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Early life risk factors for current wheeze, asthma, and bronchial hyperresponsiveness at 10 years of age

Early life risk factors for current wheeze, asthma, and bronchial hyperresponsiveness at 10 years of age
Early life risk factors for current wheeze, asthma, and bronchial hyperresponsiveness at 10 years of age

STUDY OBJECTIVES: We sought to identify early life factors (ie, first 4 years) associated with wheeze, asthma, and bronchial hyperresponsiveness (BHR) at age 10 years, comparing their relative influence for these conditions.

METHODS: Children were seen at birth, and at 1, 2, 4, and 10 years of age in a whole-population birth cohort study (1,456 subjects). Information was collected prospectively on genetic and environmental risk factors. Skin-prick testing was performed at 4 years of age. Current wheeze (in the last 12 months) and currently diagnosed asthma (CDA) [ie, current wheeze and ever-diagnosed asthmatic subject] were recorded at 10 years of age when BHR was measured at bronchial challenge. Independent significant risk factors for these outcomes were identified by logistic regression.

RESULTS: Independent significance for current wheeze occurred with maternal asthma (odds ratio [OR], 2.08; 95% confidence interval [CI], 1.27 to 3.41) and paternal asthma (OR, 2.12; 95% CI 1.29 to 3.51), recurrent chest infections at 2 years (OR, 3.98; 95% CI, 2.36 to 6.70), atopy at 4 years of age (OR, 3.69; 95% CI, 2.36 to 5.76), eczema at 4 years of age (OR, 2.15; 95% CI, 1.24 to 3.73), and parental smoking at 4 years of age (OR, 2.18; 95% CI, 1.25 to 3.81). For CDA, significant factors were maternal asthma (OR, 2.26; 95% CI, 1.24 to 3.73), paternal asthma (OR, 2.30; 95% CI, 1.17 to 4.52), and sibling asthma (OR, 2.00; 95% CI, 1.16 to 3.43), recurrent chest infections at 1 year of age (OR, 2.67; 95% CI, 1.12 to 6.40) and 2 years of age (OR, 4.11; 95% CI, 2.06 to 8.18), atopy at 4 years of age (OR, 7.22; 95% CI, 4.13 to 12.62), parental smoking at 1 year of age (OR, 1.99; 95% CI, 1.15 to 3.45), and male gender (OR, 1.72; 95% CI, 1.01 to 2.95). For BHR, atopy at 4 years of age (OR, 5.38; 95% CI, 3.06 to 9.47) and high social class at birth (OR, 2.03; 95% CI, 1.16 to 3.53) proved to be significant.

CONCLUSIONS: Asthmatic heredity, predisposition to early life atopy, plus early passive smoke exposure and recurrent chest infections are important influences for the occurrence of wheeze and asthma at 10 years of age. BHR at 10 years of age has a narrower risk profile, suggesting that factors influencing wheezing symptom expression may differ from those predisposing the patient to BHR.

Asthma/etiology, Bronchial Hyperreactivity/etiology, Bronchial Provocation Tests, Child, Child, Preschool, Cohort Studies, Female, Genetic Predisposition to Disease/genetics, Humans, Hypersensitivity/complications, Infant, Infant, Newborn, Intradermal Tests, Longitudinal Studies, Male, Prospective Studies, Recurrence, Respiratory Sounds/etiology, Respiratory Tract Infections/complications, Risk Factors, Tobacco Smoke Pollution/adverse effects, United Kingdom
0012-3692
502-508
Arshad, S. Hasan
795d8599-b77d-44e5-bb9c-67db78822057
Kurukulaaratchy, Ramesh J.
9c7b8105-2892-49f2-8775-54d4961e3e74
Fenn, Monica
8fe24028-c9e6-465d-ba76-78b5a1fb129f
Matthews, Sharon
da71ceaa-c974-4fda-aea0-13c7cdecaf04
Arshad, S. Hasan
795d8599-b77d-44e5-bb9c-67db78822057
Kurukulaaratchy, Ramesh J.
9c7b8105-2892-49f2-8775-54d4961e3e74
Fenn, Monica
8fe24028-c9e6-465d-ba76-78b5a1fb129f
Matthews, Sharon
da71ceaa-c974-4fda-aea0-13c7cdecaf04

Arshad, S. Hasan, Kurukulaaratchy, Ramesh J., Fenn, Monica and Matthews, Sharon (2005) Early life risk factors for current wheeze, asthma, and bronchial hyperresponsiveness at 10 years of age. Chest, 127 (2), 502-508. (doi:10.1378/chest.127.2.502).

