Day-care center attendance and risk of Asthma-A systematic review

Main Article Content

Carlos Ochoa Sangrador
Alba Vázquez Blanco

Keywords

Asthma, Child Day Care Centers, Risk

Abstract

Introduction and Objectives: Asthma and other wheezing disorders are common chronic health problems in childhood. We aim to evaluate whether the attendance by children under three years of age to day-care centers is a protector or risk factor in the development of recurrent wheezing or asthma in the following years of their lives.


Methods: Systematic review of published cohort or cross-sectional studies, without any time limitation. We searched in PubMed, Cinhal, Cuiden and Scopus (EMBASE included). The quality of the studies was evaluated using the Newcastle-Ottawa Scale. Disagreements were solved by mutual consensus. Weighted odds ratio (ORs) were estimated using RevMan 5.3, following random-effects models.


Results: We selected 18 studies for qualitative analysis, nine cohort studies and nine cross-sectional studies. Day-care center attendance is associated with an increased risk of early recurrent wheezing (four studies; 50,619 subjects; adjusted OR 1.87 [1.21 to 2.88]; I2 91%) and asthma before the age of six (five studies; 5412 subjects; adjusted OR 1.59 [1.26 to 2.01]; I2 0%), but not later (five studies; 5538 subjects; adjusted OR 0.86 [0.55 to 1.32]; I2 76%).


Conclusions: Children attending day-care center during the first years of life have a higher risk of recurrent wheezing during the first three years and asthma before the age of six, but not later. This risk must be taken into account to inform parents in order to choose what kind of care children should have throughout infancy and to implement preventive measures to reduce its impact.

Abstract 58 | PDF Downloads 33

References

1. Ochoa Sangrador C, Barajas Sánchez MV, Munoz ˜ Martín B. Relación entre la asistencia a guarderías y enfermedad infecciosa aguda en la infancia Una revisión sistemática. Rev Esp Salud Publica. 2007;81:113-29.

2. Guilbert TW, Denlinger LC. Role of infection in the development and exacerbation of asthma. Expert Rev Respir Med. 2010;4:71-83.

3. Rantala A, Jaakkola JJ, Jaakkola MS. Respiratory infections precede adult-onset asthma. PLOS One. 2011;6:e27912.

4. Wu P, Dupont WD, Griffin MR, et al. Evidence of a causal role of winter virus infection during infancy in early childhood asthma. Am J Respir Crit Care Med. 2008;178:1123-9.

5. Martinez FD. Maturation of immune responses at the beginning of asthma. J Allergy Clin Immunol. 1999;103:355-61.

6. Strachan DP. Hay fever hygiene, and household size. BMJ. 1989;299:1259-60.

7. Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ. Asthma and wheezing in the first six years of life. The Group Health Medical Associates. N Engl J Med. 1995;332:133-8.

8. Ball TM, Castro-Rodriguez JA, Griffith KA, Holberg CJ, Martinez FD, Wright AL. Siblings, day-care attendance, and the risk of asthma and wheezing during childhood. N Engl J Med. 2000;343:538-43.

9. Barry RJ, Pickett W, Rennie DC, Senthilselvan A, Cockcroft DW, Lawson JA. Factors contributing to risks for pediatric asthma in rural Saskatchewan. Ann Allergy Asthma Immunol. 2012;109:255-9.

10. Benicio MH, Ferreira MU, Cardoso MR, Konno SC, Monteiro CA. Wheezing conditions in early childhood: prevalence and risk factors in the city of Sao Paulo, Brazil. Bull World Health Organ. 2004;82:516-22.

11. Bercedo-Sanz A, Lastra-Martínez L, Pellegrini-Belinchón J, Vicente-Galindo E, Lorente-Toledano F, García-Marcos L, Wheezing and risk factors in the first year of life in Cantabria, Spain. The EISL study. Allergol Immunopathol (Madr). 2015;43:543-52.

12. Caudri D, Wijga A, Scholtens S, et al. Early daycare is associated with an increase in airway symptoms in early childhood but is no protection against asthma or atopy at 8 years. Am J Respir Crit Care Med. 2009;180:491-8.

13. Celedon JC, Litonjua AA, Ryan L, Weiss ST, Gold DR. Daycare attendance, respiratory tract illnesses, wheezing, asthma, and total serum IgE level in early childhood. Arch Pediatr Adolesc Med. 2002;156:241-5.

14. Celedon JC, Wright RJ, Litonjua AA, et al. Daycare attendance in early life, maternal history of asthma, and asthma at the age of 6 years. Am J Respir Crit Care Med. 2003;167: 1239-43.

15. Cheng G, Smith AM, Levin L, et al. Duration of day care attendance during infancy predicts asthma at the age of seven: the Cincinnati Childhood Allergy and Air Pollution Study. Clin Exp Allergy. 2014;44:1274-81.

16. García-Marcos L, Mallol J, Sole D, Brand PL, Sánchez-Bahillo M, Sánchez-Solis M. Latitude modifies the effect size of factors related to recurrent wheeze in the first year of life. Respir Med. 2013;107:665-72.

17. Grabenhenrich LB, Gough H, Reich A, et al. Early-life determinants of asthma from birth to age 20 years: a German birth cohort study. J Allergy Clin Immunol. 2014;133: 979-88.

18. Gurka MJ, Blackman JA, Heymann PW. Risk of childhood asthma in relation to the timing of early child care exposures. J Pediatr. 2009;155, 781-7 e1.

19. Hagen EW, Sadek-Badawi M, Palta M. Daycare attendance and risk for respiratory morbidity among young very low birth weight children. Pediatr Pulmonol. 2009;44:1093-9.

20. Hagerhed-Engman L, Bornehag CG, Sundell J, Aberg N. Day-care attendance and increased risk for respiratory and allergic symptoms in preschool age. Allergy. 2006;61: 447-53.

21. Indinnimeo L, Porta D, Forastiere F, et al. Prevalence and risk factors for atopic disease in a population of preschool children in Rome: challenges to early intervention. Int J Immunopathol Pharmacol. 2016;29:308-19.

22. Marbury MC, Maldonado G, Waller L. Lower respiratory illness, recurrent wheezing, and day care attendance. Am J Respir Crit Care Med. 1997;155:156-61.

23. Nafstad P, Hagen JA, Oie L, Magnus P, Jaakkola JJ. Day care centers and respiratory health. Pediatrics. 1999;103: 753-8.

24. Nystad W, Skrondal A, Magnus P. Day care attendance, recurrent respiratory tract infections and asthma. Int J Epidemiol. 1999;28:882-7.

25. Ojembarrena Martínez E, Fernández de Pinedo Montoya R, Lafuente Mesanza P, Corera Sánchez M. Papel de la guardería y de la escolarización precoz en la incidencia de enfermedades infecciosas. An Esp Pediatr. 1996;45:45-8.

26. Rusconi F, Galassi C, Bellasio M, et al. Fattori di rischio pre e perinatali e del primo anno di vita e sviluppo di wheezing in eta prescolare. Epidemiol Prev. 2005;29:47-51.

27. Prescott SL, Macaubas C, Smallacombe T, Holt BJ, Sly PD, Holt PG. Development of allergen-specific T-cell memory in atopic and normal children. Lancet. 1999;353:196-200.