The effects of respiratory infections, atopy, and breastfeeding on childhood asthma

Oddy, W. H., de Klerk, N. H., Sly, P. D. and Holt, P. G. (2002) The effects of respiratory infections, atopy, and breastfeeding on childhood asthma. European Respiratory Journal, 19 5: 899-905. doi:10.1183/09031936.02.00103602


Author Oddy, W. H.
de Klerk, N. H.
Sly, P. D.
Holt, P. G.
Title The effects of respiratory infections, atopy, and breastfeeding on childhood asthma
Journal name European Respiratory Journal   Check publisher's open access policy
ISSN 0903-1936
1399-3003
Publication date 2002-05-01
Year available 2002
Sub-type Article (original research)
DOI 10.1183/09031936.02.00103602
Open Access Status Not yet assessed
Volume 19
Issue 5
Start page 899
End page 905
Total pages 7
Place of publication Lausanne, Switzerland
Publisher European Respiratory Society
Language eng
Abstract The objectives of the present study were to quantify the association of atopy and respiratory infections with asthma, and exclusive breastfeeding with respiratory illness, atopy and asthma in children. A cohort study of 2,602 children enrolled prior to birth and followed prospectively, provided data on respiratory illness, the method of feeding in the first year of life, as reported on a prospective diary card, and current asthma at the age of 6 yrs (defined as doctor-diagnosed asthma with wheeze in the last year or cough without a cold, and currently taking either preventer or reliever asthma medication), as reported by parental questionnaire. Atopy was defined by a positive skin-prick test assessed at the age of 6 yrs. Wheezing lower respiratory illness (LRI) in the first year of life, particularly multiple episodes of wheezing LRI, increased the risk for current asthma in both nonatopic (odds ratio (OR) 4.10, p≤0.0005) and atopic children (OR 9.00, p≤0.0005), but did not increase the risk for atopy. In contrast, up to three upper respiratory tract infections demonstrated a negative association and four or more a positive risk for current asthma in unadjusted (p=0.006) and adjusted (p=0.057) analysis. Following adjustment, exclusive breastfeeding for <4 months was associated with an increased risk for current asthma (OR 1.36, 95% confidence interval 1.00-1.85, p=0.047). Wheezing lower respiratory illness in the first year of life and atopy are independently associated with increased risk for current asthma at the age of 6 yrs, suggesting that their effects are mediated via different causal pathways and that these risk factors are multiplicative when they operate concomitantly within individual children. Exclusive breastfeeding protects against asthma via effects on both these pathways, as well as through other as yet undefined mechanisms.
Keyword Breastfeeding
Childhood asthma
Respiratory infections
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: Faculty of Health and Behavioural Sciences -- Publications
 
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