| Morbidity patterns among low-income wheezing infants. | |
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MedLine Citation:
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PMID: 12837867 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: This study describes morbidity attributable to wheezing illness in a multi-ethnic sample of low-income infants younger than age 2, and examines biological, environmental, and psychosocial correlates of morbidity indexes. METHOD: Infants 9 to 24 months old, considered at risk for developing asthma on the basis of having had 3 or more health care contacts with documented wheezing, received comprehensive evaluations as part of an environmental intervention study. Baseline evaluations with the infants, their families, and their home environments focused on biological, environmental, and psychosocial factors that would potentially increase asthma risk for the children. At study entry, prior morbidity attributable to wheezing illness was assessed with caregiver reports of symptom frequency and severity and medication use, caregiver quality of life, and medical record documentation of hospitalizations and emergency department (ED) visits. RESULTS: Forty-six percent of the infants had 1 or more hospitalizations and 59% had 2 or more ED visits since birth for wheezing illness. Foreign-born Hispanic families had significantly more ED visits for their children's wheezing illness than US-born Hispanic families, whites, or blacks, although they used fewer controller medications and they reported less illness severity. Multivariate analyses showed 3 biological factors, respiratory syncytial virus, elevated child IgE, and cockroach allergen in the home, were independently associated with hospitalizations within this sample. Similar analyses showed that ED visits were not associated with biological variables, but rather with caregivers with single parent status and smokers. Caregiver reports of wheezing illness severity were correlated with ED visits, but not with hospitalizations. Severity ratings were higher for children of mothers with asthma and for those whose caregivers had higher anxiety and stress. The only correlate of caregiver ratings of poor quality of life was high caregiver anxiety. CONCLUSIONS: Ethnic and immigrant status was an important factor in morbidity attributable to infant wheezing illness. In addition to respiratory infection, both allergic processes and social variables were associated with morbidity as measured by health care utilization. Caregiver reports of illness severity were significantly correlated with psychosocial factors. |
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Authors:
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Mary D Klinnert; Marcella R Price; Andrew H Liu; JoAnn L Robinson |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Pediatrics Volume: 112 ISSN: 1098-4275 ISO Abbreviation: Pediatrics Publication Date: 2003 Jul |
Date Detail:
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Created Date: 2003-07-02 Completed Date: 2003-12-18 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0376422 Medline TA: Pediatrics Country: United States |
Other Details:
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Languages: eng Pagination: 49-57 Citation Subset: AIM; IM |
Affiliation:
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Department of Pediatrics, National Jewish Medical and Research Center, Denver, Colorado 80206, USA. klinnertm@njc.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Animals Asthma / epidemiology, etiology, prevention & control* Caregivers / psychology Child, Preschool Cockroaches / immunology Colorado / epidemiology Emigration and Immigration Environmental Exposure Ethnic Groups Humans Hypersensitivity / epidemiology, etiology Immunoglobulin E / blood Infant Medicaid / utilization Poverty Respiratory Sounds* / etiology Respiratory Syncytial Virus Infections / epidemiology Socioeconomic Factors Tobacco Smoke Pollution / statistics & numerical data |
| Grant Support | |
ID/Acronym/Agency:
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M01 RR00051/RR/NCRR NIH HHS; R18 AI41137/AI/NIAID NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Tobacco Smoke Pollution; 37341-29-0/Immunoglobulin E |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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