Early rapid weight gain and current overweight in relation to asthma in adolescents born with very low birth weight

Early catch-up growth and subsequent overweight are suggested to be associated with later cardiovascular diseases and later type II diabetes. However, the impact of early catch-up growth and childhood overweight on the development of asthma has been less studied, particularly in children born with very low birth weight (VLBW). A birth cohort of 74 VLBW children (birth weight < or = 1500 g) was followed from birth and investigated on asthma at 12 yr of age. Early rapid weight gain was in one way defined as an increase of weight > or =1 standard deviation score (SDS) at 6 months of corrected postnatal age. Current overweight was defined by body mass index (BMI) exceeding 21.2 and 21.7 kg/m(2), respectively, for boys and girls at 12 yr of age. Current asthma was diagnosed by a pediatrician, according to asthma ever in combination with a positive response to hypertonic saline bronchial provocation test and/or wheeze at physical examination at 12 yr old. Being overweight at 12 yr of age was associated with an increased risk for current asthma in the VLBW children [crude odds ratio (OR): 5.5, 95% confidence interval (CI): 1.3-22.2]. After adjustment for early weight gain and neonatal risk, the OR of overweight increased nearly three times (adjusted OR: 15.3, 95% CI: 2.5-90.6). Early rapid weight gain seemed to be inversely associated with current asthma (adjusted OR: 0.49 for an increase of weight equal to 1 SDS, 95% CI: 0.23-1.02, p = 0.06). In addition, early rapid weight gain was inversely associated with the magnitude of bronchial responsiveness at 12 yr (coefficient -1.15, p < 0.01). There was a strong and positive association between overweight and asthma at 12 yr of age in the VLBW children. This strong association had been reduced by early rapid weight gain, possibly via the reduction of bronchial responsiveness.     

Breastfeeding and transmission of cytomegalovirus to preterm infants. Case report and kinetic of CMV-DNA in breast milk

Background

Obesity has been identified as a risk factor for higher prevalence of asthma and asthma-related symptoms in children. The objective of this study was to evaluate the relationship between the prevalence of asthma symptoms and obesity among school-age children in the city of Ahvaz, Iran.

Methods

A total of 903 children, 7 to 11 years of age, were enrolled in this study through cluster sampling. The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was used to identify the children who were currently suffering from asthma. Height and weight were measured and body mass index (BMI) was calculated in kg/m². Overweight was defined as BMI greater than the age- and sex-specific 85th percentile, and obesity as BMI greater than the 95th percentile. We determined the relationship between obesity and asthma symptoms by chi-square tests.

Results

The prevalence of wheeze ever, current wheezing, obesity, and overweight was 21.56%, 8.7%, 6.87%, and 9.5%, respectively. The current prevalence of wheezing among obese and overweight children was 68.75% and 37%, respectively, and there was a statistical association between obesity and the prevalence of current wheezing (p < 0.001), night cough (p < 0.001), and exercise-induced wheezing (p = 0.009), but obesity and overweight were not associated with eczema and allergic rhinoconjunctivitis, so it seems that the pathophysiology of asthma in obese and overweight children is not related to allergy.

Conclusion

There is a strong association between asthma symptoms and both overweight and obesity in both sexes among school-age children.     

Breast-feeding history and overweight in Latino preschoolers.

OBJECTIVE: Describe the relationship between breast-feeding history and risk of overweight in the preschool years in a sample of primarily Mexican-origin Latinos. METHODS: Children's breast-feeding history, health history, and demographics were obtained in interviewer-administered questionnaires of a convenience sample of 364 parents of children ages 2-5 in an outpatient clinic waiting room serving a predominantly Mexican immigrant population in a large Midwestern city. Child weight status was determined by weighing and measuring each child and calculating age- and sex-specific body mass index (BMI) percentile using 2000 Centers for Disease Control reference values, with children > or =95th percentile defined as overweight. RESULTS: Seventy-six of 364 children (21%) were overweight. Eighty-seven percent of children had been breast-fed. Increased duration of breast-feeding was associated with a linearly decreased risk of overweight in bivariate analysis, ranging from an overweight prevalence of 35% for those never breast-fed to 12% for those breast-fed for at least a year. This inverse relationship remained significant in the smaller sample for which maternal BMI data were available (n = 127), as each additional month of breast-feeding was associated with a 10% decreased odds ratio (OR) of overweight (adjusted OR = 0.90; 95% CI = 0.81, 0.99) after controlling for child's sex, current age, prematurity, birth-weight category, maternal education level, and maternal weight status. CONCLUSION: This sample of children of Mexican-origin immigrant families had high rates of overweight at very young ages but also very high rates of breast-feeding. Duration of breast-feeding was strongly and inversely related with prevalence of overweight as a preschooler.     

