To evaluate the outcome of asthma in preschool-age children who were hospitalized at <6 months of age for bronchiolitis. Other predictors of childhood asthma were collected about parental risk factors and atopic dermatitis in children.
Full-term infants (n = 166) <6 months of age were enrolled upon hospitalization for bronchiolitis and were followed up at 5 to 6 years of age.
From participant nasopharyngeal aspirates, 7 viruses including respiratory syncytial virus (RSV) and rhinovirus were assessed for the bronchiolitis etiology. At follow-up, questionnaires identified doctor-diagnosed asthma, inhaled corticosteroid usage, parental report of wheezing episodes, information of current (past 12 months) asthma symptoms, atopic dermatitis, and allergic rhinitis.
The predominant virus was RSV (70.5%) in the 166 bronchiolitis hospitalizations at <6 months. Follow-up at 6.5 years of age reported only 7.7% (9 children) of the former RSV hospitalized bronchiolitis group was shown to have developed asthma, which was defined by the use of continuous or intermittent inhaled corticosteroids. Conversely, the former non-RSV bronchiolitis group showed a 24.4% rate of asthma.
Asthma at preschool age was more common after non-RSV bronchiolitis in infancy. Notably, the prevalence (12.6%) of the 2 groups was significantly lower than previously reported values.
The findings of this prospective study contribute to the debate that is ongoing about RSV/non-RSV bronchiolitis at infancy as an asthma predictive factor. This study contributes new data to the debate on bronchiolitis admissions at age <6 months. However, the reported rate of asthma in the follow-up group was notably lower than what has been reported in previous research. Future research should focus on investigating further the mechanisms of viral etiology in bronchiolitis and whether it can contribute to early-life risk factors for developing asthma.
- Copyright © 2012 by the American Academy of Pediatrics