Association between respiratory syncytial viral disease and the subsequent risk of the first episode of severe asthma in different subgroups of high-risk Australian children

a whole-of-population-based cohort study

N. Homaira, N. Briggs, C. Pardy, M. Hanly, J. L. Oei, L. Hilder, B. Bajuk, K. Lui, W. Rawlinson, T. Snelling, A. Jaffe

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    Abstract

    Objective: To determine the contribution of respiratory syncytial virus (RSV) to the subsequent development of severe asthma in different subgroups of children at risk of severe RSV disease.


    Settings: The study was conducted in New South Wales (NSW), Australia.


    Participants: The study comprised all children born in NSW between 2000 and 2010 with complete follow-up till 31 December 2011. The cohort was divided into three subgroups: (1) non-Indigenous high-risk children: non-Indigenous children born preterm or born with a low birth weight; (2) Indigenous children: children of mothers whose Indigenous status was recorded as Aboriginal and/or Torres Strait Islander and (3) non-Indigenous standard risk children: all other non-Indigenous term children.


    Primary outcome measure: Risk of development of severe asthma in different subgroups of children who had RSV hospitalisation in the first 2 years of life compared with those who did not.


    Design: We performed a retrospective cohort analysis using population-based linked administrative data. Extended Cox model was used to determine HR and 95% CI around the HR for first asthma hospitalisation in different subgroups of children.


    Results: The cohort comprised 847 516 children born between 2000 and 2010. In the adjusted Cox model, the HR of first asthma hospitalisation was higher and comparable across all subgroups of children who had RSV hospitalisation compared with those who did not. The HR (95% CI) was highest in children aged 2–3 years; 4.3 (95% CI 3.8 to 4.9) for high-risk, 4.0 (95% CI 3.3 to 4.8) for Indigenous and 3.9 (95% CI 3.7 to 4.1) for non-Indigenous standard risk children. This risk persisted beyond 7 years of age.


    Conclusion: This large study confirms a comparable increased risk of first asthma hospitalisation following RSV disease in the first 2 years of life across different subgroups children at risk.

    Original languageEnglish
    Article numbere017936
    Pages (from-to)1-6
    Number of pages6
    JournalBMJ Open
    Volume7
    Issue number11
    DOIs
    Publication statusPublished - 8 Nov 2017

    Fingerprint

    Virus Diseases
    Cohort Studies
    Asthma
    Population
    Respiratory Syncytial Viruses
    Hospitalization
    New South Wales
    Proportional Hazards Models
    South Australia
    Low Birth Weight Infant
    Mothers

    Cite this

    Homaira, N. ; Briggs, N. ; Pardy, C. ; Hanly, M. ; Oei, J. L. ; Hilder, L. ; Bajuk, B. ; Lui, K. ; Rawlinson, W. ; Snelling, T. ; Jaffe, A. / Association between respiratory syncytial viral disease and the subsequent risk of the first episode of severe asthma in different subgroups of high-risk Australian children : a whole-of-population-based cohort study. In: BMJ Open. 2017 ; Vol. 7, No. 11. pp. 1-6.
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    title = "Association between respiratory syncytial viral disease and the subsequent risk of the first episode of severe asthma in different subgroups of high-risk Australian children: a whole-of-population-based cohort study",
    abstract = "Objective: To determine the contribution of respiratory syncytial virus (RSV) to the subsequent development of severe asthma in different subgroups of children at risk of severe RSV disease. Settings: The study was conducted in New South Wales (NSW), Australia. Participants: The study comprised all children born in NSW between 2000 and 2010 with complete follow-up till 31 December 2011. The cohort was divided into three subgroups: (1) non-Indigenous high-risk children: non-Indigenous children born preterm or born with a low birth weight; (2) Indigenous children: children of mothers whose Indigenous status was recorded as Aboriginal and/or Torres Strait Islander and (3) non-Indigenous standard risk children: all other non-Indigenous term children. Primary outcome measure: Risk of development of severe asthma in different subgroups of children who had RSV hospitalisation in the first 2 years of life compared with those who did not. Design: We performed a retrospective cohort analysis using population-based linked administrative data. Extended Cox model was used to determine HR and 95{\%} CI around the HR for first asthma hospitalisation in different subgroups of children. Results: The cohort comprised 847 516 children born between 2000 and 2010. In the adjusted Cox model, the HR of first asthma hospitalisation was higher and comparable across all subgroups of children who had RSV hospitalisation compared with those who did not. The HR (95{\%} CI) was highest in children aged 2–3 years; 4.3 (95{\%} CI 3.8 to 4.9) for high-risk, 4.0 (95{\%} CI 3.3 to 4.8) for Indigenous and 3.9 (95{\%} CI 3.7 to 4.1) for non-Indigenous standard risk children. This risk persisted beyond 7 years of age. Conclusion: This large study confirms a comparable increased risk of first asthma hospitalisation following RSV disease in the first 2 years of life across different subgroups children at risk.",
    keywords = "Adolescent Asthma/*epidemiology Child Child, Preschool Female Hospitalization/*statistics & numerical data Humans Infant Infant, Newborn Male New South Wales/epidemiology Respiratory Syncytial Virus Infections/*complications/*epidemiology Respiratory Syncytial Viruses/isolation & purification Retrospective Studies Risk Factors asthma community child health respiratory infections",
    author = "N. Homaira and N. Briggs and C. Pardy and M. Hanly and Oei, {J. L.} and L. Hilder and B. Bajuk and K. Lui and W. Rawlinson and T. Snelling and A. Jaffe",
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    Association between respiratory syncytial viral disease and the subsequent risk of the first episode of severe asthma in different subgroups of high-risk Australian children : a whole-of-population-based cohort study. / Homaira, N.; Briggs, N.; Pardy, C.; Hanly, M.; Oei, J. L.; Hilder, L.; Bajuk, B.; Lui, K.; Rawlinson, W.; Snelling, T.; Jaffe, A.