Association between obesity and asthma in Japanese preschool children

Obesity may increase the risk of subsequent asthma. We have previously reported that there is a clear association between obesity and asthma in Japanese school-aged children. To evaluate whether a similar association exists in younger children, a nationwide cross-sectional questionnaire-based survey was performed focusing on children aged 4-5 yr. A child who had experienced wheezing during the past 12 months and had ever been diagnosed with asthma by a physician was defined as having current asthma. Overweight and underweight were defined as BMI ≥90th percentile and ≤10th percentile, respectively, according to the reference values for Japanese children from 1978 to 1981. After excluding 2547 children because of incomplete data, 34,699 children were analyzed. Current asthma was significantly more prevalent in overweight children compared with underweight and normal weight children (13.2% for overweight vs. 10.5% for underweight and 11.1% for normal weight; both p < 0.001). Even after adjusting for other variables, such as gender, other coexisting allergic diseases, and parental history of asthma, there was an association between overweight and current asthma (adjusted odds ratio: 1.23, 95% CI: 1.10-1.38, p < 0.001). Even in preschool children, obesity is already associated with asthma, and there was no gender effect on this association. Physicians should consider the impact of obesity when managing asthma in younger children.     

The impact of early lifestyle factors on wheezing and asthma in Austrian preschool children

AIM: This study investigated the influence of early lifestyle factors on the prevalence of asthma and wheezing in preschool children in Tyrol, Austria. METHODS: A cross-sectional questionnaire survey was performed in 1761 preschool children to obtain information on wheezing and asthma in the light of early lifestyle factors. RESULTS: Factors independently associated with an increased risk for wheezing in the past 12 months included high parental education (OR: 1.5, 95% CI: 1.1-2.1) and parental hay fever (OR: 1.5, 95%CI: 1.1-2.2). Risk factors for doctor-diagnosed asthma (DDA) were early pet contact (OR: 2.2, 95% CI: 1.1-4.8) and parental asthma (OR: 3.0, 95%CI: 1.0-9.1), whereas breastfeeding decreased the risk (OR: 0.5, 95% CI: 0.2-1.0). Boiling the pacifier/sucker daily increased the risk for wheezing in the past 12 months (OR: 1.4, 95%CI: 1.0-2.0) and revealed a tendency towards DDA (OR: 1.9, 95% CI: 0.9-4.0). CONCLUSION: In preschool children, we established an independent association between wheezing in the past 12 months, DDA and boiling frequency of the pacifier/bottle sucker during infancy. The impact of pacifier boiling frequency on atopic diseases on the basis of the hygiene hypothesis needs further investigation.     

Prevalence and correlates of paediatric asthma and wheezing in a largely rural USA population

