Supitra Suwanpromma MD*, Charoon Boonlarbtaweechoke MD*, Umaporn Udomsubpayakul MD**, Arunwan Preutthipan MD***
Affiliation : * Department of Pediatrics, Lerdsin General Hospital, Bangkok, Thailand ** Section for Clinical Epidemiology & Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand *** Division of Pediatric Pulmonology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Objective : Determine the prevalence of airflow obstruction in schoolchildren in Bangkok and identify its risk factors.
Material and Method: Schoolchildren, aged 6 to 18 years, were randomly selected from six schools in central Bangkok.
Parents of the children completed a questionnaire. Standard spirometry was performed. Children were classified as having
airflow obstruction if FEV1/FVC ratio was < 0.8. Children with FEV1/FVC ratio ≥ 0.8, matched by sex, age, weight, and
height, were randomly selected and classified as having no airflow obstruction. Risk factors were identified by univariate
and multivariate analyses.
Results : Among 1,065 children assessed by spirometry, 43 (4%) demonstrated airflow obstruction. Only three factors
including wheezing apart from cold in the past 12 months (OR, 12.82; 95% CI, 1.3-126.5), family history of allergic rhinitis
(OR, 2.54; 95% CI, 1.21-5.32), and starting infant formula since birth (OR, 2.47; 95% CI, 1.21-5.04) were shown to be
significant risk factors associated with airflow obstruction.
Conclusion : The prevalence of airflow obstruction in schoolchildren is lower than those reported in most adult studies.
Asthma and family history of allergic rhinitis are important risk factors associated with airflow obstruction. Exclusively
breastfeeding since birth might be another helpful measure to prevent the development of airflow obstruction in children.
Keywords : Airflow obstruction, Spirometry, Children, Asthma, Allergy, Breastfeeding
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