Article Sidebar
NUTRITIONAL STATUS IN CHILDREN UNDER 3 YEARS OLD WITH RECURRENT WHEEZING AT E HOSPITAL IN 2025–2026
Main Article Content
Abstract
Aims: To assess the nutritional status, serum micronutrient profiles (vitamin D, iron, and zinc), and associated determinants among hospitalized children under 3 years of age with recurrent wheezing at E Hospital between 2025 and 2026.
Methods: A cross-sectional study was conducted on 69 children aged 2 to 36 months diagnosed with recurrent wheezing (≥ 3 episodes within 12 months) admitted to E Hospital from January 2025 to June 2026. Anthropometric parameters were assessed according to the Vietnam Pediatric Association consensus guidelines. Serum concentrations of 25-hydroxyvitamin D [25(OH)D], iron, and zinc were measured.
Multinomial and multivariable logistic regression analyses were performed to identify associated factors.
Results: The mean age of the cohort was 20.33 ± 7.94 months, with 53.6% being male. The prevalence of underweight, stunting, and wasting was 1.4%, 15.9%, and 2.9%, respectively, while the proportion of children at risk of underweight, stunting, and wasting reached 40.6%, 53.6%, and 7.2%. Micronutrient deficiencies were highly prevalent: 25(OH)D < 30 ng/mL (49.3%), 25(OH)D < 20 ng/mL (13.0%), hypozincemia (47.8%), and low serum iron (82.6%). Inadequate dietary intake significantly increased the odds of being at risk of underweight (aOR = 5.32; 95% CI: 1.39-20.36; p = 0.015) and stunting (aOR = 13.99; 95% CI: 1.49-131.55; p = 0.021). The absence of vitamin D supplementation was associated with an elevated risk of underweight (aOR = 14.17; 95% CI: 1.34-150.15; p = 0.028). Vitamin D supplementation (aOR = 0.036; 95% CI: 0.006-0.227; p < 0.001) and age > 24 months (aOR = 0.324; 95% CI: 0.109-0.962; p = 0.042) were identified as independent protective factors against vitamin D insufficiency/deficiency.
Conclusion: Children under 3 years of age with recurrent wheezing exhibit a notable burden of stunting and coexisting micronutrient deficiencies, particularly of iron, zinc, and vitamin D. Inadequate feeding practices and lack of vitamin D supplementation are key modifiable risk factors. Routine nutritional screening and micronutrient profiling should be systematically integrated into the clinical management of early childhood recurrent wheezing.
Keywords
Nutritional status, Micronutrients, Recurrent wheezing, Children under 3 years, E Hospital
Article Details
References
2. Piippo-Savolainen E, Korppi M. Wheezy babies--wheezy adults? Review on long-term outcome until adulthood after early childhood wheezing. Acta Paediatr. 2008;97(1):5-11. https://doi.org/10.1111/j.1651-2227.2007.00558.x
3. Phạm Thị Hồng Khánh, Nguyễn Thị Diệu Thúy. Khò khè tái diễn và hoặc dưới 5 tuổi tại Trung tâm Hô hấp bệnh viện Nhi Trung Ương. Tạp chí Y học Việt Nam 2023;Tập 529, số 2. https://doi.org/10.51298/vmj.v529i2.6448
4. Teijeiro A, Badellino H, Raiden MG. Risk factors for recurrent wheezing in the first year of life in the city of Cordoba, Argentina. Allergol Immunopathol (Madr). 2017;45(3):234-9. https://doi.org/10.1016/j.aller.2016.08.009
5. Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ, et al. Asthma and wheezing in the first six years of life. New England Journal of Medicine. 1995;332(3):133-8. https://doi.org/10.1056/nejm199501193320301