OBJECTIVE: The prevalence of asthma among children has been increasing in the United States and it is estimated that there are approximately 5 million children with asthma. This cross-sectional survey sought to estimate the prevalence of asthma and asthma symptoms and potential risk factors among children aged 16 and younger, in a largely rural population in the USA. METHODS: This study was a telephone survey of 1500 households in the South Plains/Panhandle region of Texas. Parents of children were interviewed with a response rate of 64%. Having been diagnosed with asthma by a physician and a report of wheezing in the last 12 months were used as dependent variables in multivariate logistic regressions with several sociodemographic and environmental factors as potential confounders. RESULTS: The age-adjusted prevalence of asthma and wheezing among children were approximately 15 and 18%, respectively. The prevalence of asthma was highest (20%) among children aged 11-16 (P < 0.001). Living in urban areas was associated significantly with asthma and wheezing. Non-Hispanic blacks reported significantly increased odds of asthma in their children (adjusted odds ratio (OR) = 2.04, 95%CI 1.02-4.08), whereas Mexican-Americans reported significantly reduced odds of asthma (adjusted OR = 0.48, 95%CI 0.29-0.78) and wheezing (adjusted OR = 0.58, 95%CI 0.37-0.89) in their children. The odds of asthma (adjusted OR = 1.78, 95%CI 1.09-2.92) and wheezing (adjusted OR = 2.45, 95%CI 1.52-3.95) was highest among children in the highest body mass index quartile. No significant association with pet ownership and exposure to second-hand smoke with asthma and wheezing was observed in this study. CONCLUSION: Urban residence, non-Hispanic black and Mexican-American race/ethnicity, and being overweight were significantly associated with the increased risk of asthma and/or wheezing.     

乌鲁木齐地区喘息患儿发生支气管哮喘的危险因素

目的 探讨乌鲁木齐地区喘息患儿发生支气管哮喘(哮喘)的危险因素.方法 对2008年1 -12月在新疆医科大学第五附属医院门诊及住院的300例喘息患儿的临床资料进行统计.用统一的调查表调查其年龄、性别、湿疹、变应性鼻炎、食物过敏、家族过敏史/哮喘史、运动相关性喘息等.出院后通过门诊或电话进行随访.采用 Logistic回归分析方法对各因素与哮喘发生的关系及相关程度进行分析.结果 随访2a,275例获得随访;25例失访.275例喘息患儿在随访期内86例(31.2％)发生哮喘.Logistic回归分析发现湿疹、变应性鼻炎、家族过敏史/哮喘史、运动相关性喘息、反复下呼吸道感染( LRTI)、外周血嗜酸性粒细胞(EOS)增高与喘息患儿发生哮喘有关(湿疹:OR=2.376,95％ CI0.098～0.935,P=0.039;变应性鼻炎:OR=1.052,95％ CI2.267 ～14.283,P =0.024;家族过敏史/哮喘史:OR=1.886,95％CI1.004～3.542,P =0.048;运动相关性喘息:OR=1.881,95％ CI2.267 ～18.983,P =0.001;LRTI:OR=5.341,95％ CI1.676～ 10.983,P =0.016;外周血EOS增高:OR=3.915,95％ CI1.459～ 10.501,P=0.002).结论 个人过敏史(湿疹和变应性鼻炎)、家族过敏史/哮喘史、运动相关性喘息、LRTI、外周血EOS增高是乌鲁木齐地区喘息患儿发生哮喘的危险因素.     

Decreased quality of life associated with obesity in school-aged children

OBJECTIVES: To examine the association between health-related quality of life and body mass index (BMI) in preadolescent school-aged children and to provide the possible risk factors among participant characteristics, BMI status, and health-related quality of life.Design, Setting, and PARTICIPANTS: Cross-sectional analysis of 371 (50% female; 32% minority) children from a community-based sample of 8- to 11-year-olds participating in an ongoing cohort study, excluding those who had sleep apnea or who were born prematurely. Using BMI percentiles for age and sex, 17.5% of the children were considered overweight (BMI > or =95th percentile), 12.4% were at risk for overweight (BMI 85th-94th percentile), 8.1% were relatively underweight (BMI <20th percentile), and the remaining 62.0% were of normal weight (BMI 20th-84th percentile). MAIN OUTCOME MEASURES: Health-related quality-of-life scores as determined by the Child Health Questionnaire-Parent Form 50, dichotomized into the bottom quartile or decile. RESULTS: After adjustment for covariates (host factors and health status measurements), overweight children compared with normal weight children scored lower on the Psychosocial Health Summary (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.1-3.6) and on subscales measuring self-esteem (OR, 3.5; 95% CI, 1.9-6.3), physical functioning (OR, 2.8; 95% CI, 1.7-6.8), and effect on the parent's emotional well-being (OR, 2.0; 95% CI, 1.1-3.6). Compared with the normal weight group, children who are at risk for overweight scored significantly lower for physical functioning. CONCLUSION: Overweight children have an increased odds of low scores for several health-related quality-of-life domains, suggesting the importance in considering such dimensions in programs aimed at further understanding obesity in children.     

