Clinical risk factors at 3 months of age for the development of bronchial asthma at 36 months of age

Abstract

AbstractBackgroundWe examined the associations between factors evident at the routine 3‐month well‐child visit (WCV) and the risk of developing 36‐month parent‐reported physician‐diagnosed bronchial asthma (BA).MethodsThis longitudinal study was conducted in Nagoya City, Japan, and included 40,242 children who qualified for the 3‐month WCVs in the city between April 1, 2016 and March 31, 2018. In total, 22,052 (54.8%) questionnaires linked to their 36‐month WCVs were analyzed.ResultsThe prevalence of BA was 4.5%. The multivariable Poisson regression model identified male sex (adjusted risk ratio [aRR], 1.59; 95% confidence interval [CI]: 1.40–1.81), born in autumn (aRR, 1.30; 95% CI: 1.09–1.55), having at least one sibling (aRR, 1.31; 95% CI: 1.15–1.49), wheeze history before 3‐month WCVs, with clinic/hospital visit: aRR, 1.99; 95% CI: 1.53–2.56; hospitalization: aRR, 2.99; 95% CI: 2.09–4.12, eczema with itch (aRR, 1.51; 95% CI: 1.27–1.80), paternal history of BA (aRR, 1.98; 95% CI: 1.66–2.34), maternal history of BA (aRR, 2.11; 95% CI: 1.77–2.49), and rearing pets with fur (aRR, 1.35; 95% CI: 1.15–1.58) were independent risk factors for BA at 36 months of age. The combination of severe wheeze history (with clinic/hospital visit or hospitalization) and maternal and paternal BA could identify high‐risk infants whose prevalence of BA was 20%.ConclusionsThe combined assessment of important clinical factors enabled us to identify high‐risk infants set to derive optimal benefit from health guidance provided to the parent or caregiver of the child or infant at WCVs.