Strategies for preventing wheezing and asthma in small children.
OBJECTIVE
To assess the effects of living in agreement with allergy preventive guidelines on wheezing and asthma at 2 years of age.


METHODS
Prospective birth cohort study (BAMSE). Questionnaires on heredity and environmental factors were answered when the child was 2 months, and detailed questionnaires on symptoms at 1 and 2 years of age.


METHODS
4089 children, born during 1994-1996.


METHODS
Child Health Centres in central and north-western parts of Stockholm, Sweden.


METHODS
Wheezing and asthma up to the age of 2.


RESULTS
The effects of preventive guidelines regarding breastfeeding, maternal tobacco smoke and home dampness on wheezing and asthma were assessed in multiple logistic regression models. The cumulative incidence of recurrent wheezing at 2 years of age was 12.6% and of asthma 6.8% among those with a lifestyle in agreement with all guidelines and 24.1 and 17.9%, respectively, in families exposed to at least two of the three risk factors. Among children with no heredity, family lifestyle according to the guidelines gave a twofold reduction of asthma (5.3 vs. 10.5%), while the group with heredity had a threefold reduction (9.1 vs. 27.3%). The attributable fraction for asthma associated with the guidelines was 23% in total and 33% among those with heredity.


CONCLUSIONS
In this observational study, family lifestyle according to preventive guidelines is associated with an important reduction of recurrent wheezing and asthma at 2 years of age, especially among children with allergic heredity. A follow-up will determine whether there still a risk reduction of both symptoms and disease.
Wickman
M
M
Department of Occupational and Environmental Health, Stockholm County Council, Stockholm, Sweden.
Melén
E
E
Berglind
N
N
Lennart Nordvall
S
S
Almqvist
C
C
Kull
I
I
Svartengren
M
M
Pershagen
G
G
D001249:Asthma / Q000209:etiology / Q000235:genetics / Q000517:prevention & control*; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D008423:Maternal Age; D016017:Odds Ratio; D011322:Primary Prevention; D011446:Prospective Studies; D012111:Residence Characteristics; D012135:Respiratory Sounds / Q000209:etiology* / Q000235:genetics; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects
D014028:Tobacco Smoke Pollution