Rhinovirus bronchiolitis, maternal asthma, and the development of asthma and lung function impairments

Abstract

Background: Children with a history of rhinovirus (RV) positive bronchiolitis have a high risk of developing subsequent asthma. Maternal asthma might also increase this risk. The aim of this study was to investigate the combined effects of hospitalization for RV positive bronchiolitis in infancy and a history of maternal asthma on the development of asthma at preschool age. Methods: This is a prospective cohort study of 139 preschool-aged children, with a history of hospital admission for bronchiolitis in infancy, followed-up to ascertain asthma and asthma-like symptoms, skin prick allergy test positivity, and lung function measured pre-and post-bronchodilator using impulse oscillometry. Results: Children with a past hospitalization for RV positive bronchiolitis (42.4% of all) and a history of maternal asthma (36.7% of all) had the greatest prevalence and risk ratio (RR) for doctor-diagnosed asthma (prevalence 81.8% and RR 2.10, 95% confidence interval [CI] 1.37-3.19, p = .001), use of inhaled corticosteroids (68.2% and RR 2.17, 95% CI 1.19-3.99, p = .001) and short-acting β-agonists in the last 12 months (95.2% and RR 1.49, 95% CI 1.17-1.89, p = .001), as compared to those with RV negative bronchiolitis and no maternal asthma history. More children in this group had an abnormal airway resistance (33.3% and adjusted risk ratio [aRR] 3.11, 95% CI 1.03-9.47, p = .045) and reactance (27.8% and aRR 2.11, 95% CI 1.06-4.26, p = .035) at 5 Hz, as compared to those with RV negative bronchiolitis and no maternal asthma history. Conclusion: Hospitalization for RV positive bronchiolitis in early life combined with a history of maternal asthma identifies a subgroup of children with a high asthma burden while participants with only one of the two risk factors had intermediate risk for asthma.

The role of respiratory syncytial virus‐ and rhinovirus‐induced bronchiolitis in recurrent wheeze and asthma—A systematic review and meta‐analysis

“…There were eight studies 9,10,17,22,40–42 and Makrinioti et al (https://doi.org/10.3389/falgy.2021.728389) investigating associations between RSV‐bronchiolitis and recurrent wheeze development as compared to RV‐bronchiolitis. All studies included in this meta‐analysis reported data for coinfections.…”

Bronchiolitis hospital admission in infancy is associated with later preschool ventilation inhomogeneity

“…12 In our previous study, oscillometry-based outcomes at this followup suggested that the combined effects of RV infection and maternal asthma history were associated with increased airway resistance and reactance at preschool age. 14 Here we add to this evidence by showing lung ventilation inhomogeneities in those children with a history of hospital admission for RV bronchiolitis which are more apparent in those with a severe clinical course.…”

“…One hundred and thirty-nine children were followed-up at preschool age after bronchiolitis admission in infancy as described previously. 14 Technically acceptable MBW data were collected for 84 out of 103 (82%) participants who attempted MBW, and 60% of the overall cohort could be followed up. There were no differences in baseline characteristics between children in the total cohort (n = 139) and children with acceptable MBW measurements (n = 85) (Table 1).…”

“…Children aged less than 24 months presenting to the emergency department or admitted to the ward were eligible for inclusion if they had a clinical diagnosis of bronchiolitis that was assessed as being of moderate or severe severity using the NSW Health clinical practice guideline and required supplemental oxygen as described by Kepreotes et al, and described by Da Silva Sena et al 7,14 During the HFWHO RCT, a diagnosis of bronchiolitis was made following the NSW Health Clinical practice guideline that states that children with moderate bronchiolitis need to be admitted to a hospital and be seen by a pediatrician. They usually presented with an unwell appearance, moderate tachypnea, mild or moderate work of breathing, with oxygen saturation between 90% and 95% in room air, mild tachycardia, and some feeding difficulty.…”

Are wheezing, asthma and eczema in children associated with mother’s health during pregnancy? Evidence from an Australian birth cohort

“…Pregnancy is a crucial period in determining the future health of the offspring [10] and hence, further understanding on mother's pregnancy health and children's respiratory and allergic diseases are necessary. To date several studies have shown that maternal asthma during pregnancy, pre-pregnancy obesity, and gestational weight gain are associated with an increased risk of asthma or wheezing in the offspring [12,[22][23][24]. However, most of these existing studies followed children from the first year of life to preschool or early school age [12,25].…”