Parental smoking, presence of older siblings, and family history of asthma increase risk of bronchiolitis
K. M. McConnochie and K. J. Roghmann
Bronchiolitis is a common lower respiratory tract illness in infants and
has substantial acute morbidity and sequelae. To identify risk factors for
bronchiolitis, a case-control study was conducted in which 53 subjects who
had bronchiolitis were matched with two controls who had no bronchiolitis
in infancy. In multivariate analysis, direct effects of passive smoking and
older siblings achieved statistical significance. Family history of asthma
appeared to interact with older siblings. Among subjects without a family
history of asthma, statistically significant predictors proved to be older
siblings (odds ratio, 2.31) and passive smoking (odds ratio, 3.87). Among
subjects with a family history of asthma, older siblings proved to be an
even stronger predictor (odds ratio, 46.81), while the odds ratio for
passive smoking did not change much (odds ratio, 4.03). The combined
presence of older siblings and passive smoking yielded an odds ratio of
8.94 among subjects without a family history of asthma and 181.67 among
subjects with a family history of asthma. Analysis provided risk estimates
that were particularly high for certain groups. Among infants with a family
history of asthma, 49% who have an older sibling may develop bronchiolitis.
If they are also exposed to cigarette smoke, almost 80% may develop
bronchiolitis. Among infants without a family history of asthma,
bronchiolitis may develop in 46% of infants if there is both an older
sibling and exposure to smoke. Exposure of infants to cigarette smoke might
diminish more rapidly if clinicians and parents were aware of such high
risks. Efforts to reduce morbidity from bronchiolitis in infants might best
be directed at the reduction of smoking in families with previous children,
particularly if there is a family history of asthma, and at methods that
protect infants from respiratory virus carried by siblings.
The treatment of bronchiolitis
Yanney and Vyas
Arch. Dis. Child. 2008;93:793-798.
ABSTRACT
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Prospective Multicenter Study of Bronchiolitis: Predicting Safe Discharges From the Emergency Department
Mansbach et al.
Pediatrics 2008;121:680-688.
ABSTRACT
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Maternal Asthma and Maternal Smoking Are Associated With Increased Risk of Bronchiolitis During Infancy
Carroll et al.
Pediatrics 2007;119:1104-1112.
ABSTRACT
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Maternal Smoking, Asthma, and Bronchiolitis: Clear-Cut Association or Equivocal Evidence?
Simoes
Pediatrics 2007;119:1210-1212.
FULL TEXT
Bronchiolitis to Asthma: A Review and Call for Studies of Gene-Virus Interactions in Asthma Causation
Singh et al.
Am. J. Respir. Crit. Care Med. 2007;175:108-119.
ABSTRACT
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A Parental History of Asthma Is a Risk Factor for Wheezing and Nonwheezing Respiratory Illnesses in Infants Younger than 18 Months of Age
BOSKEN et al.
Am. J. Respir. Crit. Care Med. 2000;161:1810-1815.
ABSTRACT
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Reduced Interferon-gamma Production in Infants with Bronchiolitis and Asthma
RENZI et al.
Am. J. Respir. Crit. Care Med. 1999;159:1417-1422.
ABSTRACT
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Rehospitalization With Respiratory Syncytial Virus After Neonatal Intensive Care Unit Discharge: A 3-Year Follow-up
Nachman et al.
Pediatrics 1997;100:e8-e8.
ABSTRACT
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Local variability in respiratory syncytial virus disease severity
Brandenburg et al.
Arch. Dis. Child. 1997;77:410-414.
ABSTRACT
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Socioeconomic Variation in Discretionary and Mandatory Hospitalization of Infants: An Ecologic Analysis
McConnochie et al.
Pediatrics 1997;99:774-784.
ABSTRACT
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Review : Analysis of Potential Confounding Variables in Epidemiologic Studies of Parental/ Household Smoking and Respiratory Health in Preschool Children
Witorsch and Witorsch
Indoor and Built Environment 1993;2:71-91.
ABSTRACT
Environmental Tobacco Smoke Exposure and Respiratory Health in Children: An Updated Critical Review and Analysis of the Epidemiological Literature
Hood et al.
Indoor and Built Environment 1992;1:19-35.
ABSTRACT
From the Journals
Jacobi
J Hum Lact 1986;2:129-132.