Pará Research Medical Journal
http://www.prmjournal.org/article/doi/10.4322/prmj.2019.008
Pará Research Medical Journal
Artigo Original Pediatria

Sibilância recorrente em lactentes no primeiro ano de vida em Belém (Pará, Brasil): prevalência e fatores de risco associados

Recurrent wheezing in infants in the first year of life in Belém (Pará, Brazil): prevalence and associated risk factors

Elaine Xavier Prestes, Javier Mallol, Dirceu Solé

Downloads: 0
Views: 26

Resumo

Objetivo: determinar a prevalência e os fatores de risco para sibilância recorrente em lactentes no primeiro ano de vida em Belém, Pará, Brasil. Método: Estudo transversal que utilizou o questionário escrito do Estudio Internacional de Sibilancias en Lactentes (EISL) para pais de lactentes de 12 a 15 meses, nas Unidades de Saúde de Belém, por ocasião de vacinação, entremaioeagosto de 2006. Utilizou-se o Teste t de Student na comparação de médias numéricas e estimação da razão de chances (RC), com intervalo de confiança 95%, e ajuste de modelo de regressão logística para avaliar fatores de risco ou proteção com nível de significância de 5%. Resultados: 3.024 crianças participaram do estudo. A prevalência de sibilância recorrente nesses lactentes foi de 21,9%. Os fatores de risco para sibilância recorrente no primeiro ano de vida foram: gênero masculino, infecção de vias aéreas, infecção de vias aéreas antes de cinco meses de idade, raça negra, exposição à poluição atmosférica, história familiar de asma e rinite, dermatite atópica pessoal. Ter o calendário vacinal atualizado e ter seis meses de idade ou mais na primeira infecção foram fatores de proteção. Conclusão: a prevalência de sibilância recorrente é elevada em Belém e seus fatores de risco estão ligados a genética e fatores ambientais. Prevenir infecção de vias aéreas em lactente jovem e controlara poluição ambiental pode minimizar a doença sibilante.

Palavras-chave

sons respiratórios; recorrente; lactente; fator de risco; fator de proteção; asma.

Abstract

Purpose: To identify the prevalence and risk factors for recurrent wheezing in infants fromBelém, Pará, Brazil. Methods: A cross-sectional study that used the written questionnaire EstudioInternational de Sibilancias en Lactentes (EISL) for parents of infants 12 to15 month-old, in the Health Units of Belém at the time of vaccination between May and August 2006. The Student t test for continuous variables and Chi-square test for categorical variables, estimation of Odds ratio (OR) with 95% confidence interval and adjustmentof logistic regression model to evaluate risk factors with a significance level of 5% were done. Results: 3,024 children participated in the study. The prevalence of recurrent wheezing in these infants was 21.9%. Risk factors associated with recurrent wheezing were male sex, respiratory infections, especially under five months-old, rhinitis and asthma in the family, atopic dermatitis, living in a polluted area, and blackrace. Immunization schedule completeand respiratory infections after six months-old were protective factor. Conclusion: The prevalence of recurrent wheezing is higher in Belém and some of its known risk factors may help to promote preventive measures applicable to wheezing.

Keywords

respiratory sounds; recurrent; wheezing infant; risk factors; asthma.

Referências

1. Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ, et al. Asthma and wheezing in the first six years of life. N Engl J Med. 1995;332(3):133-8. http://dx.doi.org/10.1056/NEJM199501193320301. PMid:7800004.

2. Stern DA, Morgan WJ, Wright AL, Guerra S, Martinez FD. Poor airway function in early infancy and lung function by age 22 years: a non selective longitudinal cohort study. Lancet. 2007;370(9589):758-64. http://dx.doi.org/10.1016/S0140-6736(07)61379-8. PMid:17765525.

3. Stein RT. Long-term airway morbidity following viral LRTI in early infancy: recurrent wheezing or asthma? Paediatr Respir Rev. 2009;10(Suppl 1):29-31. http://dx.doi.org/10.1016/S1526-0542(09)70013-2. PMid:19651399.

