Children who started eating fish before nine months of age are less likely to suffer from pre-school wheeze, but face a higher risk if they were treated with broad spectrum antibiotics in the first week of life or their mother took paracetamol during pregnancy. Those are the key findings from a large-scale Swedish study published in the December issue of Acta Paediatrica.
Researchers analysed responses from 4,171 randomly selected families, who answered questions when their child was six months, 12 months and four-and-a-half years of age.
“Recurrent wheeze is a very common clinical problem in preschool children and there is a need for better medical treatment and improved understanding of the underlying mechanisms” says lead author Dr Emma Goksor from the Queen Silvia Children’s Hospital, University of Gothenburg, Sweden. “The aim of our study was to identify both important risk factors and protective factors for the disease.
“Our demographic analysis suggests that the responses we received were largely representative of the population as a whole and we believe our findings provide useful information on three important factors involved in pre-school wheeze.”
The study examined children who had had three or more episodes of wheezing in the last year, including those who did and did not use asthma medication (inhaled corticosteroid), comparing them with children who did not wheeze. The wheezy sample was further broken down into children who only developed episodic viral wheeze when they had colds and multiple trigger wheeze, where children also wheezed when they didn’t have a cold, reacting to factors such as allergens, tobacco smoke or exercise.
Key findings of the study include:
Fish consumption before nine months of age
Antibiotic treatment in the first week of life
Use of paracetamol during pregnancy
“The aim of this study was to determine the risk factors for pre-school wheeze, with particular reference to prenatal paracetamol use, early exposure to antibiotics and fish consumption. A secondary aim was to analyse possible differences between multiple-trigger wheeze and episodic viral wheeze.
“Our findings clearly show that while fish has a protective effect against developing pre-school wheeze, children who had antibiotics in the first week of life and whose mothers took paracetamol during pregnancy faced an increased risk, particularly of multiple-trigger wheeze.”
Preschool wheeze – impact of early fish introduction and neonatal antibiotics. Emma Goksör, Bernt Alm, Hrefna Thengilsdottir, Rolf Pettersson, Nils Åberg, Göran Wennergren. Acta Pædiatrica. 2011 100, pp. 1561–1566.
Prenatal paracetamol exposure and risk of wheeze at preschool age. Emma Goksör, Hrefna Thengilsdottir, Bernt Alm, Gunnar Norvenius, Göran Wennergren. Acta Pædiatrica 2011 100, pp. 1567–1571. DOI:10.1111/j.1651-2227.2011.02403.x.