Effective interventional program to reduce the prevalence of asthma in children at high risk

An interventional program in place before the birth of a child and applied during the first year of life appears to be effective in reducing the occurrence of asthma at the age of seven years in the high-risk families, study shows Canadian published in the "Journal of Allergy and Clinical Immunology" (JACI).

Asthma and atopic diseases involve factors to both environmental and genetic, remember Moira Chan-Yeun and colleagues at the University of Manitoba.

This team of Canadian researchers sought to evaluate the efficacy of an interventional program for primary prevention for children at high risk of asthma. Were considered as children with at least one first-degree relative with asthma or two first-degree relatives were affected suffered another IgE dependent allergic disease (atopic dermatitis, allergic rhinitis, food allergy).

For this study, two groups were formed at random: 279 families participated in an interventional program involving different actions, and 266 others have formed a control group.

Families who attended this preventive program first had to remove allergens from home four and eight months before and after the birth of the child (cleaning carpets and furniture, pets left outside the home or at least the child's bedroom). In addition, parents were encouraged to stop smoking or to smoke outside, the mother was encouraged to continue breastfeeding for at least the first four months of the child's life, as well as delay introduction of new foods into the diet of infants after the age of six months.

The authors had previously reported that during early childhood, the proportion of children with asthmatic symptoms showed significantly lower in the group of children who attended the interventional than in the control group program (34% less in age of one year, 40% less at the age of two years).

Asthma itself (defined as wheezing in the absence of a cold and bronchial hyperresponsiveness) has also been less common in the intervention group (12.9%) than in the control group (25% ), a reduction of 61%.

The following seven years of this cohort (380 of 545 children seen) confirmed that the percentage of children receiving a diagnosis of asthma by a specialized pediatric allergist shows significantly lower in the intervention group (14.9%) in the control group (23%). This means that the interventional program implemented in this study reduces by 56% the risk of asthma at age 7 years.

In contrast, the prevalence of allergic rhinitis and atopic dermatitis, as well as bronchial hyperresponsiveness proved similar in both groups. It is possible that the interventional program has only a limited impact on these atopic diseases genetically predetermined impact, the authors write.

These results show that interventional program applied at the end of pregnancy and during the first year of life the child is effective in primary prevention of asthma in children at high risk of developing this disease. The success of this program in this cohort could be explained by the high socio-educational level of mothers and a low level of smoking in these families, the authors note.

These children will be assessed again at the age of 11-12 years to see if this interventional program actually reduces the risk of asthma or if only delays the onset of disease.