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Early childhood wheeze across Europe: prevalence estimates and risk factors in the EuroPrevall birth cohort

Early childhood wheeze across Europe: prevalence estimates and risk factors in the EuroPrevall birth cohort
Early childhood wheeze across Europe: prevalence estimates and risk factors in the EuroPrevall birth cohort
Background: Preschool wheeze is an important problem worldwide. No comparative population-based studies covering different countries have previously been undertaken. Objective: To assess the prevalence of early childhood wheeze across Europe and evaluate risk factors, focusing on food allergy, breastfeeding and smoke exposure. Methods: Infants from nine countries were recruited into the EuroPrevall birth cohort. At 12 and 24 months, data on wheeze, allergic signs/symptoms, feeding, smoke exposure, infections and day care attendance were collected using questionnaires. Poisson regression was used to assess risk factors for wheeze. Results: 12,049 infants were recruited. Data from the second year of life were available in 8,805 (73.1%). The prevalence of wheeze in the second year of life ranged from <2% in Lodz (Poland) and Vilnius (Lithuania) to 13.1% (95% CI 10.7-15.5%) in Southampton (UK) and 17.2% (15.0-19.5%) in Reykjavik (Iceland). In multivariable analysis, frequent lower respiratory tract infections in the first and second years of life (incidence rate ratio (IRR) 1.9 (95% CI 1.3-2.6) and 2.5 (1.9-3.4), respectively), postnatal maternal smoking (IRR 1.6, 95% CI 1.1-2.4), day care attendance (IRR 1.6, 95% CI 1.1-2.5) and male gender (IRR 1.3, 95% CI 1.0-1.7) were associated with wheeze. The strength of their association with wheeze differed between countries. Food allergy and breastfeeding were not independently associated with wheeze. Conclusion: The prevalence of early childhood wheeze varied considerably across Europe. Lower respiratory tract infections, day care attendance, postnatal smoke exposure and male gender are important risk factors. Further research is needed to identify additional modifiable risk factors which may differ between countries.
0040-6376
1-13
Selby, Anna C
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Munro, Alasdair
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Grimshaw, Kathryn
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Cornelius, Victoria
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Keil, Thomas
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Grabenhenrich, Linus
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Clausen, Michael
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Dubakiene, Ruta
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Fiocchi, Alessandro
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Kowalski, Marek L
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Papadopoulos, Nikolaos G
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Reche, Marta
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Sigurdardottir, Sigurveig T
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Sprikkelman, Aline B
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Xepapadaki, Paraskevi
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Mills, E N Clare
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Beyer, Kirsten
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Roberts, Graham
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Selby, Anna C
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Munro, Alasdair
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Grimshaw, Kathryn
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Cornelius, Victoria
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Keil, Thomas
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Grabenhenrich, Linus
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Clausen, Michael
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Dubakiene, Ruta
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Fiocchi, Alessandro
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Kowalski, Marek L
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Papadopoulos, Nikolaos G
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Reche, Marta
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Sigurdardottir, Sigurveig T
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Sprikkelman, Aline B
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Xepapadaki, Paraskevi
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Mills, E N Clare
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Beyer, Kirsten
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Roberts, Graham
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Selby, Anna C, Munro, Alasdair, Grimshaw, Kathryn, Cornelius, Victoria, Keil, Thomas, Grabenhenrich, Linus, Clausen, Michael, Dubakiene, Ruta, Fiocchi, Alessandro, Kowalski, Marek L, Papadopoulos, Nikolaos G, Reche, Marta, Sigurdardottir, Sigurveig T, Sprikkelman, Aline B, Xepapadaki, Paraskevi, Mills, E N Clare, Beyer, Kirsten and Roberts, Graham (2018) Early childhood wheeze across Europe: prevalence estimates and risk factors in the EuroPrevall birth cohort. Thorax, 1-13. (doi:10.1136/thoraxjnl-2016-209429).

Record type: Article

Abstract

Background: Preschool wheeze is an important problem worldwide. No comparative population-based studies covering different countries have previously been undertaken. Objective: To assess the prevalence of early childhood wheeze across Europe and evaluate risk factors, focusing on food allergy, breastfeeding and smoke exposure. Methods: Infants from nine countries were recruited into the EuroPrevall birth cohort. At 12 and 24 months, data on wheeze, allergic signs/symptoms, feeding, smoke exposure, infections and day care attendance were collected using questionnaires. Poisson regression was used to assess risk factors for wheeze. Results: 12,049 infants were recruited. Data from the second year of life were available in 8,805 (73.1%). The prevalence of wheeze in the second year of life ranged from <2% in Lodz (Poland) and Vilnius (Lithuania) to 13.1% (95% CI 10.7-15.5%) in Southampton (UK) and 17.2% (15.0-19.5%) in Reykjavik (Iceland). In multivariable analysis, frequent lower respiratory tract infections in the first and second years of life (incidence rate ratio (IRR) 1.9 (95% CI 1.3-2.6) and 2.5 (1.9-3.4), respectively), postnatal maternal smoking (IRR 1.6, 95% CI 1.1-2.4), day care attendance (IRR 1.6, 95% CI 1.1-2.5) and male gender (IRR 1.3, 95% CI 1.0-1.7) were associated with wheeze. The strength of their association with wheeze differed between countries. Food allergy and breastfeeding were not independently associated with wheeze. Conclusion: The prevalence of early childhood wheeze varied considerably across Europe. Lower respiratory tract infections, day care attendance, postnatal smoke exposure and male gender are important risk factors. Further research is needed to identify additional modifiable risk factors which may differ between countries.

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Early Childhood Wheeze across Europe- Revised Manuscript December 2017 FINAL - Author's Original
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More information

Accepted/In Press date: 29 January 2018
e-pub ahead of print date: 10 May 2018
Published date: November 2018

Identifiers

Local EPrints ID: 421976
URI: http://eprints.soton.ac.uk/id/eprint/421976
ISSN: 0040-6376
PURE UUID: ce61d63a-5051-4e01-805f-c2814abe7fd9
ORCID for Graham Roberts: ORCID iD orcid.org/0000-0003-2252-1248

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Date deposited: 12 Jul 2018 16:30
Last modified: 26 Nov 2021 02:49

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Contributors

Author: Anna C Selby
Author: Alasdair Munro
Author: Victoria Cornelius
Author: Thomas Keil
Author: Linus Grabenhenrich
Author: Michael Clausen
Author: Ruta Dubakiene
Author: Alessandro Fiocchi
Author: Marek L Kowalski
Author: Nikolaos G Papadopoulos
Author: Marta Reche
Author: Sigurveig T Sigurdardottir
Author: Aline B Sprikkelman
Author: Paraskevi Xepapadaki
Author: E N Clare Mills
Author: Kirsten Beyer
Author: Graham Roberts ORCID iD

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