Prevalence of asthma, allergic rhinitis and pollinosis in a city of Brazil: A monitoring study

BACKGROUND: Allergic respiratory diseases such as asthma and allergic rhinitis have increased considerably in the last decades. OBJECTIVE: The present study estimates prevalence trends of asthma, allergic rhinitis and pollinosis in the population of a city of Southern Brazil, without restriction of age, from 2011 to 2018, using the ISAAC standardized questionnaire. METHODS: Data was collected from March to June of 2011 and during the same months in 2018, in order to verify trends in the prevalence of these allergic conditions. The total sample consisted of 3132 individuals of both sexes living in the municipality of Santo Ângelo, in the state of Rio Grande do Sul, Brazil. RESULTS: No differences were observed in the prevalence of asthma diagnosis (15.1% in 2011 and 13.8% in 2018), however the prevalence of current wheeze was significantly reduced from 24.7% in 2011 to 21.2% in 2018 (p < 0.05). Regarding allergic conditions in 2011 and in 2018, a significant reduction was observed (p < 0.001) in reported current rhinitis (63.3% vs. 50.5%), rhinoconjunctivitis (48.9% vs. 38.8%), hay fever (52.0% vs. 43.3%), and pollinosis (29.0% vs 17.0%). Moreover, we observed an inverse relation between age and rhinoconjunctivitis and hay fever, and all symptoms were more frequent in females. Rhinoconjunctivitis and hay fever, as well as current rhinitis and pollinosis were highly prevalent among 30-39 years-old individuals, whereas current wheeze affected mainly the age group 10-19 years-old. CONCLUSION: While the prevalence of asthma remained similar after seven years, allergic rhinitis and pollinosis declined between 2011 and 2018

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Young maternal age at delivery is associated with asthma in adult offspring.

OBJECTIVE: Some studies have shown an association between lower maternal age at delivery and increased asthma in children and young adults. It is unclear whether this represents an effect of maternal ageing or a protective effect of siblings. In a North-European population based study, we investigated whether mother's age at delivery was associated with risk for asthma and hay fever in adult offspring, taking into account relevant confounders. METHODS: A total of 16,190 subjects (74%) aged 23-54 yr answered a postal questionnaire in a follow-up of the European Community Respiratory Health Survey (ECRHS I). RESULTS: The associations of maternal age at delivery with hay fever, respiratory symptoms and diagnosed asthma were analysed using logistic regression, adjusting for household size, dwelling, parental education, centre, gender, adult hay fever, smoking, age and body mass index (BMI). The adjusted odds ratios (95% CI) for wheeze with breathlessness, wheeze without a cold and asthma in the offspring were 0.94 (0.90-0.99), 0.89 (0.86-0.94) and 0.92 (0.88-0.97), respectively, per 5 yr increase in maternal age. No heterogeneity between centres was found (p=0.84). The estimates remained similar in sub-sample analyses when adjusting for siblings, maternal smoking (n=3109) and for birth weight (n=1686). Hay fever was more common among those with the youngest and oldest mothers. CONCLUSIONS: In this large North-European multi-centre study, asthma was less common with increasing maternal age. This effect was consistent between centres and persisted with adjustment for several potential confounders, suggesting that the association may possibly be explained by biological changes related to maternal ageing.

Prenatal paracetamol exposure and risk of asthma and elevated immunoglobulin E in childhood.

BACKGROUND: We recently found that paracetamol (acetaminophen) use in late pregnancy was associated with an increased risk of early wheezing in the offspring. OBJECTIVE: To see whether use of paracetamol in late pregnancy is associated with an increased risk of asthma, wheezing and other atopic outcomes in the child at school age. METHODS: In the population-based Avon Longitudinal Study of Parents and Children, we measured associations of paracetamol and aspirin use in late pregnancy (20-32 weeks) with asthma, hayfever, eczema (n = 8511) and wheezing (8381) in the offspring at 69-81 months, and with atopy (positive skin prick test to Dermatophagoides pteronyssinus, cat or grass, n = 6527) and blood total IgE (n = 5148) at 7 years. We used logistic and linear regression to analyse binary outcomes and log-transformed IgE, respectively, controlling for potential confounders. RESULTS: Use of paracetamol, but not aspirin, in late pregnancy was positively associated with asthma (odds ratios (ORs), comparing children whose mothers took paracetamol 'sometimes' and 'most days/daily' with those whose mothers never took it, 1.22 (95% confidence interval (CI): 1.06-1.41) and 1.62 (95% CI: 0.86-3.04), respectively; P trend = 0.0037), wheezing (ORs 1.20 (95% CI: 1.02-1.40) and 1.86 (95% CI: 0.98-3.55), respectively; P trend = 0.011), and total IgE (geometric mean ratios 1.14 (95% CI: 1.03-1.26) and 1.52 (95% CI: 0.98-2.38), respectively; P trend = 0.0034), but not hayfever, eczema or skin test positivity. The proportion of asthma attributable to paracetamol use in late pregnancy, assuming a causal relation, was 7%. CONCLUSION: Paracetamol exposure in late gestation may cause asthma, wheezing and elevated IgE in children of school age.

The relation of markers of fetal growth with asthma, allergies and serum immunoglobulin E levels in children at age 5-7 years.

BACKGROUND: It has been suggested that fetal growth and maturation have an impact on the development of allergic diseases later in life. OBJECTIVE: To examine the association between measures of fetal growth and allergic disease in children at age 5-7 years. METHODS: As part of the German International Study of Asthma and Allergies in Childhood phase II surveys, a random sample of school beginners (n=1138) was examined in 1995. Data on anthropometric measures at birth and gestational age were obtained from maternal copies of birth records. Data on symptoms and doctor-diagnosed asthma, atopic dermatitis and hayfever were gathered by parental questionnaires. Atopic sensitization was assessed by serum IgE and skin prick tests to common aeroallergens. Children (741) had complete data for the explanatory variables of interest and were thus eligible for this analysis. Confounder-adjusted prevalence odds ratios (PORs) and means ratios with 95% confidence intervals (CI) were calculated using multiple logistic and linear regression. RESULTS: Birth weight and gestational age were positively associated with atopic sensitization (Ptrend=0.025 and 0.035, respectively). Children with a low birth weight relative to head circumference had a decreased risk of sensitization (POR 0.44, 95% CI 0.21-0.91; Ptrend=0.020). Moreover, total serum IgE increased with increasing birth weight (Ptrend=0.042). No consistent relationship was observed between markers of fetal growth and wheezing, doctor-diagnosed asthma, atopic dermatitis and hayfever. CONCLUSION: These data suggest that fetal growth and maturity are associated with atopic sensitization and total serum IgE levels in childhood.