title: Gastroesophageal Reflux Disease Increases Infant Acute Respiratory Illness Severity, but not Childhood Asthma.
abstract: It is unknown whether gastroesophageal reflux disease (GERD) during infancy affects infant bronchiolitis severity or childhood asthma inception. Four hundred thirty-two infants presenting with acute respiratory illness due to bronchiolitis or upper respiratory infection were studied. The primary exposure was the parental report of a previous GERD diagnosis. Outcomes included bronchiolitis severity at initial presentation and childhood asthma diagnosis at age 4. Infants with parentally reported GERD had a higher bronchiolitis severity score (range=0-12, clinically significant difference=0.5), indicating more severe disease, than infants without reported GERD (median 5.5 [interquartile range 3.5-9.0] among those with reported GERD versus 4.0 [1.0-7.0] among those without,P=0.005). This association persisted after adjusting for infant age, race, gender, and secondhand smoke exposure by a propensity score (adjusted odds ratio [OR] 1.99, 95% confidence interval [CI] 1.14-3.46,P=0.02). The parental report of GERD during infancy was not associated with the parental report of asthma diagnosis at age 4. GERD during infancy may contribute to acute respiratory illness severity, but is not associated with asthma diagnosis at age 4. Future prospective studies are needed to confirm these findings.
authors.affiliation: Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine , Nashville, Tennessee.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Valet
authors.affiliation: Department of Pediatrics, Vanderbilt University School of Medicine , Nashville, Tennessee.
authors.forename: Kecia N
authors.initials: KN
authors.lastname: Carroll
authors.affiliation: Department of Biostatistics, Vanderbilt University School of Medicine , Nashville, Tennessee.
authors.forename: Tebeb
authors.initials: T
authors.lastname: Gebretsadik
authors.affiliation: Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine , Nashville, Tennessee.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Minton
authors.affiliation: Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine , Nashville, Tennessee.
authors.forename: Kimberly B
authors.initials: KB
authors.lastname: Woodward
authors.affiliation: Department of Biostatistics, Vanderbilt University School of Medicine , Nashville, Tennessee.
authors.forename: Zhouwen
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine , Nashville, Tennessee. ; Institute of Medicine and Public Health, Vanderbilt University School of Medicine , Nashville, Tennessee.
authors.forename: Tina V
authors.initials: TV
authors.lastname: Hartert