A comprehensive assessment of postnatal risk factors associated with recurrent respiratory infections in preschool children

Abstract

Purpose - to determine the influence degree of particular postnatal risk factors to the likelihood of the recurrent course of acute respiratory infections (ARI) in preschool children. Materials and methods. Three hundred and fourteen children (176 boys and 138 girls) aged 1 to 6 years old, undergoing inpatient treatment on ARI, were involved in the clinical study. The number of ARI episodes during their previous year of life, as well as the presence or absence of 19 potential postnatal risk factors associated with recurrent respiratory infections (RRI), were taken into account for the examined children. Additionally, two integral indices of ARI recurrence, namely the infection index (InI) and resistance index (InR), were calculated. The statistical processing of the primary digital data obtained was performed by IBM SPSS Statistics 28 licensed program. A сross-tabulation method was applied to compute the odds ratio (OR) and its 95% confidence interval (CI). Results. The difference between the age subgroups of the examined preschool children in the ARI episodes number during their previous year of life was demonstrated (H=11.243; p=0.047). First of all, the higher incidence of ARI was detected among the patients aged 36 to 71 months compared with those aged 12 to 35 months. Besides, the weak but significant correlation was revealed between six stratified age subgroups of children and their clinical diagnoses (φc=0.183; p=0.006). The studied integral indicators of the recurrent course of ARI (InI and InR) are inversely correlated with the majority of the postnatal risk factors considered, with the degree of the relationship strength being higher for InR than for InI. Conclusions. The majority of the potential RRI risk factors registered, namely 10 out of 19, separately increase the probability of children belonging to the group with more frequent ARI episodes. The most significant risk factors of RRI were as follows: 1) breastfeeding for 0-4 months after birth (OR=2.868; p<0.001; 95% CI: 1.681-4.895), 2) an older child in a family attending an organized childhood group (OR=2.814; p<0.001; 95% CI: 1.662-4.763); 3) second-hand smoke exposure (OR=2.537; p<0.001; 95% CI: 1.509-4.267). The prevalence of the studied RRI risk factors among the preschool children does not correlate with their significance in contributing to more frequent ARI episodes. The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local ethics committees of the institutions mentioned in the paper. An informed parental consent was obtained for the study in children. No conflict of interests was declared by the author.