Milica Jakovljevic, Dragana Mitrović, Snežana Živanović

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Asthma is one of the most frequent chronic diseases of childhood. Its etiology is not fully understood and risk factors for its development are numerous. The aim of this study was to determine the incidence of prenatal and postnatal risk factors in children suffering from asthma. The study was conducted on a sample of 100 patients with a diagnosis of asthma according to Global Initiative for Asthma guidelines. The data was collected using a questionnaire. We have considered prenatal (smoking during pregnancy, hormone and antibiotic therapy, the use of acetaminophen and dietary supplements, maternal blood sugar level, the term of delivery and the method of childbirth) and postnatal risk factors (oxygen and antibiotic therapy during the first year of life, immunization status during the first 6 months of life and presence of the older sibling in the family). In our study group, the most common prenatal risk factors related to asthma were: smoking during pregnancy, hormone therapy, the use of the dietary supplements and delivery via Caesarean section, while the most frequently found postnatal risk factors were: antibiotic therapy during the first year of life and the presence of older child in the family.


asthma, prenatal risk factors, postnatal risk factors.

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Britt RD, Faksh A, Vogel E, Martin RJ, Pabelick CM, Prakash YS. Perinatal factors in neonatal and pediatric lung diseases. Expert Rev Resp Med. 2013; 7(5): 515-531. doi: 10.1586/17476348.2013.838020.

Subbarao P, Mandhane PJ, Sears MR. Asthma: epidemiology, etiology and risk factors. CMAJ. 2009; 181(9). doi:10.1503/cmaj.080612.

Davidson R, Roberts SE, Wotton CJ, Goldcre MJ. Influence of maternal and perinatal factors on subsequent hospitalisation for asthma in children: evidence from the Oxford record linkage study. BMC Pulm Med. 2010; 16; 10:14. doi: 10.1186/1471-2466-10-14.

van Merode T, Maas T, Twellaar M, Kester A, van Schayck CP. Gender-specific differences in the prevention of asthma-like symptoms in high-risk infants. Pediatr Allergy Immunol. 2007; 18(3): 196-200. doi:10.1111/j.1399-3038.2006.00513.x.

Nepomnyaschy L, Reichman NE. Low Birthweight and Asthma Among Young Urban Children. Am J Public Health. 2006; 96(9): 1605-10. doi: 10.2105/AJPH.2005.079400.

Wu FY, Chiu HT, Wu HD, Lin CJ, Lai JS, Kuo HW. Comparison of urinary and plasma cotinine levels during the three trimesters of pregnancy. Paediatr Perinat Epidemiol. 2008; 22(3): 296–301. doi: 10.1111/j.1365-3016.2008.00927.x.

Lødrup Carlsen KC, Jaakkola JJ, Nafstad P, Carlsen KH. In utero exposure to cigarette smoking influences lung function at birth. Eur Respir J. 1997; 10(8):1774–1779. PMID: 9272918.

Metsälä J, Kilkkinen A, Kaila M, Tapanainen H, Klaukka T, Gissier M, Virtanen SM: Perinatal factors and the risk of asthma in childhood – A population-based register study in Finland. Am J Epidemiol. 2008; 168 (2): 170-8. doi: 10.1093/aje/kwn105.

Burke H, Leonardi J, Hashim A, Pine-Abata H, Chen Y, Cook DG, Britton JR, McKeever TM. Prenatal and Passive Smoke Exposure and Incidence of Asthma and Wheeze: Systematic Review and Meta-analysis. Pediatrics. 2012; 129 (4): 735-44. doi:10.1542/peds.2011-2196.

Jaakkola JJK, Gissler M: Maternal smoking in pregnancy, fetal development, and childhood asthma. Am J Public Health. 2004; 94 (1):136-140.

Lapin B, Piorkoski J, Ownby D, Freels S, Chavez N, Hernandez E, Wagner-Cassanova C, Pelzel D, Vergara C, Persky V. The Relationship between Prenatal Antibiotic Use and Asthma in At-Risk Children. Ann Allergy Asthma Immunol. 2015; 114(3): 203–207. doi:10.1016/j.anai.2014.11.014.

Metsälä J, Lundqvist A, Virta LJ, Kaila M, Gissler M, Virtanen SM. Prenatal and post-natal exposure to antibiotics and risk of asthma in childhood. Clin Exp Allergy. 2015; 45 (1): 137-45. doi: 10.1111/cea.12356.

Stensballe LG, Simonsen J, Jensen SM, Bønnelykke K, Bisgaard H. Use of antibiotics during pregnancy increases the risk of asthma in early childhood. J Pediatr. 2013; 162 (4): 832–838.e3. doi: 10.1016/j.

