2010, Number 4
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Bol Med Hosp Infant Mex 2010; 67 (4)
Association among prematurity, low birth weight and exclusive breastfeeding with allergic rhinitis in 2 to 7 year-old pediatric patients from Hospital Nacional Cayetano Heredia, Peru
Goycochea VWA, Hidalgo TCM, Hérnandez DH, Centeno HJ
Language: Spanish
References: 28
Page: 315-326
PDF size: 267.18 Kb.
ABSTRACT
Background. The association among perinatal factors for the development of allergic rhinitis is controversial. The aim of this study was to determine the association among prematurity, low birth weight, and exclusive breastfeeding with allergic rhinitis in pediatric patients from the Hospital Nacional Cayetano Heredia (HNCH).
Methods. We carried out a case-control study with a sample size of 366 children (122 cases and 244 controls) (a = 5%; b = 20%). A questionnaire was completed through direct interview with the parents to assess allergic rhinitis symptoms in order to classify the children as cases or controls. Previous medical history such as birth weight, gestational age and exclusive breastfeeding were entered and verified with the clinical chart of the patients as well as with the growth and development chart.
Results. There were 369 children included in the study aged 2 to 7 years. They were seen as outpatients at the Pediatric Service at HNCH between August 2006 and June 2007. Of these children, 156 met the criteria for cases and 213 were identified as controls. An odds ratio (OR) of 0.53 was found (95% CI 0.35-0.80, p = 0.0025) for the association between allergic rhinitis and exclusive breastfeeding. Also, an OR of 0.55 (95% CI 0.27-1.12, p = 0.0658) was found for allergic rhinitis and low birth weight and an odds ratio of 1.20 (95% CI 0.67-2.17, p = 0.5414) was found for allergic rhinitis and prematurity. A stratified analysis was executed to evaluate the relationship between allergic rhinitis and exclusive breastfeeding with a family history of atopy and early environmental tobacco smoke exposure. Mantel-Haenszel statistical test was used for this purpose: OR of 0.52 was found (95% CI, 0.33-0.78, p = 0.0025) for the association between allergic rhinitis and exclusive breastfeeding with family history of atopy. Mantel-Haenszel odds ratio of 0.56 (95% CI 0.36-0.84, p = 0.0064) was found for the association between allergic rhinitis and exclusive breastfeeding with early environmental tobacco smoke exposure.
Conclusions. Our results support a protective effect for allergic rhinitis in children who receive exclusive breastfeeding. We did not find any association between prematurity and low birth weight with the subsequent development of allergic rhinitis. The previously described protective effect is seemingly not altered by family history of atopy or early exposure to environmental tobacco smoke.
REFERENCES
Ortega-López MC. Rinitis alérgica: un hecho. Revisión, seguimiento clínico y de tratamiento en 25 casos de niños y niñas menores de 2 años. Disponible en: http://med.javeriana.edu.co/publi/vniversitas/serial/v44n2/0017%20rinitis.pdf
Togias AG. Systemic immunologic and inflammatory aspects of allergic rhinitis. J Allergy Clin Immunol 2000;106(suppl 5):S247-S250.
Buckley R. T Lymphocytes, B lymphocytes, and natural killer cells. In: Behrman RE, Kliegman RM, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. Philadelphia: Saunders; 2003. pp. 683-689.
Gore C, Custovic A. Can we prevent allergy? Allergy 2004;59:151–161.
Beasley R. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. Lancet 1998;351:1225-1232.
Von Mutius E, Weiland SK, Fritzsch C, Duhme H, Keil U. Increasing prevalence of hay fever and atopy among children in Leipzig, East Germany. Lancet 1998;351:862-866.
Ellwood P, Asher MI, Björkstén B, Burr M, Pearce N, Robertson CF. Diet and asthma, allergic rhinoconjunctivitis and atopic eczema symptom prevalence: an ecological analysis of the International Study of Asthma and Allergies in Childhood (ISAAC) data. Eur Respir J 2001;17:436-443.
Braun-Fahrländer CH, Wüthrich B, Gassner M, Grize L, Sennhauser FH, Varonier HS, et al. Validation of a rhinitis symptom questionnaire (ISAAC core questions) in a population of Swiss school children visiting the school health services. SCARPOL-team. Swiss Study on Childhood Allergy and Respiratory Symptom with respect to Air Pollution and Climate. International Study of Asthma and Allergies in Childhood. Pediatr Allergy Immunol 1997;8:75-82.
