Determinar la influencia de la exposición prenatal yposnatal a tabaco en el posterior desarrollo de bronquiolitis

Se realizó una encuesta a los padres de los lactantes ingresadosentre agosto de 2001 y agosto de 2002, acerca delhábito tabáquico de ambos progenitores y el hábito tabáquicomaterno durante la gestación. Para el diagnósticode bronquiolitis se utilizaron criterios clínicos, analíticos yradiológicos

De los 450 lactantes ingresados durante ese período,123 (27,3 %) fueron diagnosticados de bronquiolitis, y327 constituyeron el grupo control. El 61,6 % tenía al menosun progenitor fumador, de los cuales el 32,9 % desarrollóbronquiolitis; el 39,1 % no tenía ningún progenitorfumador, y desarrolló bronquiolitis el 18,2 % de ellos(odds ratio [OR] 5 2,20 [1,39-3,47]). El 35,3 % del total deniños estudiados tenían madre fumadora, de los que el37,7% fueron casos frente al 21,4 % de bronquiolitis en loshijos de no fumadoras (OR 5 2,22 [1,45-3,39]). El 49,6%eran hijos de padre fumador, con un porcentaje de bronquiolitisdel 32,3 % frente al 22 % de los lactantes hijos depadre no fumador (OR 5 1,65 [1,10-2,57]). El 44 % de loshijos de madre fumadora durante la gestación ingresó porbronquiolitis frente a sólo el 20,9% de los no expuestosprenatalmente (OR 5 2,96 [1,90-4,62]). Destaca el elevadoíndice de mujeres fumadoras durante el embarazo(27,8 %). Tras la realización del estudio multivariante conregresión logística, sólo el tabaquismo durante la gestaciónmantuvo la significación estadística (p < 0,00001;OR 5 3,27 [1,39-7,71])

El hábito tabáquico materno durante la gestación pareceser el principal factor de riesgo para el posterior desarrollode bronquiolitis en el lactante

To determine the influence of pre- and postnatal tobaccoexposure in the development of bronchiolitis

A questionnaire was given to the parents of childrenhospitalized between August 2001 and August 2002. It includeditems on parental smoking habits and maternalsmoking during pregnancy. Clinical, analytical and radiologicalcriteria were used to diagnose bronchiolitis

Of 450 children, 123 (27.3%) were diagnosed with bronchiolitis.The control group was composed of 327 children.A total of 61.6 % of the children had at least one parent whosmoked and 32.9 % of these children developed bronchiolitis;39.1 % had non-smoking parents and 18.2% were hospitalizedwith bronchiolitis (OR 5 2.20 [1.39-3.47]). Of theentire group of children studied, 35.3 % had mothers whosmoked and 37.7% of these children had bronchiolitiscompared with 21.4 % of children whose mothers werenon-smokers (OR 5 2.22 [1.45-3.39]). A total of 49.6 % hadfathers who smoked, and 32.3 % of these children were diagnosedwith bronchiolitis compared with 22 % of childrenwhose fathers were non-smokers (OR 5 1.65 [1.10-2.57]).Forty-four percent of children whose mothers smoked duringpregnancy were hospitalized with bronchiolitis comparedwith only 20.9 % of non-exposed children (OR 5 2.96[1.90-4.62]). The large number of mothers who smoked duringpregnancy (27.8 %) was notable. Multivariant analysiswith logistic regression was performed and the only variablethat remained statistically significant was smokingduring pregnancy (p <0.00001; OR 5 3.27 [1.39-7.71])

Maternal smoking during pregnancy seems to be themain risk factor for the subsequent development of bronchiolitis