Factors Influencing Recurrent Wheezing in Infants: The Relationship between Respiratory Syncytial Virus Infections and the Development of Recurrent Wheezing

Hyo Jin Jung; Min Jung Kim; Kwan Lee; Hyun Ji Kim; Soon Ok Byun

doi:10.7581/pard.2011.21.4.319

Journal List > Pediatr Allergy Respir Dis > v.21(4) > 1033143

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Jung, Kim, Lee, Kim, and Byun: Factors Influencing Recurrent Wheezing in Infants: The Relationship between Respiratory Syncytial Virus Infections and the Development of Recurrent Wheezing

Abstract

Pediatr Allergy Respir Dis 2011;21(4):319-325.

Published online: 20 January 2011

DOI: https://doi.org/10.7581/pard.2011.21.4.319

Factors Influencing Recurrent Wheezing in Infants: The Relationship between Respiratory Syncytial Virus Infections and the Development of Recurrent Wheezing

Hyo Jin Jung, MD¹, Min Jung Kim, MD², Kwan Lee, MD, PhD³, Hyun Ji Kim, MD^1,, Soon Ok Byun, MD, PhD¹

¹Department of Pediatrics, Wallace Memorial Baptist Hospital, Busan, Korea

²Department of Pediatrics, Marynoll Medical Center, Busan, Korea

³Department of Occupational and Environmental Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Korea

책임저자:김현지, 부산광역시 금정구 남산동 374-75 왈레스기념 침례병원 소아과 Tel: 051)580-1303 Fax: 051)583-7114 E-mail: khjwood@hanmail.net

Received 1 August 2011 Revised 27 September 2011 Accepted 29 September 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study investigated factors affecting recurrent wheezing in infants, focusing on whether or not respiratory syncytial virus (RSV) infections in children <3 years of age induce recurrent wheezing later in life.

Methods

The inclusion criteria were children <3 years of age who were hospitalized for an RSV infection from January 2006 to December 2009. We evaluated lateral flow immunochroma-tography (RSV Respi-Strip test). Subjects with at least three episodes of physician-verified wheezing were defined as recurrent wheezers. A group of 79 children hospitalized with RSV infections were compared with a matched control group. The following data were collected: age, gender, admission duration, gestational age, obesity, history of atopic dermatitis, parental history of allergic diseases, exposure to passive smoking, exposure to indoor animals, and daycare attendance.

Results

Rates of obesity and exposure to passive smoking were significantly higher in the RSV group than those in the control group. The frequency of recurrent wheezing in the RSV group (39.2 %) was higher than that in the control group (10.1%). Compared to the control group, recurrent wheezing occurred 5.76 times more often in the RSV group, 2.49 times more often in males, and 2.41 times often in patients with a parental history of allergic diseases.

Conclusion

The results demonstrated that RSV infection is significantly associated with recurrent wheezing, and that the risk is higher in male children and in children with a parental history of allergic diseases.

Keywords: Respiratory Syncytial Virus, Recurrent Wheezing

References

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Table 1.

General Characteristics of Categorical Data in the Case and Control Group

Factor	Group		P -value^∗
Factor	Case (n=79)	Control (n=79)	P -value^∗
Male gender	48 (60.8)	48 (60.8)	1.000
Obesity (Kaup index^†>18)	26 (32.9)	6 (7.6)	0.000
Past history for atopic dermatitis (+)	20 (25.3)	19 (24.1)	0.854
Heredity for allergic disease, parents (+)	33 (41.8)	35 (44.3)	0.872
Passive smoking (+)	29 (36.7)	15 (19.0)	0.013
Indoor animal (+)	3 (3.8)	3 (3.8)	1.000
Daycare (+)	59 (74.7)	62 (78.5)	0.573
Recurrent wheezing (+)^‡	31 (39.2)	8 (10.1)	0.000

Values are presented as number (%).

^∗ By Chi-sqaure test. 7.90) by Taylor series confidence interval method.

^† Kaup index: weight(gm)/[height(cm)]² 10.

^‡ Relative risk=3.88 (95% confidnece interval, 1.90

Table 2.

General Characteristics of Continuous Data in the Case and Control Group

Factor	Case (n=79)	Control (n=79)	P -value^∗
Age (mo) in admission	14.4 10.3 ±	14.8 9.6 ±	0.805
Admission duration (day)	7.3 2.8 ±	6.8 3.1 ±	0.293
Gestational age (wk)	38.7 2.2 ±	39.4 1.5 ±	0.016
Height (cm)	76.5 11.6 ±	77.4 9.4 ±	0.604
Weight (kg)	10.4 3.4 ±	10.2 2.2 ±	0.736

Values are presented as mean±SD.

^∗ By Student'st-test.

Table 3.

Various Risk Factors for Recurrent Wheezing in Categorical Data

Factor	Recurrent wheezing		P-value^∗	OR	95% CI^†
Factor	Positive (n=39)	Negative (n=119)	P-value^∗	OR	Lower	Upper
Male gender	29 (74.4)	67 (56.3)	0.045	2.25	1.01	5.03
Obesity (Kaup index>18)	12 (30.8)	20 (16.8)	0.060	2.20	0.96	5.06
Past history for atopic dermatitis (+)	11 (26.9)	21 (17.9)	0.261	0.60	0.24	1.48
Heredity for allergic disease, parents (+)	21 (53.8)	47 (39.5)	0.116	1.79	0.86	3.71
Passive smoking (+)	16 (41.0)	28 (23.5)	0.034	2.26	1.05	4.86
Indoor animal (+)	1 (2.6)	5 (4.2)	0.642	0.60	0.07	5.30
Daycare (+)	32 (82.1)	89 (74.8)	0.353	1.54	0.62	3.85
RSV (+)	31 (79.5)	48 (40.3)	<0.001	5.73	2.43	13.53

Values are presented as number (%).

RSV, respiratory syncitial virus; OR, odds ratio; CI, confidence interval.

^∗ By Chi-sqaure test.

^† By Taylor series CI method.

Table 4.

Various Risk Factors for Recurrent Wheezing in Continuous Data

Factors	Recurrent wheezing (+) (n=39)	Recurrent wheezing (−) (n=119)	P -value^∗
Age (mo)	14.7 9.8 ±	14.6 10.0 ±	0.969
Admission duration (day)	7.5 2.9 ±	6.9 3.0 ±	0.228
Gestational age (wk)	38.8 1.6 ±	39.1 2.0 ±	0.320
Height (cm)	77.4 10.2 ±	76.7 10.7 ±	0.718
Weight (kg)	10.6 2.8 ±	10.2 2.9 ±	0.382

Values are presented as mean±SD.

^∗ By Studentt-test.

Table 5.

Odds Ratios of Risk Factors for Recurrent Wheezing Symptoms by Logistric Regression Analysis

Factors	P -value	Odds ratio	95% confidence interval
Factors	P -value	Odds ratio	Lower	Upper
Male	0.040	2.49	1.04	5.92
Parents history for allergic diseases	0.039	2.41	1.05	5.52
RSV (+)	0.000	5.76	2.35	14.09

RSV, respiratory syncitial virus.

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