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Trajectories of early‐onset rhinitis in the Singapore GUSTO mother‐offspring cohort

Trajectories of early‐onset rhinitis in the Singapore GUSTO mother‐offspring cohort
Trajectories of early‐onset rhinitis in the Singapore GUSTO mother‐offspring cohort
Background: The natural history of childhood rhinitis is not well described.
Objective: This study aimed to identify different rhinitis trajectories in early childhood and their predictors and allergic associations.
Methods: Rhinitis symptoms were ascertained prospectively from birth until 6 years using standardized questionnaires in 772 participants. Rhinitis was defined as one or more episodes of sneezing, runny and/or blocked nose >2 weeks duration. Latent trajectories were identified using group‐based modelling, and their predictive risk factors and allergic associations were examined.
Results: Three rhinitis trajectory groups were identified: 7.6% (n = 59) were termed early transient rhinitis, 8.6% (n = 66) late transient rhinitis, and 6.6% (n = 51) persistent rhinitis. The remaining 77.2% (n = 596) were classified as non‐rhinitis/reference group. Early transient rhinitis subjects were more likely of Indian ethnicity, had siblings, reported childcare attendance, early wheezing and eczema in the first 3 years of life. Late transient rhinitis was associated with antenatal exposure to smoking, higher maternal education levels, and wheezing at age 36‐72 months. Persistent rhinitis was associated with male gender, paternal and maternal history of atopy, eczema, and house dust mite sensitization.
Conclusions & Clinical Relevance: Risk factors for early transient rhinitis involve a combination of genetic and early environmental exposures, whereas late transient rhinitis may relate to maternal factors and early respiratory infections independent of atopy. In contrast, persistent rhinitis is strongly associated with atopic risk and likely represents the typical trajectory associated with allergic disorders. Allergic rhinitis symptoms may commence as early as the first year of life and may inform development of early interventive strategies.
asthma, environment and hygiene hypothesis, paediatrics, rhinitis
0954-7894
Loo, Evelyn X.L.
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Liew, Tau Ming
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Yap, Gaik Chin
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Wong, Lydia Su Yin
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Shek, Lynette Pei-Chi
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Goh, Anne
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van Bever, Hugo
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Teoh, Oon Hoe
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Yap, Fabian
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Tan, Kok Hian
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Thomas, Biju
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Ramamurthy, Mahesh Babu
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Goh, Daniel Yam Thiam
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Eriksson, Johan G.
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Chong, Yap-Seng
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Godfrey, Keith
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Lee, Bee Wah
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Tham, Elizabeth Huiwen
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Loo, Evelyn X.L.
c21376cb-00e3-4c16-b6e4-1a81b66a7604
Liew, Tau Ming
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Yap, Gaik Chin
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Wong, Lydia Su Yin
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Shek, Lynette Pei-Chi
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Goh, Anne
75c7945a-718e-4b10-ab57-a643ccd71536
van Bever, Hugo
967ee912-3ad6-4c7b-ab6c-bb50914ea687
Teoh, Oon Hoe
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Yap, Fabian
92843bb8-1c32-46d7-a778-92b2e655e533
Tan, Kok Hian
672ae6c4-d4c8-4b1b-8512-efec36431503
Thomas, Biju
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Ramamurthy, Mahesh Babu
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Goh, Daniel Yam Thiam
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Eriksson, Johan G.
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Chong, Yap-Seng
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Godfrey, Keith
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Lee, Bee Wah
81ec0089-b824-4835-b908-1fc8e9f62249
Tham, Elizabeth Huiwen
e22014ec-8242-478a-aafc-e4177164f814

Loo, Evelyn X.L., Liew, Tau Ming, Yap, Gaik Chin, Wong, Lydia Su Yin, Shek, Lynette Pei-Chi, Goh, Anne, van Bever, Hugo, Teoh, Oon Hoe, Yap, Fabian, Tan, Kok Hian, Thomas, Biju, Ramamurthy, Mahesh Babu, Goh, Daniel Yam Thiam, Eriksson, Johan G., Chong, Yap-Seng, Godfrey, Keith, Lee, Bee Wah and Tham, Elizabeth Huiwen (2020) Trajectories of early‐onset rhinitis in the Singapore GUSTO mother‐offspring cohort. Clinical & Experimental Allergy. (doi:10.1111/cea.13803).

