As this was a cross-sectional study, wheezing

could not b

As this was a cross-sectional study, wheezing

could not be characterized as a RG7420 chemical structure triggering or consequent factor of pulmonary infections, but pneumonia was an important risk factor in this study. In a cohort of newborns of low socioeconomic class in Santiago (Chile), followed during the first year of life, a prevalence of pneumonia of 13.3%, was observed, and the presence of recurrent wheezing during the first three months of life was strongly associated with the diagnosis of pneumonia.23 EISL publications in Brazil also found the presence of pneumonia in the first year of life as a risk factor associated with wheezing.17, 18 and 24 In the present study, exposure to maternal smoking during pregnancy see more and passive exposure after birth was associated with

wheezing only in the bivariate analysis (Table 1). The multivariate analysis did not confirm this association, which can be explained by the low frequency of mothers of wheezing infants who smoked during pregnancy (5.4%) or after birth (7.5%). There is a tendency towards undernotification of the frequency of smoking by parents and caregivers of children with respiratory diseases, as they know the harmful effects of smoking on the respiratory system. Obtaining objective measures of this exposure could minimize this bias. Exposure to cigarette smoke, both in the prenatal period and after birth, was associated with the risk of wheezing in infants and preschool children in several studies.1, 17 and 25 A meta-analysis

observed that prenatal or postnatal exposure increased the risk of incidence of wheezing by 30% to 70%, mainly in children younger than two years, stressing that parental smoking prevention is crucial for asthma prevention.7 The present study demonstrated that living in a moderately polluted environment was a risk factor C59 molecular weight for wheezing in the first year of life, similar to that observed in other studies.18 and 26 Exposure to pollutants may be associated with respiratory symptoms such as wheezing, not only as a triggering factor, but also as a risk factor for the development of asthma, according to the results of a cohort study of 4,089 Swedish children, which demonstrated that exposure to air pollution from traffic during the first year of life was associated with risk of persistent wheezing and low lung function at the age of 4 years.27 In a Chilean cohort study, the prevalence of wheezing in the first year of life was high (80.3%), and it was observed that 82.2% of the children were exposed to pollutants resulting from the fuel used for heating or cooking (kerosene, gas), and that 38.5% of the homes were located on unpaved roads.23 As the pollution exposure was known only through parental report, this result must be analyzed with caution, as it lacks objective measures to assess the degree of intra- and extra-domiciliary environment pollution.

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