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Asthma trajectories in early childhood: identifying modifiable factors

Asthma trajectories in early childhood: identifying modifiable factors
Asthma trajectories in early childhood: identifying modifiable factors
Background

There are conflicting views as to whether childhood wheezing represents several discreet entities or a single but variable disease. Classification has centered on phenotypes often derived using subjective criteria, small samples, and/or with little data for young children. This is particularly problematic as asthmatic features appear to be entrenched by age 6/7. In this paper we aim to: identify longitudinal trajectories of wheeze and other atopic symptoms in early childhood; characterize the resulting trajectories by the socio-economic background of children; and identify potentially modifiable processes in infancy correlated with these trajectories.

Data and Methods

The Millennium Cohort Study is a large, representative birth cohort of British children born in 2000–2002. Our analytical sample includes 11,632 children with data on key variables (wheeze in the last year; ever hay-fever and/or eczema) reported by the main carers at age 3, 5 and 7 using a validated tool, the International Study of Asthma and Allergies in Childhood module. We employ longitudinal Latent Class Analysis, a clustering methodology which identifies classes underlying the observed population heterogeneity.

Results

Our model distinguished four latent trajectories: a trajectory with both low levels of wheeze and other atopic symptoms (54% of the sample); a trajectory with low levels of wheeze but high prevalence of other atopic symptoms (29%); a trajectory with high prevalence of both wheeze and other atopic symptoms (9%); and a trajectory with high levels of wheeze but low levels of other atopic symptoms (8%). These groups differed in terms of socio-economic markers and potential intervenable factors, including household damp and breastfeeding initiation.

Conclusion

Using data-driven techniques, we derived four trajectories of asthmatic symptoms in early childhood in a large, population based sample. These groups differ in terms of their socio-economic profiles. We identified correlated intervenable pathways in infancy, including household damp and breastfeeding initiation.
1932-6203
1-11
Panico, Lidia
f7817975-4ddd-43a7-8aab-d4d5da80e8f5
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Bartley, Mel
6136c932-7b67-46b0-baee-2a5526bc19af
Kelly, Yvonne
71c6a35e-28fa-4627-95a9-38fd1c656a22
Panico, Lidia
f7817975-4ddd-43a7-8aab-d4d5da80e8f5
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Bartley, Mel
6136c932-7b67-46b0-baee-2a5526bc19af
Kelly, Yvonne
71c6a35e-28fa-4627-95a9-38fd1c656a22

Panico, Lidia, Stuart, Beth, Bartley, Mel and Kelly, Yvonne (2014) Asthma trajectories in early childhood: identifying modifiable factors. PLoS ONE, 9 (11), 1-11. (doi:10.1371/journal.pone.0111922).

Record type: Article

Abstract

Background

There are conflicting views as to whether childhood wheezing represents several discreet entities or a single but variable disease. Classification has centered on phenotypes often derived using subjective criteria, small samples, and/or with little data for young children. This is particularly problematic as asthmatic features appear to be entrenched by age 6/7. In this paper we aim to: identify longitudinal trajectories of wheeze and other atopic symptoms in early childhood; characterize the resulting trajectories by the socio-economic background of children; and identify potentially modifiable processes in infancy correlated with these trajectories.

Data and Methods

The Millennium Cohort Study is a large, representative birth cohort of British children born in 2000–2002. Our analytical sample includes 11,632 children with data on key variables (wheeze in the last year; ever hay-fever and/or eczema) reported by the main carers at age 3, 5 and 7 using a validated tool, the International Study of Asthma and Allergies in Childhood module. We employ longitudinal Latent Class Analysis, a clustering methodology which identifies classes underlying the observed population heterogeneity.

Results

Our model distinguished four latent trajectories: a trajectory with both low levels of wheeze and other atopic symptoms (54% of the sample); a trajectory with low levels of wheeze but high prevalence of other atopic symptoms (29%); a trajectory with high prevalence of both wheeze and other atopic symptoms (9%); and a trajectory with high levels of wheeze but low levels of other atopic symptoms (8%). These groups differed in terms of socio-economic markers and potential intervenable factors, including household damp and breastfeeding initiation.

Conclusion

Using data-driven techniques, we derived four trajectories of asthmatic symptoms in early childhood in a large, population based sample. These groups differ in terms of their socio-economic profiles. We identified correlated intervenable pathways in infancy, including household damp and breastfeeding initiation.

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More information

Accepted/In Press date: 2 October 2014
Published date: 7 November 2014
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 371963
URI: https://eprints.soton.ac.uk/id/eprint/371963
ISSN: 1932-6203
PURE UUID: 10d95681-7bcc-43b9-8ca2-c5c713c9ae8e

Catalogue record

Date deposited: 26 Nov 2014 12:28
Last modified: 30 Sep 2019 18:54

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