Örtqvist AK, Lundholm C, Kieler H, Ludvigsson JF, Fall T, Ye W, et al. Antibiotics in fetal and early life and subsequent childhood asthma: nationwide population based study with sibling analysis. BMJ. 2014; 349: g6979. doi: 10.1136/bmj.g6979

Popovic M, Rusconi F, Zugna D, Galassi C, Merletti F, Migliore E, Trevisan M, Nannelli T, Gagliardi L, Richiardi L. Prenatal exposure to antibiotics and wheezing in infancy: a birth cohort study. Eur Respir J. 2016; 47 (3): 810-7. doi: 10.1183/13993003.00315-2015.

Stokholm J, Sevelsted A, Bønnelykke K, Bisgaard H. Maternal propensity for infections and risk of childhood asthma: a registry-based cohort study. Lancet Resp Med. 2014; 2 (8): 631-7. doi: 10.1016/S2213-2600(14)70152-3 .

Renz H, Blumer N, Virna S, Sel S, Garn H. The immunological basis of the hygiene hypothesis. Chem Immun Allergy. 2006; 91:30–48. doi: 10.1159/000090228.

Lange NE, Celedon JC, Forno E, et al. Maternal intestinal flora and wheeze in early childhood. Clin Exp Allergy. 2012; 42(6): 901-8. doi: 10.1111/j.1365-2222.2011.03950.x.

Stokholm J, Schjørring S, Eskildsen CE, Pedersen L, Bischoff AL, Følsgaard N, et al. Antibiotic use during pregnancy alters the commensal vaginal microbiota. Clin Microbiol Infect. 2014; 20(7): 629-35. doi: 10.1111/1469-0691.12411.

Chu S, Yu H, Chen Y, Chen Q, Wang B, Zhang J. Periconceptional and Gestational Exposure to Antibiotics and Childhood Asthma. PloS One. 2015; 10 (10): e0140443. doi: 10.1371/journal.pone.0140443.

Zhao D, Su H, Cheng J, Wang X, Xie M, Li K, Wen L, Yang H. Prenatal antibiotic use and risk of childhood wheeze/asthma: A meta-analysis. Pediatr Allergy Immunol. 2015; 26(8): 756-64. doi: 10.1111/pai.12436.

Shaheen SO, Newson RB, Sherriff A, et al. Paracetamol use in pregnancy and wheezing in early childhood. Thorax. 2002; 57(11): 958–963.

Anderen AB, Farkas DK, Mehnert F, Ehrenstein V, Erichsen R. Use of prescription paracetamol during pregnancy and risk of asthma in children: a population-based Danish cohort study. Clin Epidemiol. 2012; 4:33-40. doi: 10.2147/CLEP.S28312.

Crider KS, Cordero AM, Qi YP, Mulinare J, Downling NF, Berry RJ. Prenatal folic acid and risk of asthma in children: a systematic review and meta-analysis. Am J Clin Nutr 2013; 98 (5): 1272–81. doi: 10.3945/ajcn.113.065623.

Veeranki SP, Gebretsadik T, Mitchel EF, Tylavsky FA, Hartert TV, Cooper WO, Dupont WD, Dorris SL, Hartman TJ, Carroll KN. Maternal Folic Acid Supplementation During Pregnancy and Early Childhood Asthma. Epidemiology. 2015; 26(6): 934-41. doi: 10.1097/EDE.0000000000000380.

Azad MB Becker AB, Kozyrskyj AL. Association of maternal diabetes and child asthma. Pediatr Pulmol. 2013; 48 (6): 545-52. doi: 10.1002/ppul.22668.

Alshehri MA, Almegamesi TM, Alfrayh AS. Predictors of short-term hospital readmissions of asthmatic children. J Family Community Med. 2005; 12(1): 11–7.

Risnes KR, Belager K, Murk W, Bracken MB. Antibiotic exposure by 6 months and asthma and allergy at 6 years: Findings in a cohort of 1,401 US children. Am J Epidemiol. 2011; 173(3): 310-8. doi: 10.1093/aje/kwq400.

Marra F, Lynd L, Coombes M, et al. Does antibiotic exposure during infancy lead to development of asthma? A systematic review and metaanalysis. Chest. 2006; 129(3): 610–618. doi: 10.1378/chest.129.3.610.

Kummeling I, Thijs C, Stelma F, Huber M, van den Brandt PA, Dagnelie PC. Diphtheria, pertussis, poliomyelitis, tetanus, and Haemophilus influenzae type b vaccinations and risk of eczema and recurrent wheeze in the first year of life: the KOALA Birth Cohort Study. Pediatrics. 2007; 119 (2): e367-73. doi: 10.1542/peds.2006-1479



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