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Bronchiolitis may predispose children to respiratory illnesses

22 Mar 2019

Bronchiolitis in infancy carries a three- to fivefold increased risk of developing respiratory illnesses, including asthma, wheeze, and lower and upper respiratory tract infections (LRTI and URTI) in the first 5 years of life, a study has found.

Researchers looked at a cohort of 613,377 children, among whom 16,288 (2.7 percent) had been admitted at least once for bronchiolitis in the first year of life. Relative to those who had no history of the lung infection, infants admitted with bronchiolitis were more likely to be boys, reside in deprived areas, be preterm at birth and be born with a comorbid condition.

A total of 68,315 admissions for respiratory illness were recorded between 1 and 5 years of age, with 49,509 children (8.07 percent) having at least one respiratory admission. These admissions occurred more frequently among children with vs without bronchiolitis during infancy (21.7 percent vs 7.6 percent).

On multivariable Cox regression analysis, bronchiolitis during infancy was associated with an elevated risk of developing respiratory diseases within 5 years of life (adjusted hazard ratio [aHR], 2.82; 95 percent CI, 2.72–2.92). The highest risk was seen for asthma (aHR, 4.35; 4.00–4.73) and wheezing (aHR, 5.02; 4.64–5.44). Significant risk increases were also observed for LRTI (aHR, 3.10; 2.91–3.31) and URTI (aHR, 2.34; 2.23–2.45).

The findings underscore the importance of communicating to parents the increased risk of subsequent childhood respiratory illness in infants with bronchiolitis, researchers said. Clinicians should also stress the weight of reducing other respiratory health risk factors, such as passive smoke exposure, in this at-risk population.

With regard to future studies, researchers recommended linking laboratory virological data with large population level admission data, as well as controlling for environmental smoke exposure due to its significance as a risk factor.

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