    In: BMJ Open, Vol. 7, No. 11, e017936, 08.11.2017, p. 1-6.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Association between respiratory syncytial viral disease and the subsequent risk of the first episode of severe asthma in different subgroups of high-risk Australian children

    T2 - a whole-of-population-based cohort study

    AU - Homaira, N.

    AU - Briggs, N.

    AU - Pardy, C.

    AU - Hanly, M.

    AU - Oei, J. L.

    AU - Hilder, L.

    AU - Bajuk, B.

    AU - Lui, K.

    AU - Rawlinson, W.

    AU - Snelling, T.

    AU - Jaffe, A.

    PY - 2017/11/8

    Y1 - 2017/11/8

    N2 - Objective: To determine the contribution of respiratory syncytial virus (RSV) to the subsequent development of severe asthma in different subgroups of children at risk of severe RSV disease. Settings: The study was conducted in New South Wales (NSW), Australia. Participants: The study comprised all children born in NSW between 2000 and 2010 with complete follow-up till 31 December 2011. The cohort was divided into three subgroups: (1) non-Indigenous high-risk children: non-Indigenous children born preterm or born with a low birth weight; (2) Indigenous children: children of mothers whose Indigenous status was recorded as Aboriginal and/or Torres Strait Islander and (3) non-Indigenous standard risk children: all other non-Indigenous term children. Primary outcome measure: Risk of development of severe asthma in different subgroups of children who had RSV hospitalisation in the first 2 years of life compared with those who did not. Design: We performed a retrospective cohort analysis using population-based linked administrative data. Extended Cox model was used to determine HR and 95% CI around the HR for first asthma hospitalisation in different subgroups of children. Results: The cohort comprised 847 516 children born between 2000 and 2010. In the adjusted Cox model, the HR of first asthma hospitalisation was higher and comparable across all subgroups of children who had RSV hospitalisation compared with those who did not. The HR (95% CI) was highest in children aged 2–3 years; 4.3 (95% CI 3.8 to 4.9) for high-risk, 4.0 (95% CI 3.3 to 4.8) for Indigenous and 3.9 (95% CI 3.7 to 4.1) for non-Indigenous standard risk children. This risk persisted beyond 7 years of age. Conclusion: This large study confirms a comparable increased risk of first asthma hospitalisation following RSV disease in the first 2 years of life across different subgroups children at risk.

    AB - Objective: To determine the contribution of respiratory syncytial virus (RSV) to the subsequent development of severe asthma in different subgroups of children at risk of severe RSV disease. Settings: The study was conducted in New South Wales (NSW), Australia. Participants: The study comprised all children born in NSW between 2000 and 2010 with complete follow-up till 31 December 2011. The cohort was divided into three subgroups: (1) non-Indigenous high-risk children: non-Indigenous children born preterm or born with a low birth weight; (2) Indigenous children: children of mothers whose Indigenous status was recorded as Aboriginal and/or Torres Strait Islander and (3) non-Indigenous standard risk children: all other non-Indigenous term children. Primary outcome measure: Risk of development of severe asthma in different subgroups of children who had RSV hospitalisation in the first 2 years of life compared with those who did not. Design: We performed a retrospective cohort analysis using population-based linked administrative data. Extended Cox model was used to determine HR and 95% CI around the HR for first asthma hospitalisation in different subgroups of children. Results: The cohort comprised 847 516 children born between 2000 and 2010. In the adjusted Cox model, the HR of first asthma hospitalisation was higher and comparable across all subgroups of children who had RSV hospitalisation compared with those who did not. The HR (95% CI) was highest in children aged 2–3 years; 4.3 (95% CI 3.8 to 4.9) for high-risk, 4.0 (95% CI 3.3 to 4.8) for Indigenous and 3.9 (95% CI 3.7 to 4.1) for non-Indigenous standard risk children. This risk persisted beyond 7 years of age. Conclusion: This large study confirms a comparable increased risk of first asthma hospitalisation following RSV disease in the first 2 years of life across different subgroups children at risk.

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