Overweight and Obesity as a Risk Factor for Severe Wheezing in Pre-school Children

Background Recently, overweigth/obesity were found to be a risk factor for asthma.

Objective The aim of the study was to investigate the relationship between obesity in early life and recurrent wheezing.

Methods: One-hundred and fifty pre-school children with recurrent wheezing were enrolled in this retrospective cohort study in Santos, Brazil. Children were followed in our pediatric allergy unit and the data of birth weigth, annual weigth and height, were reviewed from their electronic medical records from birth up to 5 years old, during the period from 2015 to 2017. International Body Mass Index (BMI) cut-offs were used to define: normal weight: BMI ≤85th; risk of overweight: 85 < BMI ≤ 97th; overweight: BMI >97th obesity: BMI >99.9. Recurrent wheezing was defined as three or more wheezing episodes in the past year. Severe wheezing was considered uncontrolled wheezing despite high doses of inhaled corticosteroids or that had indication to hospitalization. Infection of the upper or lower respiratory tract requiring antibiotics were recorded. The association between severe wheezing and risk factors studied was assessed by Poisson regression analysis at a 5% statistical significance.

Results: Adjusted analysis revealed that overweigth/obese children presented 2.23 of Incidence Rate Ratio to development of severe wheezing (p= 0.002). On the other hand there was no significant association between low bith weigth or respiratory infection and severe wheezing .

Conclusion: Overweigth and obesity in early life were associated with severe wheezing in pre-school children.