Headache and asthma

The aim of this study was to investigate the association between headache and asthma, bronchodilators and atopy in school children. A cross-sectional survey of all primary school children was conducted in two towns near Newcastle, New South Wales, Australia; one in the vicinity of two coal-fired power stations, the other free of outdoor industrial air pollution. The main outcome measures were frequent headache, wheezing, bronchial reactivity, use of bronchodilators and atopy. Eight hundred and fifty-one primary school children aged 5-12 years participated (92% response rate). Twenty-three per cent of the children were reported to have had a history of frequent headache. Crude odds ratios indicated that the odds of frequent headache was significantly higher in children with asthma and atopy and where there was a smoker in the home, but that there was no association between frequent headache and use of bronchodilators or the sex of the child or socio-economic status measured as father's occupation. Stepwise logistic regression with frequent headache as the outcome of interest showed that, after adjusting for age and smoking in the home, the odds ratio for asthma (defined as current wheeze) was 3.24 (95% confidence interval [CI] 2.19-4.77). The similarly adjusted odds ratio for asthma defined as bronchial hyperreactivity (BHR).was 1.60 (95% Cl 1.09-2.37). Atopy was not statistically significantly associated with headache for either model. Asthma (defined as wheeze or BHR) is an independent risk factor for frequent headache. The relationship between headache and asthma is an association with bronchial hyperresponsiveness rather than atopy.     

中国三城市儿童个人过敏原与喘息及气道高反应性的相关性研究

目的 了解个人过敏原阳性与喘息及气道高反应性的关系。方法 在北京、广州及香港三城市中采用整群抽样的方法,在9～11岁在校学龄儿童中,应用国际间儿童哮喘与过敏性疾病研究的第二阶段研究方案进行研究,内容包括(1)家长书面问卷(共收集问卷10902份),(2)儿童皮肤过敏原点刺试验(3478例),(3)乙酰甲胆碱支气管激发试验(608例)。结果 近期喘息(在12个月内有发作)发生率：北京3．8％、广州3．4％、香港5．8％。特应性(即≥1种过敏原阳性)阳性率北京23．9％、广州30．8％、香港41．2％。乙酰甲胆碱支气管激发试验阳性率：北京33．2％、广州45．8％、香港30．7％。多因素logistic回归分析显示,屋尘螨P[相对危险度(OR)=4．48;95％可信限(CI)：3．02—6．66]、猫毛(OR=2．59;95％CI：1．67～4．02)、粉尘螨F(OR=2．41;95％CI：1．65～3．51)及混合草花粉过敏(OR=2．85;95％CI：1．24～6．50)是近期喘息显著相关的危险因素;特应性(OR=1．29;95％CI：0．74～2．24)与近期喘息无显著相关性。特应性(OR=2．53;95％CI：1．07～5．97)、猫毛(OR：3．01;95％CI：1．39～6．52)及粉尘螨F(OR=3．67;95％CI：1．93～6．97)是气道高反应性显著相关的危险因素。结论 屋尘螨P、粉尘螨F、猫毛、混合草花粉是9-ll岁组儿童近期喘息的危险因素,而特应性不是近期喘息的独立危险因素。特应性、猫毛、粉尘螨F是气道高反应性的危险因素。     

C-reactive protein and body mass index in children: findings from the Third National Health and Nutrition Examination Survey, 1988-1994

