Weight gain in infancy and post-bronchiolitis wheezing.
ABSTRACT Low birth weight, high birth weight and excessive weight gain after birth may be risk factors for asthma in childhood, but their associations with wheezing in early childhood are poorly studied. The aim of the study was to evaluate birth weight, weight gain in early infancy and overweight in infancy assessed by weight for length (WFL) as risk factors for wheezing after hospitalization for bronchiolitis in early infancy.
In all, 127 full-term infants hospitalized for bronchiolitis at age <6 months have been followed up until the mean age of 1.5 years. The weights and lengths of the infants were measured on admission to hospital and at the control visit. Birth weights were obtained from the hospital records.
Both occurrence and recurrence of post-bronchiolitis wheezing were associated with birth weight >4000 g and the recurrence of post-bronchiolitis wheezing with WFL >110% at age 1.5 years. The associations were robust to adjustments with gender and allergy. Higher weight gain from birth to hospitalization at age <6 months was associated with wheezing in the subgroup of children with birth weight >4000 g.
High birth weight and the development of overweight may be associated with post-bronchiolitis wheezing in infancy.
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ABSTRACT: Objective: To evaluate associations between different patterns of weight gain in the first year of life with the prevalence and severity of wheezing and asthma in infancy. Methods: Answers to the EISL questionnaire from 9159 parents living in the cities of São Paulo, Recife, Cuiabá, Curitiba and Belém were analyzed. Data from reported weight at birth and at one year were converted to Z-scores (z). Rapid weight gain was defined by the difference in weight superior to 0.67z and excessive weight gain by the difference superior to 2.01z. Results: Rapid weight gain was found in 55.7% infants and excessive weight gain in 20.8%. Infants with rapid weight gain showed a significantly higher prevalence of recurrent wheezing (18.9% vs. 18.2%) and hospitalization for wheezing (8.9% vs. 7.5%). Infants with excessive weight gain had a significantly higher prevalence of hospitalization for wheezing (10.1% vs. 7.8%) and medical diagnosis of asthma (8.7% vs. 7.3%). Breastfeeding for at least six months was significantly less frequent among infants with rapid weight gain (45.2% vs. 51.4%). Conclusions: The majority of the evaluated infants showed weight gain above expected in the first year of life. Rapid and excessive weight gain in the first year of life were significantly associated with more severe patterns of wheezing in infancy, while excessive weight gain was associated with the medical diagnosis of asthma, independently from the presence of breastfeeding.Revista Portuguesa de Imunoalergologia 01/2013; 21(1):19-26.
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ABSTRACT: Objetivo: Avaliar a relação entre diferentes padrões de ganho de peso no primeiro ano de vida e a prevalência e gravidade de sibilância e asma nesse período. Métodos: Foram analisadas as respostas do questionário EISL de 9159 pais moradores das cidades de São Paulo, Recife, Cuiabá, Curitiba e Belém. Os dados referidos do peso de nascimento e com um ano de vida foram convertidos em Z -scores (z). Foram considerados como tendo ganho de peso acelerado aqueles com diferença entre os pesos superior a 0,67z e ganho de peso excessivo aqueles com diferença superior a 2,01z. Resultados: Ganho de peso acelerado foi observado em 55,7% dos lactentes e ganho excessivo em 20,8%. Lactentes com ganho de peso acelerado apresentaram prevalência significativamente maior de sibilância recorrente (18,9% vs. 18,2%) e hospitalização por sibilância (8,9% vs. 7,5%). Entre os lactentes com ganho de peso excessivo houve significativamente maior prevalência de hospitalização por sibilância (10,1% vs. 7,8%) e diagnóstico médico de asma (8,7% vs. 7,3%). A presença de aleitamento materno por pelo menos seis meses foi significativamente menor naqueles com ganho acelerado de peso (45,2% vs. 51,4%). Conclusões: A maioria dos lactentes avaliados no presente estudo apresentou ganho de peso superior ao esperado durante o primeiro ano de vida. O ganho de peso acelerado e excessivo no primeiro ano de vida foram significativamente associados a formas mais graves de sibilância, enquanto que o ganho de peso excessivo foi associado ao diagnóstico médico de asma, independentemente da presença do aleitamento materno.
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ABSTRACT: To provide perspective to the most recent evidence regarding the association between early weight gain in infancy and the development of asthma and atopy during childhood, and highlight the potential mechanisms involved. Recently, several birth cohort studies involving more than 25 000 children have found a consistent association between early weight gain in the first 2 years of life and incident asthma during school age. Methodology differs substantially between the studies and complicates the establishment of definite conclusions. Specific mechanisms for this association have been proposed, including impairment in lung development and elevated levels of growth factors and cytokines associated with airway inflammation and remodeling. A limited number of studies indicate that early weight gain in infancy is also associated with recurrent wheezing during preschool age but not with the development of atopy. A consistent association between early weight gain in infancy and incident asthma during school age has been observed in several cohort studies. The identification of this modifiable risk factor for the development of asthma opens the possibility of preventive intervention. Additional studies are necessary to clarify the involved mechanisms and some pending questions, such as the influence of early weight gain in asthma phenotypes and severity.Current Opinion in Allergy and Clinical Immunology 01/2014; · 3.40 Impact Factor