p trend<0.001), and current wheezing (p trend=0.016). After multivariable adjustment for covariates these patterns persisted. When adjusting simultaneously for fever episodes and all infection groups, only the number of URI (OR 2.42 (95% CI 1.27;4.60), ≥ 4 vs. 0 episodes) and LRI (3.98 (1.58;10.10), ≥ 4 vs. 0 episodes) contributed independently to the risk of asthma. For persistent wheeze, LRI was the only significant determinant (4.41 (2.07;9.42), 2-3 vs. 0 episodes).

Conclusions: Infection related fever episodes in infancy strongly increase the risk of asthma related disorders in preschool children. Both lower and upper respiratory infections are important.

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References

1.
Strachan DP. Hay fever, hygiene, and household size. BMJ. 1989;299(6710):1259-60.
2.
Benn CS, Melbye M, Wohlfahrt J, Bjorksten B, Aaby P. Cohort study of sibling effect, infectious diseases, and risk of atopic dermatitis during first 18 months of life. BMJ. 2004;328(7450):1223.
3.
Kopp MV, Semmler S, Ihorst G, Berner R, Forster J. Hospital admission with neonatal sepsis and development of atopic disease: Is there a link? Pediatr Allergy Immunol. 2005;16(8):630-6.
4.
Illi S, von Mutius E, Lau S, Bergmann R, Niggemann B, Sommerfeld C, et al. Early childhood infectious – diseases and the development of asthma up to school age: a birth cohort study. BMJ. 2001;322(7283):390-5.
5.
Kusel MM, de Klerk NH, Kebadze T, Vohma V, Holt PG, Johnston SL, et al. Early-life respiratory viral infections, atopic sensitization, and risk of subsequent development of persistent asthma. J Allergy Clin Immunol. 2007;119(5):1105-10.
6.
Gereda JE, Leung DY, Thatayatikom A, Streib JE, Price MR, Klinnert MD, et al. Relation between house-dust endotoxin exposure, type 1 T-cell development, and allergen sensitisation in infants at high risk of asthma. Lancet. 2000;355(9216):1680-3.
7.
Ege MJ, Mayer M, Normand AC, Genuneit J, Cookson W, Braun-Fahrländer C, et al. Exposure to environmental microoganisms and Childhood Asthma. N Eng J Med. 2011;364:701-9.