OBJECTIVES: To examine the relationship between C-reactive protein (CRP) concentration and body mass index (BMI) in children. STUDY DESIGN: With the use of data from 5305 children aged 6 to 18 years in the Third National Health and Nutrition Examination Survey (1988 to 1994), a cross-sectional health survey, we examined whether CRP concentrations were elevated among overweight children. RESULTS: Among children whose BMI was below the age- and sex-specific 15th percentile, 6.6% of boys and 10.7% of girls had an elevated CRP concentration (>2.1 mg/L) compared with 24.2% of boys and 31.9% of girls whose BMI was > or =95th percentile. After adjustment was done for age, sex, race or ethnicity, poverty income ratio, high-density lipoprotein cholesterol concentration, white blood cell count, and history of chronic bronchitis, the adjusted odds of having an elevated CRP concentration were 2.20 (95% CI 1.30, 3.75) for children with a BMI of 85th to <95th percentile and 4.92 (95% CI 3.39, 7.15) for children with a BMI of > or =95th percentile compared with children who had a BMI of 15th to <85th percentile. The associations did not differ significantly by age, sex, or race or ethnicity. CONCLUSIONS: In a large representative sample of US children, CRP concentration was significantly elevated among children with a BMI > or=85th percentile, thus confirming previous findings of this association in children and extending previous research in adults to children. Excess body weight may be associated with a state of chronic low-grade inflammation in children.     

Association between school children's overweight and maternal obesity and perception of their children's weight status

AIM: To determine the association between overweight children and a) other components of the mothers' metabolic syndrome, such as body mass index (BMI), waist circumference (WC), HDL-cholesterol, triglycerides, glucose, HOMA-IR, blood pressure (BP), and age; and b) the mothers' perception of their children's overweight. METHODS: Six hundred and twenty children (297 M) aged 9 +/- 2 years and their mothers aged 37.7 +/- 7 years were examined between April and August 2006. BMI, BP, fasting glucose and lipids and children's Tanner stage were determined. Questionnaires were filled in about the mothers' perceptions of their children's eating habits and of their children's shape. RESULTS: Ninety-five (17.4%) of the children were obese (> 95th percentile), 108 (15.3%) overweight (> 85th percentile) and 418 (67.3%) normal. One hundred and twelve (18%) of the mothers were obese and 183 (29.5%) overweight. Mean values for measures in mothers differed between normal vs overweight/obese children: z-BMI (-0.19 vs 0.42), triglycerides (84 vs 105 mg/dl), cholesterol (147 vs 157 mg/dl), glucose (78 vs 82 mg/dl) and insulin resistance (HOMA-IR 1.34 vs 1.72). There were significant differences in the proportion with distorted perception of shape (2.2% vs 47.5%) and eating habits (11.2% vs 37%) between mothers of normal versus overweight/ obese children. Logistic regression analysis using BMI > or = 85th percentile as the dependent variable showed that the mothers' perceptions of their children's shape (OR: 18.84; 95% CI: 5.0-69.6), eating habits (OR: 3.82; 95% CI: 1.5-9.5) and mothers' BMI (OR: 2.1; 95% CI: 1.3-3.4) were associated with children's overweight. CONCLUSIONS: There was an association between mothers' distorted perception of their children's shape and eating habits and mothers' obesity and their children's overweight. This observation provides clues for obesity prevention programs.     

Birth anthropometric measures, body mass index and allergic diseases in a birth cohort study (BAMSE).

OBJECTIVE: We aimed to assess increased birth weight or birth length in relation to allergic diseases at 4 years of age, taking body mass index (BMI) at age 4 as a covariate in the adjustment. METHODS: The parents of a large prospective birth cohort answered questionnaires on environmental factors and allergic symptoms when their children were 2 months and 1, 2 and 4 years old. Perinatal data on weight and length at birth were received from the child care health centres. The children were clinically examined at 4 years of age and height and weight recorded. Blood was drawn for analysis of specific IgE antibodies to common inhalant allergens. Risk associations between birth anthropometric measures and wheeze, allergic diseases or sensitisation were estimated in multivariate logistic regression analyses (n = 2869). RESULTS: There were no clear overall associations between birth weight and allergic diseases at 4 years of age. Birth length > or =90th percentile was inversely associated with any wheeze at age 4 (adjusted OR 0.64, 95% CI 0.44 to 0.92) but was significantly associated only with late-onset wheeze (adjusted OR 0.40, 95% CI 0.21 to 0.77). No such associations were seen for persistent or transient wheeze, eczema, rhinitis or allergic sensitisation. Transient wheeze during the first 2 years of age tended to be associated with increased BMI at age 4. CONCLUSION: Increased birth weight was not associated with wheeze or allergic disease. Increased birth length may play a protective role in late-onset wheeze in early childhood.     

