A Survey Of ADHD In Asthmatic Children And The Probably Risk Factors

Objective:By investigating the current situation of ADHD in the asthmatic children,analyzing the related risk factors of allergic factors,perinatal environmental and dietary exposure,in order to further understand their relationship,avoid the exposure of related risk factors and reduce the risk of disease,so as to better manage children’s asthma and ADHD.Methods:From December 2018 to September 2019,asthmatic children who were given treatment in the outpatient department of children’s asthma in Guizhou people’s Hospital and met the inclusion criteria and exclusion criteria were included in the study.At the same time,healthy children who were basically matched in gender,age,nationality and living area by 1:1 were recruited as the control group in child health care clinic in this hospital.The basic information of children was investigated by questionnaire,DSM-5 and SNAP-IV evaluation scale(short version)were used to diagnosis and evaluate the ADHD status of the children included in the study.The control status of asthmatic children was evaluated by C-ACT/ACT scale.The relevant clinical data were collected,and allergic factors,perinatal environmental and dietary exposure were investigated.The current situation of ADHD in the asthmatic children was analyzed,the risk factors were analyzed by single factor analysis,and then the risk factors with statistical differences by single factor analysis were analyzed by multi factor Logistic regression analysis.The related risk factors of allergic factors,perinatal environmental and dietary exposure were analyzed of ADHD in the asthmatic children.This study was approved by the ethics committee of Guizhou people’s Hospital([2019]No.165)and informed consent of the children or their guardians included in the study.Results:1.The current situation of ADHD in asthmatic children:①Detection of ADHD and basic demographic information:Finally,187 asthmatic children and 191 healthy children were included in the study.56 cases ADHD were detected among 187 asthmatic children,and 131 cases of them were not.The comorbidity rate was 29.95%(56/187),including 21 patients with attention disorder(37.5%),17 patients with hyperactivity/impulse(30.4%)and 18 patients with mixed(32.1%).14 cases ADHD were detected among 191 healthy children,the detection rate of ADHD was 7.33%(14/191),including 5 cases with attention disorder(35.7%),3 cases with hyperactivity/impulse(21.4%)and 6 cases with mixed(42.9%).The difference of ADHD detection rate between asthmatic children and healthy children was statistically significant(P=0.000),but there was no significant difference in ADHD subtypes(P=0.706).And there was no statistical difference in the nationality,place of residence,relationship between fillers and parents’occupation between asthmatic children and healthy children(P>0.05);② The treatment and control of asthmatic children in the comorbidity group and the non comorbidity group:There were statistically significant differences in the length of the initial onset to the beginning of standardized treatment of asthma and asthma control level between the two groups(P<0.05);③ FeNO level and the pulmonary function tests of asthmatic children in the comorbidity group and the non comorbidity group:There were statistically significant differences in the FeNO level,FEF50%,FEF75%,VT/kg between the two groups(P<0.05);2.Analyse the related risk factors of allergic factors,perinatal environmental and dietary exposure of ADHD in asthmatic children:①analyse allergic factors:the results of single factor analysis showed that whether there was allergic rhinitis symptoms,whether cetirizine hydrochloride and other antihistamines was added,the positive family history of other allergic diseases except asthma,and immunoglobulin IgE level and dust mite allergy level had statistical significance(P<0.05)between the comorbidity group and the non comorbidity group in the asthmatic children.Further multi factor Logistic regression analysis showed that adding cetirizine hydrochloride and other antihistamines may be associated with a lower risk of ADHD in asthmatic children(OR=0.343,95%CI:0.148-0.794);② analyse perinatal environmental and dietary exposure factors:the results of single factor analysis showed that the history of allergy in maternal pregnancy,the history of tobacco contact in maternal pregnancy and the history of eczema in newborn had statistical significance(P<0.05)between the comorbidity group and the non comorbidity group in the asthmatic children.Further multi factor Logistic regression analysis showed that the history of allergy in maternal pregnancy may be as a risk factor for ADHD in asthmatic children(OR=3.713,95%CI:1.368-10.079).Conclusion:1.The detection rate of ADHD in asthmatic children was higher than that in healthy children,especially Children with asthma who started standardized treatment later,had poor clinical and FeNO control;2.adding cetirizine hydrochloride and other antihistamines may be associated with a lower risk of ADHD in asthmatic children,and the history of allergy in maternal pregnancy may be as a risk factor for ADHD in asthmatic children.