SIBILÂNCIA RECORRENTE EM CRIANÇAS DE 13 A 35 MESES E FATORES ASSOCIADOS.

Abstract

Wheezing is considered the most common respiratory symptom in childhood, causing an important role in infant morbimortality and being responsible for the great demand of outpatient medical appointments, in emergency services and presenting high rates of hospitalization. In this thesis, two studies were carried out. The first study aimed to determine the prevalence and associated factors for recurrent wheezing in children aged 13 to 35 months. The second study aimed to verify the prevalence of anemia in pregnancy and its association with respiratory problems. For the first cross-sectional study, a sample of 2,780 children with 13 to 35 months of age, living in the city of São Luís-MA participating in the BRISA cohort, was considered. In the second study, a cross-sectional study was conducted involving a sample of 3,279 children who participated in the BRISA cohort and the follow-up of this cohort, aged 13 to 35 months. To evaluate the factors associated with recurrent wheezing, a multivariate logistic regression model was adjusted, with the inclusion of variables in a hierarchical fashion using the theoretical model. The outcome of interest was the presence of recurrent wheezing. The independent variables evaluated were maternal age and her education, smoking, anemia in pregnancy, type of delivery, gender, birth weight, family history of asthma, rhinitis and dermatitis, exclusive breastfeeding, presence of mold, domestic animal and carpet at home, a history of respiratory problems and hospitalization. To verify the relation of presence of anemia in pregnancy and respiratory problems, the chi-square test was performed. In the first study, the prevalence of recurrent wheezing was 9%, with associated factors: age of the mother equal to or greater than 35 years (PR = 0.49, CI = 0.24 - 0.99, p = 0.049), male (PR = 1.62, CI = 1.23 - 2.14, p = 0.001), family history of asthma (PR = 1.55, CI = 1.09 - 2.19, p = 0.013), family history of rhinitis (PR = 1.71 CI = 1.26 - 2.30, p = 0.000), anemia during pregnancy (PR = 1.33, CI = 1.02 - 1.75, p = 0.034), exclusive breastfeeding (PR = 0.75, CI = 0.56 - 0.99, p = 0.044), presence of mold in the home (PR = 1.56, CI = 1.11 - 2.18, p = 0.009 ) and respiratory problems (PR = 3.90, CI = 2.53 - 0.99, p <0.001) .In the second study, the prevalence of anemic pregnant women was 47% and the problems related to anemia were maternal age lower than 20 years (p <0.001), inadequate maternal schooling (P <0.001), smoking in pregnancy (p=0.014), alcohol in pregnancy (p <0.001), normal labor (p <0.001), and in children, recurrent wheezing (p = 0.013), pneumonia (p = 0.040), and cough (p <0.001). The results obtained in this study have great relevance, as evidenced the prevalence of recurrent wheezing among children in São Luís and the associated factors, as well as, anemia prevalence and its relationship with respiratory problems in the child.