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Prevalence and early-life risk factors of school age allergic multimorbidity - the EuroPrevall-iFAAM birth cohort

Prevalence and early-life risk factors of school age allergic multimorbidity - the EuroPrevall-iFAAM birth cohort
Prevalence and early-life risk factors of school age allergic multimorbidity - the EuroPrevall-iFAAM birth cohort

Background: Coexistence of childhood asthma, eczema and allergic rhinitis is higher than can be expected by chance, suggesting a common mechanism. Data on allergic multimorbidity from a pan-European, population-based birth cohort study have been lacking. This study compares the prevalence and early-life risk factors of these diseases in European primary school children. Methods: In the prospective multicentre observational EuroPrevall-iFAAM birth cohort study, we used standardized questionnaires on sociodemographics, medical history, parental allergies and lifestyle, and environmental exposures at birth, 12 and 24 months. At primary school age, parents answered ISAAC-based questions on current asthma, rhinitis and eczema. Allergic multimorbidity was defined as the coexistence of at least two of these. Results: From 10,563 children recruited at birth in 8 study centres, we included data from 5,572 children (mean age 8.2 years; 51.8% boys). Prevalence estimates were as follows: asthma, 8.1%; allergic rhinitis, 13.3%; and eczema, 12.0%. Allergic multimorbidity was seen in 7.0% of the whole cohort, ranging from 1.2% (Athens, Greece) to 10.9% (Madrid, Spain). Risk factors for allergic multimorbidity, identified with AICc, included family-allergy-score, odds ratio (OR) 1.50 (95% CI 1.32–1.70) per standard deviation; early-life allergy symptoms, OR 2.72 (2.34–3.16) for each symptom; and caesarean birth, OR 1.35 (1.04–1.76). Female gender, OR 0.72 (0.58–0.90); older siblings, OR 0.79 (0.63–0.99); and day care, OR 0.81 (0.63–1.06) were protective factors. Conclusion: Allergic multimorbidity should be regarded as an important chronic childhood disease in Europe. Some of the associated early-life factors are modifiable and may be considered for prevention strategies.

allergic multimorbidity, allergic rhinitis, asthma, children, eczema
0105-4538
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Sigurdardottir, Sigurveig T
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Jonasson, Kristjan
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Clausen, Michael
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Bjornsdottir, Kristin Lilja
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Sigurdardottir, Sigridur Erla
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Roberts, Graham
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Grimshaw, Kate
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Papadopoulos, Nikolaos G
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Xepapadaki, Paraskevi
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Fiandor, Ana
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Quirce, Santiago
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Sprikkelman, Aline B
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Hulshof, Lies
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Bellach, Johanna
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Reich, Andreas
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van Ree, Ronald
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Mills, Clare
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Grabenhenrich, Linus
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Beyer, Kirsten
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Keil, Thomas
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Sigurdardottir, Sigurveig T
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Jonasson, Kristjan
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Clausen, Michael
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Bjornsdottir, Kristin Lilja
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Sigurdardottir, Sigridur Erla
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Roberts, Graham
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Grimshaw, Kate
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Papadopoulos, Nikolaos G
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Fiandor, Ana
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Quirce, Santiago
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Sprikkelman, Aline B
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Hulshof, Lies
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Kowalski, Marek L
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Kurowiski, Marcin
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Yürek, Songül
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Reich, Andreas
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Erhard, Sina Maria
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Couch, Philip
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van Ree, Ronald
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Mills, Clare
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Beyer, Kirsten
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Keil, Thomas
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Sigurdardottir, Sigurveig T, Jonasson, Kristjan, Clausen, Michael, Bjornsdottir, Kristin Lilja, Sigurdardottir, Sigridur Erla, Roberts, Graham, Grimshaw, Kate, Papadopoulos, Nikolaos G, Xepapadaki, Paraskevi, Fiandor, Ana, Quirce, Santiago, Sprikkelman, Aline B, Hulshof, Lies, Kowalski, Marek L, Kurowiski, Marcin, Dubakiene, Ruta, Rudzeviciene, Odilija, Bellach, Johanna, Yürek, Songül, Reich, Andreas, Erhard, Sina Maria, Couch, Philip, Fernandez Rivas, Montserrat, van Ree, Ronald, Mills, Clare, Grabenhenrich, Linus, Beyer, Kirsten and Keil, Thomas (2021) Prevalence and early-life risk factors of school age allergic multimorbidity - the EuroPrevall-iFAAM birth cohort. Allergy, 76 (9), 2855-2865. (doi:10.1111/all.14857).

