Evaluation of the Predictors of Breath Holding Spell (BHS) in under 5-Year-Old Children in Iran: A Hospital-Based Case-Control Study

Breath holding spell (BHS) is a sudden, reflexive, non-epileptic phenomenon that is common in infancy and early childhood. The aim of this study was to determine the predictors of breath holding spell (BHS) in children under 5 in Iran.
The study was a case-control study (case, n=55; control, n=55). The cases were selected from children with BHS who had been referred to Mohammad Kermanshahi Hospital of Kermanshah, during 2019. Then, for each case, one control was selected among the children who referred to other wards of this hospital for reasons other than BHS.The data collection tool was a data collection form including demographic, family, obstetric and biochemical characteristics. The biochemical parameters (such as serum calcium, magnesium, albumin, phosphorus and vitamin D levels) were measured by a fully automatic auto-analyzer (Prestige 24i Tokyo-Boeki, Japan). Univariate and multivariate logistic regression models were used to data analysis by STATA 14.
The mean age of children for case and control groups were 22.85 ± 15.34 and 23.29 ± 16.91 months, respectively. The numbers of boys were 32(58.20) and 29(52.70) for case and control groups; respectively. The multivariate logistic regression model showed that the calcium (OR=9.03; 95% CI: 2.51 – 32.48), household size (OR=0.19; 95% CI: 0.04 – 0.90), paternal education (OR=0.48; 95% CI: 0.24 – 0.97), and history of mental illness in family (OR=8.97; 95% CI: 1.15 – 69.72) were, statistically, the most important predictors of BHS in children under 5 years.
Calcium, household size, paternal education and history of mental illness in family were the most important predictors of BHS in children under 5 years; however, studies with larger sample size are required.