Virginia Pérez-Fernández

The International Study of Wheezing in Infants: Questionnaire Validation

Background: There are no internationally validated questionnaires to investigate the prevalence of infant wheezing. This study was undertaken to validate a questionnaire for the International Study on the Prevalence of Wheezing in Infants (Estudio Internacional de Sibilancias en Lactantes, EISL). Material and Methods: Construct and criterion validity were tested for the question ‘Has your baby had wheezing or whistling in the chest during his/her first 12 months of life?’. Construct validity (i.e. the ability of parents and doctors to refer to the same symptoms with the same words) was tested in a sample of 50 wheezing and 50 non-wheezy infants 12–15 months of age in each of 10 centres from 6 different Spanish- or Portuguese-speaking countries. Criterion validity (i.e. the ability of parents to correctly detect the symptom in the general population) was evaluated in 2 samples (Santiago, Chile and Cartagena, Spain) of 50 wheezing and 50 non-wheezing infants (according to parents) of the same age, randomly selected from the general population, who were later blindly diagnosed by a paediatric pulmonologist. Results: Construct validity was very high (ĸ test: 0.98–1) in all centres. According to Youden’s index, criterion validity was good both in Cartagena (75.5%) and in Santiago (67.0%). Adding questions about asthma medication did not improve diagnosis accuracy. Conclusions: The EISL questionnaire significantly distinguished wheezy infants from healthy ones. This questionnaire has a strong validity and can be employed in large international multicentre studies on wheezing during infancy.

Is the effect of prenatal paracetamol exposure on wheezing in preschool children modified by asthma in the mother

Background: There seems to be an association between paracetamol consumption during late pregnancy and the prevalence of wheezing in infancy and childhood. The aim of the present study is to determine whether the aforementioned association is modified by the presence of asthma in the mother. Methods: A total of 1,741 children aged 3–5 years from an epidemiological survey performed in the province of Murcia (Spain) were included in the analysis. Data on paracetamol consumption (never, at least once during pregnancy or at least once per month during pregnancy), wheezing symptoms in the offspring (according to the International Study of Asthma and Allergies in Childhood protocol) and the presence of asthma in the mother, together with other known risk factors for asthma, were obtained by means of a questionnaire. Results: The mean age of the children was 4.08 ± 0.8 years and 51.1% were males. The overall prevalence of current wheezing was 20.2%. The frequency of paracetamol usage was similar among asthmatic and non-asthmatic mothers, and only a small proportion of them took this drug at least once a month (13.8% of asthmatics and 11.0% of non-asthmatics). Compared to the mothers who never took paracetamol, there was a significant association between the mother having taken paracetamol at least once per month during pregnancy and the offspring suffering from wheezing at preschool age, but only among non-asthmatic mothers (odds ratio 1.94, 95% confidence interval 1.34–2.79 vs. odds ratio 1.05, 95% confidence interval 0.21–5.08). This association was maintained after controlling for potential confounders (odds ratio 1.74, 95% confidence interval 1.15–2.61). Conclusions: The frequent usage of paracetamol during pregnancy is associated with the prevalence of wheezing in offspring during preschool years. Asthma in the mother might modify this association.

Olive oil during pregnancy is associated with reduced wheezing during the first year of life of the offspring

To test the hypothesis that consuming Mediterranean diet and using olive oil for cooking/dressing salads during pregnancy might be associated with less wheezing during the first year of the offsprings life.

Evolucion de la mortalidad por asma en España, 1960-2005

BACKGROUND AND OBJECTIVE No data have been published on trends in asthma mortality in Spain between 1960 and 2005. The aim of this study was to trace these trends for both the general population and the 5- to 34-year age group in Spain. MATERIAL AND METHODS The data on asthma mortality for the general population and by age and sex were obtained from the Spanish National Institute of Statistics and used to calculate the asthma mortality rates per 100 000 inhabitants. RESULTS The overall asthma mortality rate per 100 000 inhabitants was 9.36 in 1960 and 2.22 in 2005, showing a reduction from 12.26 to 0.96 in males and from 6.58 to 3.44 in females. In the 5- to 34-year age group, the mortality rate for both sexes ranged from 0.4 to 0.1, showing great variability over time. CONCLUSIONS Asthma mortality decreased in the period analyzed, but less in women than in men. The trend and rates in Spain are similar to those of most countries for which data are available.