Prenatal paracetamol exposure and risk of wheeze at preschool age*

Aim: To analyse the association between prenatal paracetamol exposure and preschool wheeze. Methods: Data were obtained from a prospective, longitudinal study of a cohort of children born in the region of western Sweden in 2003; 8176 families were randomly selected. The parents answered questionnaires at 6 and 12 months and at 4.5 years of age. The response rate was 55%, i.e. 4496 of the 5398 questionnaires distributed at 4.5 years (83%). Inhaled corticosteroid (ICS) treated wheeze during the last year was regarded as a proxy for doctor‐diagnosed asthma. Episodic viral wheeze was defined as wheezing only with viral infections and multiple‐trigger wheeze as wheezing also in between infections. Results: In the multivariate analysis, the risk of ICS‐treated wheeze was increased by paracetamol (OR 1.6; 95% CI 1.01–2.6). Within the ICS‐treated group, the effect was significant for multiple‐trigger wheeze (OR 2.4; 1.2–4.8) but not for episodic viral wheeze (OR 1.1; 0.5–2.3). Conclusion: Prenatal paracetamol exposure was an independent risk factor for ICS‐treated wheeze at preschool age, especially among children with ICS‐treated multiple‐trigger wheeze. Although the analysis adjusted for e.g. maternal asthma and antibiotic use, the possibility of residual confounding by maternal indication (respiratory illness) should be acknowledged.     

Hypertonic saline challenge tests in the diagnosis of bronchial hyperresponsiveness and asthma in children

The hypertonic saline challenge test is the recommended method to assess bronchial hyperresponsiveness in the International Study of Asthma and Allergies in Childhood (ISAAC). The sensitivity of this procedure to assess asthma symptoms, however, has been reported to vary among study centers. The purpose of our study was to evaluate the value of this provocation test in an epidemiological survey in children, and to relate the degree of bronchial hyperresponsiveness to the severity of asthma symptoms. All 11–13‐year‐old children from 16 randomly selected schools in Linköping, Sweden received a questionnaire regarding respiratory symptoms and allergic disease. Skin prick tests with eight inhalant allergens were performed. In addition, all children with wheeze over the past 12 months (current wheeze) and a random sample of children without current wheeze were invited to perform hypertonic saline provocation tests. A complete data set was available for 170 children, including 50 with and 120 without current wheeze. Bronchial hyperresponsiveness (BHR) was defined as at least 15% decline in FEV₁. The degree of BHR was represented by the response/dose ratio, i.e. the fall in FEV₁ divided by total dose of inhaled saline. The severity of asthma symptoms was classified by the number of wheezing episodes over the past 12 months. ‘Asthma ever’ was defined by a combination of symptoms in the questionnaires. Children with ‘asthma ever’ and current wheeze were considered as having current asthma. Current atopic asthma was defined as current asthma with at least one positive skin prick test. The sensitivity of the procedure to detect ‘asthma ever’, current asthma and current atopic asthma was 62, 61 and 83%, and the specificity 83, 81 and 60%, respectively. The positive challenge rate was 52, 34, 13 and 7% among current wheezers, previous wheezers, non‐wheezers with a history of allergy and healthy children. The degree of bronchial hyperresponsiveness increased with the number of wheezing episodes. Thus, the median and range of the response/dose ratio were 4.8%/ml (2.1–14.8), 2.6%/ml (0.7–8.6) and 1.3%/ml (0.8–2.7), respectively, for children with ≥ 4 episodes, 1–3 episodes and no wheezing episodes over the past 12 months (p<0.001). In conclusion, hypertonic saline provocation test is useful as a tool to detect asthma in epidemiological studies in children. The degree of bronchial hyperresponsiveness, as represented by the response/dose ratio, reflects the severity of asthma symptoms.     