Record type: Article

Abstract

Background: Coexistence of childhood asthma, eczema and allergic rhinitis is higher than can be expected by chance, suggesting a common mechanism. Data on allergic multimorbidity from a pan-European, population-based birth cohort study have been lacking. This study compares the prevalence and early-life risk factors of these diseases in European primary school children. Methods: In the prospective multicentre observational EuroPrevall-iFAAM birth cohort study, we used standardized questionnaires on sociodemographics, medical history, parental allergies and lifestyle, and environmental exposures at birth, 12 and 24 months. At primary school age, parents answered ISAAC-based questions on current asthma, rhinitis and eczema. Allergic multimorbidity was defined as the coexistence of at least two of these. Results: From 10,563 children recruited at birth in 8 study centres, we included data from 5,572 children (mean age 8.2 years; 51.8% boys). Prevalence estimates were as follows: asthma, 8.1%; allergic rhinitis, 13.3%; and eczema, 12.0%. Allergic multimorbidity was seen in 7.0% of the whole cohort, ranging from 1.2% (Athens, Greece) to 10.9% (Madrid, Spain). Risk factors for allergic multimorbidity, identified with AICc, included family-allergy-score, odds ratio (OR) 1.50 (95% CI 1.32–1.70) per standard deviation; early-life allergy symptoms, OR 2.72 (2.34–3.16) for each symptom; and caesarean birth, OR 1.35 (1.04–1.76). Female gender, OR 0.72 (0.58–0.90); older siblings, OR 0.79 (0.63–0.99); and day care, OR 0.81 (0.63–1.06) were protective factors. Conclusion: Allergic multimorbidity should be regarded as an important chronic childhood disease in Europe. Some of the associated early-life factors are modifiable and may be considered for prevention strategies.