Record type: Article

Abstract

STUDY OBJECTIVES: We sought to identify early life factors (ie, first 4 years) associated with wheeze, asthma, and bronchial hyperresponsiveness (BHR) at age 10 years, comparing their relative influence for these conditions.

METHODS: Children were seen at birth, and at 1, 2, 4, and 10 years of age in a whole-population birth cohort study (1,456 subjects). Information was collected prospectively on genetic and environmental risk factors. Skin-prick testing was performed at 4 years of age. Current wheeze (in the last 12 months) and currently diagnosed asthma (CDA) [ie, current wheeze and ever-diagnosed asthmatic subject] were recorded at 10 years of age when BHR was measured at bronchial challenge. Independent significant risk factors for these outcomes were identified by logistic regression.

RESULTS: Independent significance for current wheeze occurred with maternal asthma (odds ratio [OR], 2.08; 95% confidence interval [CI], 1.27 to 3.41) and paternal asthma (OR, 2.12; 95% CI 1.29 to 3.51), recurrent chest infections at 2 years (OR, 3.98; 95% CI, 2.36 to 6.70), atopy at 4 years of age (OR, 3.69; 95% CI, 2.36 to 5.76), eczema at 4 years of age (OR, 2.15; 95% CI, 1.24 to 3.73), and parental smoking at 4 years of age (OR, 2.18; 95% CI, 1.25 to 3.81). For CDA, significant factors were maternal asthma (OR, 2.26; 95% CI, 1.24 to 3.73), paternal asthma (OR, 2.30; 95% CI, 1.17 to 4.52), and sibling asthma (OR, 2.00; 95% CI, 1.16 to 3.43), recurrent chest infections at 1 year of age (OR, 2.67; 95% CI, 1.12 to 6.40) and 2 years of age (OR, 4.11; 95% CI, 2.06 to 8.18), atopy at 4 years of age (OR, 7.22; 95% CI, 4.13 to 12.62), parental smoking at 1 year of age (OR, 1.99; 95% CI, 1.15 to 3.45), and male gender (OR, 1.72; 95% CI, 1.01 to 2.95). For BHR, atopy at 4 years of age (OR, 5.38; 95% CI, 3.06 to 9.47) and high social class at birth (OR, 2.03; 95% CI, 1.16 to 3.53) proved to be significant.

CONCLUSIONS: Asthmatic heredity, predisposition to early life atopy, plus early passive smoke exposure and recurrent chest infections are important influences for the occurrence of wheeze and asthma at 10 years of age. BHR at 10 years of age has a narrower risk profile, suggesting that factors influencing wheezing symptom expression may differ from those predisposing the patient to BHR.

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More information

Published date: February 2005
Keywords: Asthma/etiology, Bronchial Hyperreactivity/etiology, Bronchial Provocation Tests, Child, Child, Preschool, Cohort Studies, Female, Genetic Predisposition to Disease/genetics, Humans, Hypersensitivity/complications, Infant, Infant, Newborn, Intradermal Tests, Longitudinal Studies, Male, Prospective Studies, Recurrence, Respiratory Sounds/etiology, Respiratory Tract Infections/complications, Risk Factors, Tobacco Smoke Pollution/adverse effects, United Kingdom

Identifiers

Local EPrints ID: 446466
URI: http://eprints.soton.ac.uk/id/eprint/446466
ISSN: 0012-3692
PURE UUID: 38a7c722-cf07-4dd7-893d-a80db3dabc4b
ORCID for Ramesh J. Kurukulaaratchy: ORCID iD orcid.org/0000-0002-1588-2400

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Date deposited: 10 Feb 2021 17:35
Last modified: 09 Jan 2022 03:01

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Contributors

Author: S. Hasan Arshad
Author: Monica Fenn
Author: Sharon Matthews

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