D1.110 - Analysis of clinical and anamnestic risk factors of bronchial asthma in children

The characteristic features of the debut and development of bronchial asthma (BA), the need for differential diagnosis with other diseases and the lack of the possibility of using functional methods of respiratory system examination complicate its timely detection in young children. These difficulties emphasize the importance of a thorough study of the child's history to identify the key risk factors for the development and exacerbation of asthma.

Objective: retrospective evaluation of anamnestic data, which included the peculiarities of intrauterine development, premorbid background, and hereditary predisposition.To solve the set tasks, 983 children aged from 1 to 18 years with a diagnosis of  BA of varying severity (boys - 850, girls - 133) were included in the study.

: High (AR=51-100%), medium (AR=26-50%) and low (AR=1-25%) risk factors for the development of BA in children were identified on the basis of attributive risk values. The analysis of the obtained results showed that the low risk factors for the development of BA in children include: age of disease debut at 4-6 years (AR=5.0%), children unvaccinated at an early age (AR=19.0%), premature maternal delivery (AR=1.0%), operative maternal delivery (AR=1.0%), aggravation of family allergoanamnesis on the mother's side (AR=8, 0%), allergic family history on the father's side (AR=10,0%), concomitant pathology of ENT organs (AR=15,0%), worm-parasitic diseases (AR=15,9%), iron deficiency anemia (AR=4,0%).  The average risk factors for the development of BA in children are as follows: the age of disease debut at 1-3 years (AR=31.0%), aggravated family allergy history in both lines of descent (AR=29.0%) and concomitant allergic pathology (AR=42.0%). %). High-risk factors for the development of BA in children include: male gender (AR=72.0%), artificial feeding (AR=79.0%), and complicated pregnancy in the mother (AR=86.0). According to the results, male gender increases the probability of severe BA more than 3-fold (OR=3.68; 95% CI: 0.90-15.0), and the debut of the disease at the age of 4-6 years 2.04-fold (OR=2.04; 95% CI: 0.43-9.62). Lack of immunizations increases the probability of severe BA in a child (OR=2.19; 95% CI: 0.64-7.53).Various ENT pathologies accompanied by upper respiratory tract infection increases the probability of severe BA  3.28-fold (OR=3.28; 95% CI: 0.95-11.30). Carried worm and parasitic infestations - 2.24 times (OR=2.24; 95% CI: 0.65-7.69), concomitant allergopathology - 3.74 times (OR=3.74; 95% CI: 0.47-29.74), pronounced dependence on weather conditions - 2.0 times. (OR=2.00; 95% CI: 0.42-9.38).

The presence of high positive values of the studied indicators in the examined children necessitates closer attention to these patients and changes in the tactics of management of these patients.