4. Wright AL, Sherrill D, Holberg CJ, Halonen M, Martinez FD. Breast-feeding, maternal IgE, and total serum IgE in childhood. J Allergy Clin Immunol. 1999;104(Pt 1):589-94. http://dx.doi.org/10.1016/S0091-6749(99)70328-3. PMid:10482832.

5. Noakes PS, Hale J, Thomas R, Lane C, Devadason SG, Prescott SL. Maternal smoking is associated with impaired neonatal toll-like-receptormediated immune responses. Eur Respir J. 2006;28(4):721-9. http://dx.doi.org/10.1183/09031936.06.00050206. PMid:16870663.

6. Luijk MP, Sonnenschein-van der Voort AM, Mileva-Seitz VR, Jansen PW, Verhulst FC, Hofman A, et al. Is parent-child bed-sharing a risk for wheezing and asthma in early childhood? Eur Respir J. 2015;45(3):661-9. http://dx.doi.org/10.1183/09031936.00041714. PMid:25504998.

7. Cardoso MRA, Cousens SN, Siqueira LFG, Alves FM, D’Angelo LAV. Crowding: risk factor or protective factor for lower respiratory disease in Young children? BMC Public Health. 2004;4(1):19. http://dx.doi.org/10.1186/1471-2458-4-19. PMid:15176983.

8. Mommers M, Weishoff-Houben M, Swaen GM, Creemers H, Freund H, Dott W, et al. Infant immunization and the occurrence of atopic disease in Dutch and German children: a nested case-control study. Pediatr Pulmonol. 2004;38(4):329-34. http://dx.doi.org/10.1002/ppul.20089. PMid:15334511.

9. Bianca AC, Wandalsen GF, Miyagi K, Camargo L, Cezarin D, Mallol J, et al. International Study of Wheezing in Infants (EISL). Validation of written questionnaire for children aged bellow 3 years. J Investig Allergol Clin Immunol. 2009;19(1):35-42. PMid:19274927.

10. Chong No HJ, Rosário NA, Solé D, Mallol J. Prevalence of recurrent wheezing in infants. J Pediatr (Rio J). 2007b;83(4):357-62. PMid:17676238.

11. Dela Bianca AC, Wandalsen G, Mallol J, Solé D. Prevalência e gravidade da sibilância no primeiro ano de vida. J Bras Pneumol. 2010;36(4):402-9. http://dx.doi.org/10.1590/S1806-37132010000400003. PMid:20835585.

12. Mallol J, García-Marcos L, Solé D, Brand P, EISL Study Group. International prevalence of recurrent wheezing during the first year of life: variability, treatment patterns and use of health resources. Thorax. 2010 nov;65(11):1004-9. http://dx.doi.org/10.1136/thx.2009.115188. PMid:20855440.

13. Mallol J, Solé D, Garcia-Marcos L, Rosario N, Aguirre V, Chong H, et al. Prevalence, severity, and treatment of recurrent wheezing during the first year of life: a cross-sectional study of 12,405 latin american infants. Allergy Asthma Immunol Res. 2016;8(1):22-31. http://dx.doi.org/10.4168/aair.2016.8.1.22. PMid:26540498.

14. Mallol J, Solé D, Aguirre V, Chong H, Rosario N, García-Marcos L. Changes in the prevalence and severity of recurrent wheezing in infants: the results of two surveys administered 7 years apart. J Asthma. 2018 nov;55(11):1214-22. PMid:29231772.

15. Garcia-Marcos L, Mallol J, Solé D, Brand PL, EISL Study Group. International study of wheezing in infants:risk factors in affluent and nonaffluentcountries during the first year of life. Pediatr Allergy Immunol. 2010;21(5):878-88. http://dx.doi.org/10.1111/j.1399-3038.2010.01035.x. PMid:20444158.

16. Seneviratne R, Gunawardena NS. Prevalence and associated factors of wheezing illnesses of children aged three to five years living in underserved settlements of the Colombo Municipal Council in Sri Lanka: a cross-sectional study. BMC Public Health. 2018;18(1):127. http:// dx.doi.org/10.1186/s12889-018-5043-3. PMid:29325544.

5cfa9c470e8825fb7c58d25e prmjournal Articles
Links & Downloads

PRMJ

Share this page
Page Sections