PEDIATRICS Vol. 108 No. 4 October 2001, pp. 943-948
Respiratory Infections in Infants: Interaction of Parental
Allergy, Child Care, and Siblings
The PIAMA Study
Received Nov 10, 2000; accepted Feb 13, 2001.
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From the * Department of Pediatrics, Sophia Children's
Hospital, Erasmus University, Rotterdam, The Netherlands;
Objective. To investigate the
association between contacts with other children and the development of
respiratory infections in the first year of life in children with or
without genetic predisposition for allergy.
Methods. Children (n = 4146) who
participate in a prospective birth cohort study (Prevention and
Incidence of Asthma and Mite Allergy study) were investigated.
Questionnaires were used to obtain information on doctor-diagnosed
upper respiratory tract infection (URTI) and lower respiratory tract
infection (LRTI), child care attendance, having siblings, family
history of allergic disease, and various potential confounders.
Results. Child care attendance in the first year of life
was associated with doctor-diagnosed URTI (adjusted odds ratio [AOR]:
2.7; 95% confidence interval [CI]: 2.1-3.4 for large child care
facility vs no child care) and doctor-diagnosed LRTI (AOR: 5.6; 95%
CI: 3.9-7.9). Having siblings was associated with doctor-diagnosed LRTI (AOR: 2.6; 95% CI: 2.0-3.4). In addition, children who have allergic parents and attend child care or have older siblings have a
higher risk of developing doctor-diagnosed LRTI than do children who
have nonallergic parents.
Conclusions. Child care attendance or having siblings
increases the risk of developing doctor-diagnosed LRTI in the first
year of life to a greater extent in allergy-prone children than in
children who are not allergy prone.
Departments of Chronic Disease Epidemiology and Infectious Diseases
Epidemiology, National Institute of Public Health and the Environment,
Bilthoven, The Netherlands; § Department of Environmental and
Occupational Health, Institute for Risk Assessment Sciences, University
of Utrecht, Utrecht, The Netherlands; and Beatrix Children's
Hospital, Groningen University, Groningen, The Netherlands.
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