6. Mallol J, Garcia-Marcos L, Sole D, Brand P, Group ES. International prevalence of recurrent wheezing during the first year of life: variability, treatment patterns and use of health resources. Thorax. 2010;65(11):1004-9. https://doi.org/10.1136/thx.2009.115188
7. Kuiper-Makris C, Selle J, Nusken E. Perinatal Nutritional and Metabolic Pathways: Early Origins of Chronic Lung Diseases. Front Med (Lausanne). 2021;8:667315. https://doi.org/10.3389/fmed.2021.667315
8. Al Meslamani AZ. Insights into the immunological links between dietary habits and asthma. Expert Rev Clin Immunol. 2024;20(3):245-8. https://doi.org/10.1080/1744666x.2023.2277864
9. Siripornpanich S, Chongviriyaphan N, Manuyakorn W, Matangkasombut P. Zinc and vitamin C deficiencies associate with poor pulmonary function in children with persistent asthma. Asian Pac J Allergy Immunol. 2022;40(2):103-10. https://doi.org/10.12932/ap-100620-0878
10. Wang Z, He Y, Li Q, Zhao Y, Zhang G, Luo Z. Dysregulation of iron homeostasis in airways associated with persistent preschool wheezing. Respir Res. 2023;24(1):170. https://doi.org/10.1186/s12931-023-02466-7
11. Phạm Đức Tuấn, Nguyễn Thị Diệu Thúy. Nguyên nhân gây khò khè ở trẻ dưới 5 tuổi tại bệnh viện Đa khoa Tâm Anh. Tạp chí Y học Việt Nam. 2021;Tập 505, số 2. https://doi.org/10.51298/vmj.v505i2.1077
12. Đại học Y Hà Nội. Bài Giảng Nhi Khoa: Tập 2 (Sách giáo khoa Đại học): Nhà xuất bản Y học; 2020 (2): 247-257.
13. Trần Thanh Dương, Đinh Anh Tuấn, Trần Minh Điển, Dung Khu Thị Khánh. Đồng thuận của Hội Nhi Khoa Việt Nam: Hướng dẫn sàng lọc, đánh giá và can thiệp dinh dưỡng cho bệnh nhi. Tạp chí Nhi khoa. 2024;17(5). https://doi.org/10.52724/tcnk.v17i6.317
14. Holick MF. Vitamin D deficiency. New England journal of medicine. 2007;357(3):266-81. https://doi.org/10.1056/nejmra070553
15. Bộ Y Tế. Hướng dẫn chẩn đoán và điều trị một số bệnh thường gặp ở trẻ em (Hướng dẫn quyết định số 3312/QĐ-BYT). Bộ Y tế; 2015. [cited 2026 Aug 01]. Available from: https://kcb.vn/van-ban/huong-dan-chan-doan-va-dieu-tri-mot-so-benh-thuong-gap-o-tre-em.html
16. de Benoist B, Darnton-Hill I, Davidsson L, Fontaine O, Hotz C. Conclusions of the Joint WHO/UNICEF/IAEA/IZiNCG Interagency Meeting on Zinc Status Indicators. Food Nutr Bull. 2007;28(3 Suppl):S480-4. 10.1177/15648265070283S306
17. Bộ Y Tế. Bộ Y tế tổ chức công bố kết quả Tổng điều tra dinh dưỡng 2019 - 2020 2021. [cited 2026 Aug 01]. Available from: https://t5g.org.vn/cong-bo-ket-qua-tong-dieu-tra-dinh-duong-2019-2020.
18. Đậu Xuân Đại. Tình trạng dinh dưỡng và một số yếu tố liên quan ở trẻ mắc viêm phổi tại Bệnh viện E. Tạp chí nghiên cứu Y học. 2024;Tập 183-Số 10:148-54. https://doi.org/10.52852/tcncyh.v183i10.2917
19. Hawlader MD, Noguchi E, El Arifeen S, al. e. Nutritional status and childhood wheezing in rural Bangladesh. Public Health Nutr. 2014;17(7):1570-7. https://doi.org/10.1017/S1368980013001262
20. Devulapalli CS. Physical activity and vitamin D in children: a review of impacts on bone health and fitness. J Pediatr Endocrinol Metab. 2025;38(7):671-8. 10.1515/jpem-2024-0527
21. Ma K, Wei SQ, Bi WG, Weiler HA, Wen SW. Effect of Vitamin D Supplementation in Early Life on Children's Growth and Body Composition: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2021;13(2). https://doi.org/10.3390/nu13020524
22. Kettle AJ. Myeloperoxidase: Structure and Function of the Green Heme Peroxidase of Neutrophils: Royal Society of Chemistry; 2015. p. 272 - 308.