Purpose of the Study. To evaluate risk factors and short term outcome for subsequent wheezing in children with early bronchiolitis or pneumonia.Study Population. One hundred twenty-seven children (0 to 2 years old) hospitalized for wheezing (83) or pneumonia in a 1-year period in two hospitals in Finland.Methods. Patients with a history of hospitalization for wheezing with respiratory infection (including bronchiolitis) versus pneumonia were examined, and their parents were interviewed at 1 month, 1.5 to 2 years, and 2.5 to 3 years. Family history of atopy, environmental factors, breast feeding history, and other atopy (eczema, elevated IgE) were noted using a standardized questionnaire and physician-documented wheezing episodes were quantified. Statistical χ2 tests were analyzed comparing the wheezing group to the control group of patients with pneumonia not associated with wheezing.Findings. There was no significant difference between the groups in bacterial versus viral etiology of their lower respiratory symptoms. Subsequent wheezing after bronchiolitis occurred in 76% of children 1-2 years of age and 58% of children at 2-3 years of age. This compares with 9% and 16% (respectively by age) of the group with "non-wheezing" pneumonia. Atopic diathesis, particularly a positive family history of asthma was the host factor best associated with initial wheezing. Parenthetically, parental smoking was found in 61% of the wheezing group and 45% of the pneumonia group.Reviewer's Comments. This is a sound study, perhaps limited, in its comparability to our clinical populations with wider racial and socioeconomic diversity. Of note is the finding of no differences between the wheezing and nonwheezing groups in bacterial and viral etiologies.
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