Lung function among infants born preterm, with or without bronchopulmonary dysplasia.

Both healthy preterm infants and those with bronchopulmonary dysplasia (BPD) have poor lung function during childhood and adolescence, although there is no evidence whether prematurity alone explains the reduction in lung function found in BPD infants. Our study seeks to know if lung function, measured in infancy by means of rapid thoracic compression with raised volume technique, is different between preterm infants with and without BPD.

Early exposure to acetaminophen and allergic disorders.

Purpose of reviewTo summarize the data related to the association between acetaminophen and allergic diseases, and to try to establish a conclusion regarding the extent to which the association is unbiased and what its strength might be. Recent findingsSeveral studies have shown an association between acetaminophen use during pregnancy and allergic diseases in the offspring. Furthermore, this association has also been found between early exposure and recent exposure to the drug and several allergic conditions. However, other studies did not confirm those associations. Taken together, the available data suggest an unbiased but weak association between acetaminophen consumption and asthma/wheezing. Additional studies are needed to definitely confirm the association with rhinitis, eczema and sensitization. SummaryAlthough the use of acetaminophen is weakly associated with asthma/wheezing, the widespread use of the drug might have important public health implications. Thus, controlled studies to definitely establish not only causality but also the magnitude in which acetaminophen might increase allergic disorders are needed.

A multinational study to compare prevalence of atopic dermatitis in the first year of life

Atopic dermatitis (AD) is common in childhood, with peak prevalence in early childhood. However, international comparisons of prevalence have focused on older children. We analysed differences in prevalence rates of AD and the associations with putative risk and protective factors, among infants in two European and two Central American countries.

Effect of foods and Mediterranean diet during pregnancy and first years of life on wheezing, rhinitis and dermatitis in preschoolers.

BACKGROUND There is a conflictive position if some foods and Mediterranean diet (MedDiet) consumed by the mother during pregnancy and by the child during the first years of life can be protective for current wheezing, rhinitis and dermatitis at preschool age. METHODS Questionnaires of epidemiological factors and food intake by the mother during pregnancy and later by the child were filled in by parents in two surveys at two different time points (1.5 yrs and 4 yrs of life) in 1000 preschoolers. RESULTS The prevalences of current wheezing, rhinitis and dermatitis were 18.8%, 10.4%, and 17.2%, respectively. After multiple logistic analysis children who were low fruit consumers (never/occasionally) and high fast-food consumers (≥3 times/week) had a higher risk for current wheezing; while intermediate consumption of meat (1 or 2 times/week) and low of pasta by mothers in pregnancy were protected. For current rhinitis, low fruit consumer children were at higher risk; while those consuming meat <3 times/week were protected. For current dermatitis, high fast food consumption by mothers in pregnancy; and low or high consumption of fruit, and high of potatoes in children were associated to higher prevalence. Children consuming fast food >1 times/week were protected for dermatitis. MedDiet adherence by mother and child did not remain a protective factor for any outcome. CONCLUSION Low consumption of fruits and high of meat by the child, and high consumption of potatoes and pasta by the mother had a negative effect on wheezing, rhinitis or dermatitis; while fast food consumption was inconsistent.

Lung function gain in preterm infants with and without bronchopulmonary dysplasia.

The aim of our study was to determine whether the development of lung function, during the first 2 years of life, is different in preterm infants who suffered or did not suffer from Bronchopulmonary dysplasia (BPD). We also assessed the role of nutritional status and growth in that development.

Trends in Asthma Mortality in Spain from 1960 to 2005

Background and objective: No data have been published on trends in asthma mortality in Spain between 1960 and 2005. The aim of this study was to trace these trends for both the general population and the 5- to 34-year age group in Spain. Material and methods: The data on asthma mortality for the general population and by age and sex were obtained from the Spanish National Institute of Statistics and used to calculate the asthma mortality rates per 100 000 inhabitants. Results: The overall asthma mortality rate per 100 000 inhabitants was 9.36 in 1960 and 2.22 in 2005, showing a reduction from 12.26 to 0.96 in males and from 6.58 to 3.44 in females. In the 5- to 34-year age group, the mortality rate for both sexes ranged from 0.4 to 0.1, showing great variability over time. Conclusions: Asthma mortality decreased in the period analyzed, but less in women than in men. The trend and rates in Spain are similar to those of most countries for which data are available.