Kull I, Wickman M, Lilja G, Nordvall SL, Pershagen G. Breast feeding and allergic diseases in infants-a prospective birth cohort study. Arch Dis Child 2002;87:478-481.
Saarinen UM, Kajosaari M. Breast-feeding as prophylaxis against atopic disease: prospective follow-up study until 17 years old. Lancet 1995;346:1065-1069.
Wright AL, Holberg CJ, Martinez FD, Morgan WJ, Taussig LM. Breast feeding and lower respiratory tract illness in the first year of life. Group Health Medical Associates. BMJ 1989;299:946-949.
Oddy WH, Holt PG, Sly PD, Read AW, Landau LI, Stanley FJ, et al. Association between breast feeding and asthma in 6 year old children: findings of a prospective birth cohort study. BMJ 1999;319:815-819.
Sears MR, Greene JM, Willan AR, Taylor DR, Flannery EM, Cowan J, et al. Long-term relation between breastfeeding and development of atopy and asthma in children and young adults: a longitudinal study. Lancet 2002;360:901-907.
Perez Lu JE, Centeno HJ, Chiarella OP, Pérez Lu LE, Sialer CS. Prevalencia de rinitis alérgica en pacientes pediátricos que acuden al servicio de emergencia del Hospital Nacional Cayetano Heredia por crisis de asma. Rev Med Hered 2003;14:111-116.
Redline S, Larkin EK, Kerscman C, Berger M, Siminoff L. Development and validation of school based asthma and allergy screening instruments for parents and students. Ann Allergy Asthma Inmunol 2003;90:516-528.
Von Mutius E. The environmental predictors of allergic disease. J Allergy Clin Immunol 2000;105(1 Pt 1 ):9-19.
Leynaert B, Neukirch F, Demoly P, Bousquet J. Epidemiologic evidence for asthma and rhinitis comorbidity. J Allergy Clin Immunol 2000;106:S201-S205.
Oddy WH, Peat JK de Klerk NH. Maternal asthma, infant feeding and risk of asthma in childhood. J Allergy Clin Inmunol 2002;110:65-67.
Von Mutius E. Environmental factors influencing the development and progression of pediatric asthma. J Allergy Clin Inmunol 2002;109(suppl 6):S525-S532.
Duchén K, Casas R, Fageras-Böttcher M, Yu G, Björkstén B. Human milk polyunsaturated long-chain fatty acids and secretory immunoglobulin A antibodies and early childhood allergy. Pediatr Allergy Immunol 2000;11:29-39.
Verhasselt V, Milcent V, Cazareth J, Kanda A, Fleury S, Dombrowicz D, et al. Breast milk-mediated transfer of an antigen induces tolerance and protection from allergic asthma. Nat Med 2008;14:170-175.
Udall JN, Colony P, Fritze L, Pang K, Trier JS, Walker WA. Development of gastrointestinal mucosal barrier. II. The effect of natural versus artificial feeding on intestinal permeability to macromolecules. Pediatr Res 1981;15:245-249.
Newburg DS, Walker WA. Protection of the neonate by the innate immune system of developing gut and of human milk. Pediatr Res 2007;61:2-8.
Sheriff A, Peters TJ, Henderson J, Strachan D, The Alspac Study Team. Risk factor associations with wheezing patterns in children followed longitudinally from birth to 3 1/2 years. Int J Epidemiol 2001;30:1473-1484.
Steffensen FH, Sorensen HT, Gillman MW, Rothman KJ, Sabroe S, Fischer P, et al. Low birth weight and preterm delivery as risk factors for asthma and atopic dermatitis in young adult males. Epidemiology 2000;11:185-188.
Fuertes FEJ, Meriz RJ, Isanta PC, Pardos MC, López CV, González PE. Prevalencia actual de asma, alergia e hiperreactividad bronquial en niños de 6 a 8 años. An Esp Pediatr 2001;55:205-212.
Räsänen M, Kaprio J, Laitinen T, Winter T, Koskenvuo M, Laitinen L. Perinatal risk factors for asthma in Finnish adolescent twins. Thorax 2000;55:25-31.
Seidman DS, Laor A, Gale R, Stevenson DK, Danon YL. Is low birth weight a risk factor for asthma during adolescence? Arch Dis Child 1991;66:584-577.