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e-pub ahead of print date: 2 May 2021
Published date: September 2021
Additional Information: Funding Information: The birth cohort study was funded by the European Commission: (a) under the 6th Framework Programme (FOOD-CT-2005-514000) within the collaborative research initiative ?EuroPrevall?, and (b) under the 7th Framework Programme (FP7-KBBE-2012-6; grant agreement no. 312 147) within the collaborative project ?iFAAM?. Additional funds were received by the Icelandic birth cohort centre from Landspitali University Hospital Iceland Science Fund, and from GlaxoSmithKline Iceland; by the UK birth cohort centre from the UK Food Standards Agency; by the Polish birth cohort centre from the Ministry of Science and Higher education; by the Lithuanian birth cohort centre as unrestricted grants from Grida and MSD; and by the Dutch birth cohort centre as unrestricted grants from Nutricia Advanced Medical Nutrition Netherlands, AstraZeneca Netherlands, TEVA Netherlands and GlaxoSmithKline Netherlands. None of the funding bodies had any influence on the study design, the collection and analysis of data, interpretation of results, manuscript preparation or decision to submit the paper for publication. We thank all families who participated in the birth cohort study and the medical and nursing staff of the participating hospitals, especially G. Christopoulou, I. Roumpedaki and R. Stergiou (Greece); H. Ragnarsdottir (Iceland); S. Paschke-Goossens, G. Schulz, A. Rohrbach, S. Tschirner, T. Schrezenmaier, A. Scholz, D. McBride, and M. Kulig (Germany); A. Stanczyk-Przy?uska, K. Zeman, J. Wilczynski and L. Podciechowski (Poland); S. Quirce, M. Reche, M. Martin Esteban, R. Gabriel, J. I. Larco, I. Bobolea and T. Cuevas (Spain); K. Foote, E. Oliver, A. Selby, L. Fairhead, Z. Dobson, S. Bhatt, S. Roberts, J. Martin and NIHR/Wellcome Trust Clinical Research Facility (UK); Midwives Zorggroep Almere, N. v. d. Berg, W. M. C. van Aalderen, B. Dontje, N. C. M. Petrus, H. C. Vriesendorp and A. Schoemaker (the Netherlands); and I. Butiene and D. Vaicekauskaite (Lithuania). Funding Information: Dr. Roberts reports grants from EU and grants from Food Standards Agency, during the conduct of the study; Dr. Grimshaw reports grants from Food Standards Agency UK, during the conduct of the study; Dr. Papadopoulos reports personal fees from Novartis, personal fees from Nutricia, personal fees from HAL, personal fees from MENARINI/FAES FARMA, personal fees from SANOFI, personal fees from MYLAN/MEDA, personal fees from BIOMAY, personal fees from AstraZeneca, personal fees from GSK, personal fees from MSD, personal fees from ASIT Biotech, personal fees from Boehringer Ingelheim, grants from Gerolymatos International SA and grants from Capricare, outside the submitted work; Dr. Xepapadaki reports personal fees from Uriach, personal fees from Novartis, personal fees from Nestle and personal fees from Nutricia, outside the submitted work; Dr. Fiandor reports personal fees and non‐financial support from AstraZeneca, outside the submitted work; Dr. Quirce reports personal fees and non‐financial support from GSK, personal fees and non‐financial support from AstraZeneca, personal fees and non‐financial support from Sanofi, personal fees and non‐financial support from Novartis, personal fees and non‐financial support from Mundipharma, personal fees and non‐financial support from Teva, and personal fees and non‐financial support from Allergy Therapeutics, outside the submitted work; Dr. Sprikkelman reports grants from Nutricia Advanced Medical Nutrition Netherlands, grants from AstraZeneca, Netherlands, grants from TEVA Netherlands and grants from GlaxoSmithKline Netherlands, during the conduct of the study, and grants from Aimmune, outside the submitted work; Dr. Couch reports grants from EU FP7‐KBBE, during the conduct of the study; Dr. Fernandez‐Rivas reports grants from European Commission, during the conduct of the study, personal fees from Aimmune, DBV, Novartis and SPRIM, and grants from Aimmune, Diater, ALK, DIATER, GSK and HAL Allergy, outside the submitted work; Dr. van Ree reports personal fees from HAL Allergy BV, personal fees from Citeq BV, personal fees from Angany Inc, personal fees from Thermo Fisher Scientific, grants from European Commission and grants from Dutch Science Foundation, outside the submitted work; ENC Mills reports grants from Reacta Biotech Ltd, outside the submitted work, and Chief Scientific Adviser and shareholder of Reacta Biotech Ltd, a start‐up developed to commercialise foods for use in oral food challenges; and Dr. Beyer reports grants from European Commission, during the conduct of the study, grants and personal fees from Aimmune, personal fees from Bencard, grants and personal fees from Danone/Nutricia/Milupa, grants and personal fees from DBV, grants and personal fees from Hipp, grants and personal fees from Hycor, grants and personal fees from InfectoPharm, personal fees from Jenapharm, personal fees from Mylan/Meda, personal fees from Nestle, personal fees from Novartis and personal fees from Thermo Fisher, outside the submitted work. All other authors have nothing to disclose. Funding Information: The birth cohort study was funded by the European Commission: (a) under the 6th Framework Programme (FOOD‐CT‐2005‐514000) within the collaborative research initiative ‘EuroPrevall’, and (b) under the 7th Framework Programme (FP7‐KBBE‐2012‐6; grant agreement no. 312 147) within the collaborative project ‘iFAAM’. Additional funds were received by the Icelandic birth cohort centre from Landspitali University Hospital Iceland Science Fund, and from GlaxoSmithKline Iceland; by the UK birth cohort centre from the UK Food Standards Agency; by the Polish birth cohort centre from the Ministry of Science and Higher education; by the Lithuanian birth cohort centre as unrestricted grants from Grida and MSD; and by the Dutch birth cohort centre as unrestricted grants from Nutricia Advanced Medical Nutrition Netherlands, AstraZeneca Netherlands, TEVA Netherlands and GlaxoSmithKline Netherlands. None of the funding bodies had any influence on the study design, the collection and analysis of data, interpretation of results, manuscript preparation or decision to submit the paper for publication. Publisher Copyright: © 2021 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.
Keywords: allergic multimorbidity, allergic rhinitis, asthma, children, eczema

Identifiers

Local EPrints ID: 449480
URI: http://eprints.soton.ac.uk/id/eprint/449480
ISSN: 0105-4538
PURE UUID: ccaf8ae7-9995-4e97-b23f-d09f2814bfbb
ORCID for Graham Roberts: ORCID iD orcid.org/0000-0003-2252-1248

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Date deposited: 02 Jun 2021 16:34
Last modified: 17 Mar 2024 06:36

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Contributors

Author: Sigurveig T Sigurdardottir
Author: Kristjan Jonasson
Author: Michael Clausen
Author: Kristin Lilja Bjornsdottir
Author: Sigridur Erla Sigurdardottir
Author: Graham Roberts ORCID iD
Author: Kate Grimshaw
Author: Nikolaos G Papadopoulos
Author: Paraskevi Xepapadaki
Author: Ana Fiandor
Author: Santiago Quirce
Author: Aline B Sprikkelman
Author: Lies Hulshof
Author: Marek L Kowalski
Author: Marcin Kurowiski
Author: Ruta Dubakiene
Author: Odilija Rudzeviciene
Author: Johanna Bellach
Author: Songül Yürek
Author: Andreas Reich
Author: Sina Maria Erhard
Author: Philip Couch
Author: Montserrat Fernandez Rivas
Author: Ronald van Ree
Author: Clare Mills
Author: Linus Grabenhenrich
Author: Kirsten Beyer
Author: Thomas Keil

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