D1.396 - Identifying Allergies, Prematurities, and GERD as Risk Factors for Recurrent Respiratory Infections in Children: A Case-Control Study

Recurrent respiratory infections (RRIs) are a significant pediatric health concern, affecting up to 25% of children and impacting their quality of life. Potential risk factors for RRIs include allergies, prematurities, and gastroesophageal reflux disease (GERD). Understanding these associations is essential for developing effective prevention and management strategies.

This retrospective hospital-based case-control study was conducted at Bunda Women and Children Hospital Jakarta from April 2023 to June 2024, involving 70 children aged 1–6 years. Cases were defined based on the Italian Journal of Pediatric criteria for RRIs, with controls being children without RRIs. Data were collected from medical records and analyzed using chi-square tests and multivariate logistic regression.

Key risk factors for RRIs included GERD (OR, 8.61; 95% CI, 1.76–42.16), prematurity (OR, 4.04; 95% CI, 1.15–14.16), respiratory distress syndrome (RDS) (OR, 4.89; 95% CI, 0.96–24.97), low birth weight (OR, 4.89; 95% CI, 1.23–19.47), parental atopy (OR, 4.5; 95% CI, 1.41–14.35), parental RRIs (OR, 4.89; 95% CI, 1.23–19.47), history of allergies (OR, 10; 95% CI, 3.31–30.23), asthma history (OR, 22.6; 95% CI, 2.77–185.18), and allergic rhinitis history (OR, 5.71; 95% CI, 1.13–28.75). Protective factors included exclusive breastfeeding (OR, 0.3; 95% CI, 0.1–0.86) and complete immunization (OR, 0.1; 95% CI, 0.04–0.62). Age, sex, socioeconomic status, transient tachypnea of the newborn (TTN), and weight-for-height z-score were not associated with RRIs. Significant predictors in partial logistic regression included TTN (OR = 121.25, p = 0.028), asthma history (OR = 386.14, p = 0.033), and height-for-age z-score (OR = 0.003, p = 0.017). Simultaneous regression confirmed a strong association between predictors and RRIs (Wald = 64.873, p < 0.05). The final model explained 80.6% of variance (Nagelkerke R² = 0.806) with good fit (Hosmer-Lemeshow χ² = 4.133, p = 0.845)

Key risk factors for childhood RRIs include history of allergies, asthma and allergic rhinitis, parental history of atopy and RRIs, prematurity, RDS, low birth weight, and GERD. Height-for-age nutritional status is also related to RRIs, while exclusive breastfeeding and complete immunization offer protection.