Fever, use of antibiotics, and acute gastroenteritis during infancy as risk factors for the development of asthma in Korean school-age children.
OBJECTIVE
The hygiene hypothesis postulates that infections early in life might influence the development of asthma later in childhood. However, this hypothesis is controversial. The objective of this study was to determine whether there is a relationship between infection-related risk factors during infancy and development of asthma later in childhood.


METHODS
Data were obtained by a nationwide, population-based, cross-sectional study of 26,400 children, 7 to 12 years of age. Parents completed a questionnaire on symptoms of and risk factors for asthma, including the number of fever episodes, acute gastroenteritis, use of antibiotics, and immunization during infancy. The presence of asthma was defined by parental report of "wheeze in the last 12 months" or "asthma ever." Data were analyzed by logistic regression analysis.


RESULTS
The occurrence of fever during infancy was weakly associated with the development of asthma (P < 0.05). A higher frequency of episodes of fever was associated with a higher risk of development of asthma. The relationship between antibiotic use during infancy and development of asthma was also significant (P < 0.0001). The adjusted odds ratios of childhood asthma increased in proportion to the number of antibiotic courses during infancy. A history of acute gastroenteritis during infancy increased the risk of developing asthma in later life (P < 0.001). In contrast, immunization in infancy was not related to development of asthma in childhood (P > 0.05).


CONCLUSIONS
These data suggest that the development of childhood asthma is associated with episodes of fever, antibiotic use, and acute gastroenteritis during infancy.
Ahn
Kang-Mo
KM
Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Lee
Moo-Song
MS
Hong
Soo-Jong
SJ
Lim
Dae-Hyun
DH
Ahn
Young-Min
YM
Lee
Hae-Ran
HR
Lee
Myung-Ik
MI
Lee
Myung-Hyun
MH
Shin
Young-Kyu
YK
Kim
Kyu-Earn
KE
D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001249:Asthma / Q000453:epidemiology* / Q000209:etiology*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005334:Fever / Q000150:complications*; D005759:Gastroenteritis / Q000150:complications*; D006801:Humans; D006967:Hypersensitivity / Q000150:complications; D007114:Immunization / Q000009:adverse effects; D007723:Korea / Q000453:epidemiology; D008297:Male; D012307:Risk Factors
D000900:Anti-Bacterial Agents