Caroline J Lodge1, Sophie Zaloumis2, Adrian J Lowe3, Lyle C Gurrin2, Melanie C Matheson2, Christine Axelrad4, Catherine M Bennett5, David J Hill4, Clifford S Hosking6, Cecilie Svanes7, Michael J Abramson8, Katrina J Allen9, Shyamali C Dharmage3. 1. Center for Molecular, Environmental, Genetic, and Analytic Epidemiology, School of Population and Global Health, University of Melbourne, Melbourne, Australia. Electronic address: clodge@unimelb.edu.au. 2. Center for Molecular, Environmental, Genetic, and Analytic Epidemiology, School of Population and Global Health, University of Melbourne, Melbourne, Australia. 3. Center for Molecular, Environmental, Genetic, and Analytic Epidemiology, School of Population and Global Health, University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia. 4. Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia. 5. Deakin Population Health, Deakin University, Burwood, Australia. 6. Department of Pediatrics, John Hunter Children's Hospital, Newcastle, Australia. 7. Bergen Respiratory Research Group, Center of International Health, University of Bergen, Bergen, Norway; Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway. 8. Department of Epidemiology and Preventive Medicine, The Alfred Hospital, Monash University, Melbourne, Australia. 9. Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia.
Abstract
OBJECTIVE: To define longitudinal childhood wheeze phenotypes and identify their early-life risk factors. STUDY DESIGN:Current wheeze was recorded 23 times up to age 7 years in a birth cohort at high risk for allergy (n = 620). Latent class analysis of wheeze responses identified 5 classes. Multinomial logistic regression estimated associations of probability-weighted wheezing classes with early-life factors. All phenotypes were compared with never/infrequent wheezers. RESULTS:Lower respiratory tract infection (LRTI) by 1 year (relative risk [RR], 3.00; 95% CI, 1.58-5.70), childcare by 1 year (RR, 1.51; 95% CI, 1.02-2.22), and higher body mass index (RR, 2.51; 95% CI, 1.09-5.81) were associated with increased risk of early transient wheeze, whereas breastfeeding was protective (RR, 0.54; 95% CI, 0.32-0.90). LRTI (RR, 6.54; 95% CI, 2.55-16.76) and aeroallergen sensitization (RR, 4.95; 95% CI, 1.74-14.02) increased the risk of early persistent wheeze. LRTI (RR, 5.31; 95% CI, 2.71-10.41), eczema (RR, 2.77; 95% CI, 1.78-4.31), aeroallergen sensitization (RR, 5.60; 95% CI, 2.86-10.9), and food sensitization (RR, 2.77; 95% CI, 1.56-4.94) increased the risk of intermediate-onset wheeze, whereas dog exposure at baseline (RR, 0.52; 95% CI, 0.32-0.84) and first-born status (RR, 0.49; 95% CI, 0.32-0.76) were protective. Heavy parental smoking at birth (RR, 3.18; 95% CI, 1.02-9.88) increased the risk of late-onset wheeze, whereas breastfeeding reduced it (RR, 0.34; 95% CI, 0.12-0.96). All wheeze classes except early transient had greater risk of wheeze at age 12 years compared with never/infrequent wheezers. CONCLUSION: We found distinct early-life risk factor profiles for each wheeze phenotype. These findings provide insight into possible wheeze mechanisms and have implications for identifying preventive strategies and addressing clinical management of early-life wheeze. Crown
RCT Entities:
OBJECTIVE: To define longitudinal childhood wheeze phenotypes and identify their early-life risk factors. STUDY DESIGN: Current wheeze was recorded 23 times up to age 7 years in a birth cohort at high risk for allergy (n = 620). Latent class analysis of wheeze responses identified 5 classes. Multinomial logistic regression estimated associations of probability-weighted wheezing classes with early-life factors. All phenotypes were compared with never/infrequent wheezers. RESULTS: Lower respiratory tract infection (LRTI) by 1 year (relative risk [RR], 3.00; 95% CI, 1.58-5.70), childcare by 1 year (RR, 1.51; 95% CI, 1.02-2.22), and higher body mass index (RR, 2.51; 95% CI, 1.09-5.81) were associated with increased risk of early transient wheeze, whereas breastfeeding was protective (RR, 0.54; 95% CI, 0.32-0.90). LRTI (RR, 6.54; 95% CI, 2.55-16.76) and aeroallergen sensitization (RR, 4.95; 95% CI, 1.74-14.02) increased the risk of early persistent wheeze. LRTI (RR, 5.31; 95% CI, 2.71-10.41), eczema (RR, 2.77; 95% CI, 1.78-4.31), aeroallergen sensitization (RR, 5.60; 95% CI, 2.86-10.9), and food sensitization (RR, 2.77; 95% CI, 1.56-4.94) increased the risk of intermediate-onset wheeze, whereas dog exposure at baseline (RR, 0.52; 95% CI, 0.32-0.84) and first-born status (RR, 0.49; 95% CI, 0.32-0.76) were protective. Heavy parental smoking at birth (RR, 3.18; 95% CI, 1.02-9.88) increased the risk of late-onset wheeze, whereas breastfeeding reduced it (RR, 0.34; 95% CI, 0.12-0.96). All wheeze classes except early transient had greater risk of wheeze at age 12 years compared with never/infrequent wheezers. CONCLUSION: We found distinct early-life risk factor profiles for each wheeze phenotype. These findings provide insight into possible wheeze mechanisms and have implications for identifying preventive strategies and addressing clinical management of early-life wheeze. Crown
Authors: Sze Man Tse; Sheryl L Rifas-Shiman; Brent A Coull; Augusto A Litonjua; Emily Oken; Diane R Gold Journal: J Allergy Clin Immunol Date: 2016-04-27 Impact factor: 10.793
Authors: Anne M Fitzpatrick; Leonard B Bacharier; Theresa W Guilbert; Daniel J Jackson; Stanley J Szefler; Avraham Beigelman; Michael D Cabana; Ronina Covar; Fernando Holguin; Robert F Lemanske; Fernando D Martinez; Wayne Morgan; Wanda Phipatanakul; Jacqueline A Pongracic; Robert S Zeiger; David T Mauger Journal: J Allergy Clin Immunol Pract Date: 2018-09-26
Authors: Ana M Mora; Jane A Hoppin; Leonel Córdoba; Juan C Cano; Manuel Soto-Martínez; Brenda Eskenazi; Christian H Lindh; Berna van Wendel de Joode Journal: Int J Hyg Environ Health Date: 2020-02-15 Impact factor: 5.840
Authors: Anne M Fitzpatrick; Leonard B Bacharier; Daniel J Jackson; Stanley J Szefler; Avraham Beigelman; Michael Cabana; Ronina Covar; Theresa Guilbert; Fernando Holguin; Robert F Lemanske; Fernando D Martinez; Wayne Morgan; Wanda Phipatanakul; Jacqueline A Pongracic; Hengameh H Raissy; Robert S Zeiger; David T Mauger Journal: J Allergy Clin Immunol Pract Date: 2020-03-07
Authors: Joon Hwan Kim; Ji-Yeon Choi; Na Yeon Kim; Jin Woo Kim; Ji Hyeon Baek; Hye Sung Baek; Jung Won Yoon; Hye Mi Jee; Sun Hee Choi; Hyeung Yoon Kim; Ki Eun Kim; Youn Ho Shin; Man Yong Han Journal: Korean J Pediatr Date: 2015-07-22