Risk and protective factors for childhood asthma and wheezing disorders in the first 1,000 days of life: a systematic review of meta-analyses

  • Karoliny dos Santos Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina
  • Nicolas Isoppo University Hospital Professor Polydoro Ernani de São Thiago, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina
Palavras-chave: Asma, criança, fatores de proteção, fatores de risco

Resumo

Introdução: Os primeiros 1000 dias de vida de uma criança, período desde a concepção até o final dosegundo ano, são considerados críticos para o desenvolvimento dos sistemas respiratório e imunológico. Muitos fatores ocorridos nesse período podem estar associados ao risco de asma na infância. Objetivo: Condensar evidências sobre fatores de risco e proteção para asma infantil e/ ou sibilância ocorridos nos primeiros 1000 dias de vida. Método: Foram revisadas as bases de dados MEDLINE, CINAHL e SCOPUS. Foram incluídas revisões sistemáticas com meta-análise, ou meta-análise de estudos observacionais e de intervenção sobre fatores de risco ou proteção para asma infantil/sibilância, enfatizando os primeiros 1000 dias de vida. A qualidade dos estudos foi avaliada pela ferramenta Assess Systematic Reviews. Odds ratio, intervalos de confiança e homogeneidade entre os estudos foram analisados. Resultados: Trinta e cinco estudos preencheram os critérios de inclusão, com boa qualidade metodológica. Foram identificados como fatores de risco para asma e/ou sibilância na infância: história parental de asma, ganho de peso materno durante a gestação, infecções urogenitais, estresse psicológico, tabagismo, parto cesárea, prematuridade, peso ao nascer e hiperbilirrubinemia neonatal. A ingestão de óleo de peixe, zinco e vitamina E durante a gestação aparecem como fatores de proteção, bem como amamentação, ingestão de peixe nos dois primeiros anos e vacinação BCG. Conclusão: Diversos comportamentos ou exposições modificáveis podem estar associados à asma e sibilância na infância. O conhecimento sobre estes comportamentos e exposições pode melhorar as estratégias de prevenção precoce, visando garantir um impacto benéfico na saúde respiratória.

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Publicado
2019-11-05
Seção
ORIGINAL ARTICLES