Meta analysis of the risk factors of recurrent wheezing in infants

Objective To analyze the relevant risk factors of recurrent wheezing(≥3 attacks) in the first 3 years of life. Methods "Wheezing, respiratory sounds, risk factor"were used as key words to retrieve papers in Chinese literature databases including Sinomed, Wanfang and Weipu databases.The same strategy was used to retrieve English papers in English literature databases including PubMed, Cochrane library and EMbase.Time range was from 31th May 2004 to 1rd June 2014.The execution of quality evaluation of the included documents was in compliance with Newcastle-Ottawa Scale and cross-sectional study standard recommended by Agency for Healthcare Research and Quality.The evidence quality evaluation was conducted with GRADEpro and followed by the Meta analysis with RevMan 5.2. Results A total of 13 studies were included in this Meta-analysis.Several factors were related to recurrent wheezing episodes, including risk factors such as maternal smoking during pregnancy (OR=1.47, 95%CI: 1.30-1.66), asthma in parents(OR=1.94, 95%CI: 1.72-2.19), family history of atopy(OR=1.94, 95%CI: 1.72-2.19), male(OR=1.42, 95%CI: 1.19-1.69), history of eczema(OR=2.36, 95%CI: 1.69-3.30), colds(>6 times)(OR=2.02, 95%CI: 1.54-2.64), history of bronchopneumonia(OR=1.85, 95%CI: 1.46-2.34), exposure to cigarette smoking(OR=2.30, 95%CI: 1.68-3.14), daycare attendance(OR=2.27, 95%CI: 1.97-2.60); Education received by the mother >12 years (OR=0.80, 95%CI: 0.70-0.92) was the protective factor. Conclusions The risk factors of recurrent wheezing(≥3 attacks) in the first 3 years of life are maternal smoking during pregnancy, asthma in parents, family history of atopy, male, history of eczema, colds(>6 times), history of bronchopneumonia, exposure to cigarette smoking and daycare attendance.The protective factor is education received by the mother≥12 years.The prerequisite in precaution of infants recurrent wheezing is to ensure the utmost avoidance of hazardous factors and reinforcement of protective factors. Key words: Recurrent wheezing; Risk factor; Infant; Meta analysis