Modern Pediatrics.Ukraine.2019.7(103):23-28; doi 10.15574/SP.2019.103.23

O.V. Sharikadze
Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine

For citation: Sharikadze OV. (2019). The features of bronchial asthma in depend on the comorbid pathology in preschool children. Modern Pediatrics. Ukraine. 7(103): 23-28. doi 10.15574/SP.2019.103.23
Article received: Jul 25, 2019. Accepted for publication: Nov 05, 2019.

Goal. Analysis of the prevalence and structure of asthma in preschool children with the comorbid pathology and determine the probable predictors of asthma formation.
Materials and methods. For the period 2014–2019, 1500 patients from birth to 7 years with atopic pathology were examined. Depending on their age, the children were divided into groups: 1st group — 0–1 year (47 people), 2nd group — 1–3 years (297 people) and 3rd group — 3–7 years (1156 people). In the first stage, in order to fulfill this goal, we conducted an analysis of the prevalence and features of allergopathology formation in 501 children. In order to further accomplish this goal, a detailed analysis of the follow-up and anamnestic parameters was performed in children who reached the age of 7 years (6 years, 11 months, 30 days), which were divided into 3 groups.
Results. The most common pathology for children between the ages of 1 and 1 years is isolated recurrence wheezing (RW), which was observed in 24.5% of patients, followed by food allergy (FA), which was 17.96% and was mainly due to allergy to cow milk proteins (CMP) (74.44%), the third place was shared by persistent allergic rhinitis (PAR) and combination of FA with atopic dermatitis (AtD) by 12.97%. Isolated asthma and asthma with high-frequency comorbid conditions are formed under the influence of the following factors: smoking in parents, difficult financial situation, intake of dydrogesterone and estradiol during pregnancy, frequent respiratory diseases and antibiotic year.
Conclusions. BA most often manifests at the age of 3–7 years (35.32%) and correlates with the presence in children of the first year of life the combination of RW+AR+AtD (71.42%). The most common comorbid condition in young children with BA is AR, this tendency persists in the future — 27.75% of children 3–7 years. Predictors of the development of asthma in preschool children are the presence of atopy in both parents (p=0.043), smoking of both parents (p=0.038), distress (p=0.031), hormonal support during pregnancy (p=0.027), antibiotic therapy (p=0.015) and frequent respiratory diseases (p=0.029) in the first year of life.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of an participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interest was declared by the author.
Key words: children, bronchial asthma, comorbidity, predictors.

REFERENCES

1. Korostovtsev DS, Makarova IV, Orlov AB i dr. (2002). Organizatsionnyie voprosyi lecheniya detey, bolnyih bronhialnoy astmoy (planovogo i v ostrom periode). Pulmonologiya. 1: 77–82.

2. Kabinet Ministriv Ukrainy (2015). Pro zatverdzhennia Natsionalnoho planu zakhodiv z implementatsii ta realizatsii zasad yevropeiskoi polityky «Zdorov'ia Yevropeiskoi polityky v pidtrymku dii derzhavy i suspilstva v interesakh zdorov'ia i blahopoluchchia» shchodo neinfektsiinykh zakhvoriuvan na period do 2020 roku: proekt rozporiadzhennia. https://www.moz.gov.ua/ua/portal/Pro_20150311_0.html

3. Almqvist C, Pershagenz G et al. (2005). Low socioeconomic status as a risk factor for asthma, rhinitis and sensitization at 4 years in a birth cohort. Clin Exp Allergy 35: 612–618. https://doi.org/10.1111/j.1365-2222.2005.02243.x; PMid:15898983

4. Bai C, Jiang D, Wang L, Xue F, Chen O. (2019). A high blood eosinophil count may be a risk factor for incident asthma in population at risk. Respir Med. 151: 59–65. https://doi.org/10.1016/j.rmed.2019.03.016; PMid:31047119

5. Bugiani M, Carosso A, Migliore E et al. (2005). Allergic rhinitis and asthma comorbidity in a survey of young adults in Italy. Allergy. 60(2): 165–170. https://doi.org/10.1111/j.1398-9995.2005.00659.x; PMid:15647036

6. Forbes L. (1999). Do exogenous oestrogens and progesterone influence asthma? Thorax 54: 265–2. https://doi.org/10.1136/thx.54.3.265; PMid:10325904 PMCid:PMC1745451

7. Forno E, Ting Wang, Cancan Qi et al. (2019). DNA methylation in nasal epithelium, atopy, and atopic asthma in children: a genome-wide study. The Lancet: Respiratory medicine.7(4): 336–346. https://doi.org/10.1016/S2213-2600(18)30466-1

8. Haggerty CL, Ness R. (2003). The impact of estrogen and progesterone on asthma. Allergy Asthma Immunol. 90(3): 284–91. https://doi.org/10.1016/S1081-1206(10)61794-2

9. Hallita S, Raherisone C et al. (2018). The AAA Risk Factors Scale: A New Model to Screen for the Risk of Asthma, Allergic Rhinitis and Atopic Dermatitis in Children. Med Princ Pract. 27: 472–480. https://doi.org/10.1159/000490704; PMid:29879703 PMCid:PMC6243911

10. Huang K, Yang T. (2019). Prevalence, risk factors, and management of asthma in China: a national cross-sectional study. The Lancet. 394(10196): 407–418.

11. Lina J, Wanga W et al. (2018). Prevalence and risk factors of asthma in mainland China: The CARE study. Respiratory Medicine. 137: 48–54. https://doi.org/10.1016/j.rmed.2018.02.010; PMid:29605212

12. Peters U, Dixon AE et al (2018). Obesity and asthma. Allergy Clin Immunol. 141(4): 1169–1179. https://doi.org/10.1016/j.jaci.2018.02.004; PMid:29627041 PMCid:PMC5973542

13. Tormanen S, Lauhkonen E et al. (2018). Risk factors for asthma after infant bronchiolitis. Allergy. 73(4): 916–922. https://doi.org/10.1111/all.13347; PMid:29105099

14. Sarnowski Ch, Granell R, Laprise C et al. (2019). Genome-wide interaction study of early-life smoking exposure on time-to-asthma onset in childhood. Clin Exp Allergy. 49: 1342–1351. https://doi.org/10.1111/cea.13476;
PMid:31379025

15. Sears MR, Justina M. (2003). Longitudinal, Population-Based, Cohort Study of Childhood Asthma Followed to Adulthood. Engl J Med. 349: 1414–1422. https://doi.org/10.1056/NEJMoa022363; PMid:14534334

16. Simpson BM, Custovic A et al. (2001). NAC Manchester Asthma and Allergy Study (NACMAAS): risk factors for asthma and allergic disorders in adults. Clin Exp Allergy. 3: 391–399. https://doi.org/10.1046/j.1365-2222.2001.01050.x; PMid:11260150

17. Stokholm J, Blaser MJ, Thorsen J, Rasmussen MA, Waage J et al. (2018, Jan 10). Maturation of the gut microbiome and risk of asthma in childhood. Nat Commun.9(1):141. https://doi.org/10.1038/s41467-017-02573-2; PMid:29321519 PMCid:PMC5762761.

18. Vedel C, Larsen H et al. (2016). Long-term effects of prenatal progesterone exposure: neurophysiological development and hospital admissions in twins up to 8 years of age. Ultrasound Obstet Gynecol. 48: 382–389. https://doi.org/10.1002/uog.15948; PMid:27106105