The Case-control Study On Influencing Factors Of Community-acquired Pneumonia In Preschool Children In WuHu

Objective:To investigate the prevalence of community-acquired pneumonia in some preschool children in Wuhu,Anhui Province,and to explore its related influencing factors,so as to provide reference information for the development of corresponding prevention and control strategies for cap in preschool children.Methods:Using the case-control study method,the whole group of preschool children who were treated in the pediatrics and physical examination centers of 3 hospitals(Yijishan Hospital Affiliated to Wannan Medical College,Wuhu Women and Children Health Center,and Wuhu Second People’s Hospital)in Wuhu from October 2018 to December 2020 were selected as the research subjects.551 children who met the clinical diagnosis of community-acquired pneumonia were selected as the case group,and 1142 children with normal physical examination were selected as the control group.The case group and the control group were designed as non-matching(group).Family,environmental exposure and previous disease history of preschool children were collected through questionnaires.Univariate analysis and Multivariate Logisitc regression analysis were used to evaluate the related factors of community-acquired pneumonia in preschoolers.Results:1.Baseline data:Totally 1 693 subjects were included in the study,including 287(52.10%)boys and 264(47.90%)girls with an average age of(4.94±0.95)years.In the control group,there were 572(50.10%)boys and 570(49.90%)girls,with an average age of(4.86±0.95)years.There was no significant difference in age(χ2=2.965,P=0.397)and sex(χ2=0.595,P=0.441)between the two groups.2.Family factors:Age of father and mother in case group and control group(t father=1.625,P=0.104;tmother=1.393,P=0.164),father’s educational level(χ2=1.641,P=0.650)and family monthly income(χ2=3.344,P=0.342)had no statistical significance.In the case group,the proportion of mothers with college education or bachelor degree in case group was higher than that in control group(χ2=8.198,P=0.042).3.Gestation and breastfeeding:compared with the control group,there were no significant differences in gestational age(t=1.433,P=0.152),pregnancy(χ2=3.538,P=0.060),mode of delivery(χ2=1.104,P=0.293),birth length(t=0.394,P=0.694),birth weight(χ2=0.767,P=0.681)and breastfeeding(χ2=2.787,P=0.248).The proportion of supplementary food in 5～6 months old group and 6～7 months old group was lower than that in control group,and the difference was statistically significant(χ2=6.463,P=0.039).4.Vaccination:There was no significant difference in the proportion of preschool children in the case group who were vaccinated with the national immunization program(χ2=0.110,P=0.740),pneumococcal vaccine(χ2=0.340,P=0.560)and influenza vaccine(χ2=0.001,P=0.973)compared with the control group,and the differences were not statistically significant.5.Environmental exposure:in the case group,the proportion of father smoking(χ2=0.097,P=0.755),mother smoking before pregnancy(χ2=0.001,P=0.981),passive smoking during pregnancy(χ2=0.941,P=0.332),mildew in living environment(χ2=0.004,P=0.952),house decoration after birth(χ20.305,P=0.581)and keep flowers and plants at home(χ2=0.939,P=0.333)were not significantly different from those in the control group.There were significant differences between the two groups in pet keeping(χ2=5.480,P=0.019)and carpet using(χ2=4.851,P=0.028).6.Medical history:Compared with the control group,there were statistically significant differences in congenital heart disease(χ2=7.846,P=0.005),drug allergy(χ2=4.953,P=0.026),allergic rhinitis(χ2=21.460,P<0.001)and recurrent respiratory tract infection(χ2=26.198,P<0.001).There was no significant difference between allergic cough(χ2=0.751,P=0.386)and herpetic pharyngitis(χ2=3.626,P=0.057).7.Multivariate logistic regression analysis showed that congenital heart disease(OR=2.601,95%CI:1.185～5.708,P=0.017),allergic rhinitis(OR=2.046,95%CI:1.444～2.899,P<0.001),recurrent respiratory tract infection(OR=3.220,95%CI:1.712～6.056,P<0.001),keeping pets at home(OR=1.452,95%CI:1.030-2.046,P=0.033)and using carpets at home(OR=1.403,95%CI:1.024～1.922,P=0.035)was the risk factor for community-acquired pneumonia in preschoolers.Supplementary feeding is a protective factor for community-acquired pneumonia in preschool children aged 6 to 7 month(OR=0.658,95%CI:0.454～0.953,P=0.027).Conclusion:1.Congenital heart disease,allergic rhinitis,recurrent respiratory tract infection,keeping pets at home and using carpets at home are risk factors for the occurrence of community-acquired pneumonia in preschool children.2.Supplementary feeding is a protective factor for community-acquired pneumonia in preschool children aged 6 to 7 month.