Prevalence, severity and determinants of asthma in Danish five-year-olds

BACKGROUND: The prevalence of asthma and wheeze is increasing. AIM: To study the annual and cumulative prevalence of asthma and wheeze in 5-y-old Danish children. METHODS: We obtained data on 3052 (82.0% of eligible) Danish children by a postal parental questionnaire including ISAAC questions regarding respiratory symptoms and our own questions on sociodemography and tobacco exposure. RESULTS: "Wheeze ever" was reported in 38.3%, "doctor-diagnosed asthma ever" in 10.5%, "childhood bronchitis ever" in 30.0%, "current wheeze" (<12 mo) in 19.7%, and being "severe" (>3 episodes) in 3.9% of the children. Current wheeze was associated with male gender (OR 1.63, 95% CI 1.35-1.96), low parental post-primary education (OR 1.29, 95% CI 1.02-1.63 for <3 y vs > or =3 y) and current maternal smoking (OR 1.69, 95% CI 1.39-2.04). "Severe current wheeze" was recognized as asthma in six and childhood bronchitis in three of 10 cases. Nearly all diagnosed asthmatics had suffered wheeze, two-thirds recently. CONCLUSION: We found a high prevalence of asthma and wheeze in Danish late-preschool children, associated with male gender, current maternal tobacco smoking and low parental post-primary education. The majority of children with current wheeze had an early onset, and severe early symptoms tended to persist. Used with consideration, the label "childhood bronchitis" seems purposeful.     

Wheezing due to rhinovirus infection in infancy: Bronchial hyperresponsiveness at school age

Background: Characteristics related to decreased lung function and increased bronchial responsiveness after early childhood wheezing requiring hospitalization are not fully established.
Methods: Seventy-nine children with wheezing requiring hospitalization at age <2 years were prospectively followed up and re-investigated at age 5.6–8.8 years when the measurements of baseline lung function and bronchial responsiveness to exercise were performed.
Results: At early school age, 23% of children had decreased lung function, and 13% had increased bronchial responsiveness to exercise. Predictors of decreased lung function were maternal history of smoking during pregnancy (odds ratio [OR], 12.8; 95% confidence interval [CI]: 1.2–139.6), parental history of asthma (OR, 4.3; 95%CI: 1.1–17.1), and female gender (OR, 4.0; 95%CI: 1.2–13.7). Increased bronchial responsiveness was associated with rhinovirus infection-induced wheezing in infancy (OR, 6.5; 95%CI: 1.2–36.3), and early cat or dog exposure leading to sensitization (OR, 26.6; 95%CI: 1.3–525.2). Inhaled anti-inflammatory therapy was common in children with rhinovirus infection-induced wheezing in infancy ( n  = 13/19; P  = 0.001 vs children with other/no confirmed virus infection etiology for wheezing in infancy, n  = 16/60), which may have improved lung function and attenuated bronchial responsiveness in them.
Conclusions: After early childhood wheezing requiring hospitalization, one-fourth of children will have decreased lung function and one-eighth of children will show increased bronchial responsiveness at school age. Gender, heredity of asthma, and antenatal exposure to tobacco smoke are predictors of decreased lung function, whereas rhinovirus infection etiology of wheeze and early animal exposure leading to sensitization are associated with increased bronchial responsiveness later in childhood.     

Gender, type of education, family background and overweight in adolescents.

OBJECTIVE: To examine gender-specific socio-educational correlations of overweight in adolescents enrolled in post-mandatory education. SUBJECTS AND METHODS: Data were drawn from the Swiss Multicenter Adolescent Survey on Health, a cross-sectional study conducted on a representative sample of 3439 females and 4109 males aged 16 to 20 and enrolled in either vocational education (apprentices) or full time school (students). Adolescents reporting a body mass index (BMI) > 85th percentile for age and gender were compared with those reporting a BMI around the median (25th-75th percentile). RESULTS: Multivariate logistic regression showed that apprentices of both genders were more likely to report a BMI > or = 85th percentile than students: odds ratio (OR) in females 1.49 (95% confidence interval [CI] 1.11, 1.99), OR in males 1.61 (95%CI 1.19, 2.19). In females, but not in males, reported BMI was associated with parental education level (father with baccalaureate or university degree, OR = 1.00; father with vocational proficiency certificate, OR = 1.48 [95% CI 1.06, 2.07] and father without post-mandatory education, OR =3.44 [95% CI 2.20, 5.38]). CONCLUSIONS: The observed differences in the correlation of parents' and adolescents' own educational status with overweight suggest that parental and adolescents' own education represent distinct risk factors for overweight. Apprentices' higher risk of being overweight might be of particular interest for prevention, as they represent a large number of adolescents, who enter the adult workforce at a young age. Overall, socio-educational characteristics explained only a small fraction of the variance in overweight, particularly in males.     

