Document Detail


Morbidity patterns among low-income wheezing infants.
MedLine Citation:
PMID:  12837867     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Mary D Klinnert; Marcella R Price; Andrew H Liu; JoAnn L Robinson
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Pediatrics     Volume:  112     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-02     Completed Date:  2003-12-18     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  49-57     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, National Jewish Medical and Research Center, Denver, Colorado 80206, USA. klinnertm@njc.org
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MeSH Terms
Descriptor/Qualifier:
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:
M01 RR00051/RR/NCRR NIH HHS; R18 AI41137/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
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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