Assessing the association between bronchiolitis in infancy and recurrent wheeze: a whole English birth cohort case–control study

Abstract

The precise association between bronchiolitis and predisposition to childhood wheeze is unclear. We assessed bronchiolitis aetiology and later wheeze phenotypes in the entire 2007 English birth cohort. All infants admitted to hospital in England during their first year of life with bronchiolitis or urinary tract infection (UTI) were followed using Hospital Episode Statistics to determine risk and characteristics of wheeze admission over the subsequent 8 years. In our cohort of 21 272 children compared with UTI, the risk of wheeze admission was higher with previous bronchiolitis (risk ratio (RR) 2.4), even higher in those with non-respiratory syncytial virus bronchiolitis (RR 3.1) and persisted into late-onset wheeze (RR 1.7).

The wheezy legacy of infant bronchiolitis

“…Marlow et al 6 confirmed the association between infants with bronchiolitis and wheeze, but his study lacks some information that is missed when using discharge codes. The authors reported that a group of infants had bronchiolitis caused by RSV, but they did not describe the aetiological agents in the other two groups.…”

“…Marlow et al 6 confirmed the association between bronchiolitis and wheeze, but the question is still open. Is it RSV that causes bronchial hypersensitivity and the development of asthma or rather, does the virus identify those infants that have a genetic predisposition for the development of RW and asthma?…”

“…The article in this issue of Thorax by Marlow et al ,6 presented an English birth cohort study on the association between bronchiolitis and wheezing at the age of 8 years. They used hospital discharge codes to create two cohorts: one with bronchiolitis cases and one with urinary tract infection controls.…”

“…In the study by Marlow et al, 6 the definition used to diagnose bronchiolitis is not clear, as well as the clinical, demographic and biological characteristics of the infants included in the study. Bronchiolitis’ clinical definition remains controversial.…”

Viral wheezing in early childhood as a risk factor for asthma in young adulthood

“…3 Previous birth cohort and post-bronchiolitis studies reported that bronchiolitis and wheezing in early childhood may have long-term effects on respiratory health. 4,5 Wheezing and asthma symptoms, although common after bronchiolitis at preschool age, usually improve at school age. However, after puberty, the symptoms may recur, even in those without any symptom recurrence after bronchiolitis.…”