Prevalence and risk factors of asthma and allergic diseases among schoolchildren in Bolu, Turkey

AIM: In this study we aimed to detect the prevalence and risk factors of asthma and allergic diseases in children aged between 7 and 14 years old at rural and urban areas of Bolu, Turkey. METHODS: Questionnaire of International Study of Asthma and Allergies in Childhood (ISAAC) phase one and questionnaire including questions about family, demographic, socio-economic characteristics of children were applied to 931 schoolchildren who were selected by randomized sampling. RESULTS: In children, the prevalence of diseases and symptoms were as follows: wheeze ever: 15.5%, asthma: 5.6%, nasal symptoms ever: 41.4%, allergic rhinitis: 23.2%, itchy rash ever: 5.9% and eczema: 5.0%. In multivariate regression analysis, presence of allergic disease in the family was risk factor for wheezing (OR=1.74, 95% CI=1.19-2.76), asthma (OR=2.19, CI=1.06-4.52), allergic rhinitis (OR=2.68, CI=1.80-3.98) and eczema (OR=2.33, CI=1.17-4.65); living in shanties was risk factor for allergic rhinitis (OR=5.26, CI=2.1-13.16); a monthly income below $300 was risk factor for asthma (OR=2.54, CI=1.06-6.08). CONCLUSION: It was detected that the prevalence of allergic rhinitis and its symptoms was more common in schoolchildren living in Bolu. Presence of allergic disease in fathers or mothers and low socio-economic level increase the risk of asthma and other allergic diseases in children.     

Wheeze in children: the impact of parental education on atopic and non‐atopic symptoms

de Meer G, Reijneveld SA, Brunekreef B. Wheeze in children: the impact of parental education on atopic and non‐atopic symptoms.
Pediatr Allergy Immunol 2010: 21: 823–830.
© 2009 John Wiley & Sons A/S There is conflicting evidence for the relationship between parental socioeconomic position and their children’s asthma. The aim of this study was to investigate relationships between parental education and respiratory symptoms in their children, distinguishing atopic and non‐atopic symptoms. A cross‐sectional survey among 3262 elementary school children (age 8–13) was performed; data on parental education were obtained for 3213 children. Parents completed a questionnaire on their child’s allergic and respiratory symptoms, and potential explanatory variables including family history, indoor environment, and the child’s medical history. Subsets of children were tested for atopy (n = 1983), lung function (n = 2325), and airway hyperresponsiveness (AHR) (n = 880). Logistic regression was used to assess relationships of health outcomes with parental education. A high parental education was associated with an increased risk of atopic sensitization to indoor allergens (OR 1.31, 95% CI 1.02; 1.69). Studied explanatory variables did not influence the relationship. In contrast, a high parental education protected children from wheeze (OR 0.77, 95% CI 0.61; 0.97). This only applied to non‐atopic wheeze (OR 0.65, 95% CI 0.43; 0.99) and not to atopic wheeze (OR 0.89, 95% CI 0.60; 1.31). The protection from non‐atopic wheeze in children of highly educated parents declined after adjustment for household smoking and breastfeeding (OR 0.96, 95% CI 0.58; 1.57). Similar results were observed for non‐atopic and atopic rhinitis. We conclude that children from highly educated parents are protected from non‐atopic respiratory symptoms, which is largely explained by a lower rate of household smoking and a higher rate of breastfeeding.