Record type: Article

Abstract

Background: The natural history of childhood rhinitis is not well described.
Objective: This study aimed to identify different rhinitis trajectories in early childhood and their predictors and allergic associations.
Methods: Rhinitis symptoms were ascertained prospectively from birth until 6 years using standardized questionnaires in 772 participants. Rhinitis was defined as one or more episodes of sneezing, runny and/or blocked nose >2 weeks duration. Latent trajectories were identified using group‐based modelling, and their predictive risk factors and allergic associations were examined.
Results: Three rhinitis trajectory groups were identified: 7.6% (n = 59) were termed early transient rhinitis, 8.6% (n = 66) late transient rhinitis, and 6.6% (n = 51) persistent rhinitis. The remaining 77.2% (n = 596) were classified as non‐rhinitis/reference group. Early transient rhinitis subjects were more likely of Indian ethnicity, had siblings, reported childcare attendance, early wheezing and eczema in the first 3 years of life. Late transient rhinitis was associated with antenatal exposure to smoking, higher maternal education levels, and wheezing at age 36‐72 months. Persistent rhinitis was associated with male gender, paternal and maternal history of atopy, eczema, and house dust mite sensitization.
Conclusions & Clinical Relevance: Risk factors for early transient rhinitis involve a combination of genetic and early environmental exposures, whereas late transient rhinitis may relate to maternal factors and early respiratory infections independent of atopy. In contrast, persistent rhinitis is strongly associated with atopic risk and likely represents the typical trajectory associated with allergic disorders. Allergic rhinitis symptoms may commence as early as the first year of life and may inform development of early interventive strategies.

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Accepted/In Press date: 28 November 2020
e-pub ahead of print date: 5 December 2020
Additional Information: Funding Information: This research is supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Program and administered by the Singapore Ministry of Health's National Medical Research Council (NMRC), Singapore—NMRC/TCR/004‐NUS/2008; NMRC/TCR/012‐NUHS/ 2014. Additional funding is provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore. Tham EH is supported by the National Medical Research Council (NMRC) Research Training Fellowship grant [MH 095:003\008‐225] and the Transition Award [MOH‐000269] from NMRC, Singapore. K.M Godfrey is supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre and by the European Union's Seventh Framework Program (FP7/2007–2013), projects Early Nutrition and ODIN under grant agreement numbers 289346 and 613977. Funding Information: Godfrey KM and Chong YS are part of an academic consortium that has received research funding from Abbot Nutrition, Nestle, and Danone. Shek LP has received research funding from Danone. Publisher Copyright: © 2020 John Wiley & Sons Ltd Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
Keywords: asthma, environment and hygiene hypothesis, paediatrics, rhinitis

Identifiers

Local EPrints ID: 451400
URI: http://eprints.soton.ac.uk/id/eprint/451400
ISSN: 0954-7894
PURE UUID: de391800-c1e7-4104-a1ea-41ac95d351d9
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

Catalogue record

Date deposited: 23 Sep 2021 16:40
Last modified: 05 Dec 2021 05:01

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Contributors

Author: Evelyn X.L. Loo
Author: Tau Ming Liew
Author: Gaik Chin Yap
Author: Lydia Su Yin Wong
Author: Lynette Pei-Chi Shek
Author: Anne Goh
Author: Hugo van Bever
Author: Oon Hoe Teoh
Author: Fabian Yap
Author: Kok Hian Tan
Author: Biju Thomas
Author: Mahesh Babu Ramamurthy
Author: Daniel Yam Thiam Goh
Author: Johan G. Eriksson
Author: Yap-Seng Chong
Author: Keith Godfrey ORCID iD
Author: Bee Wah Lee
Author: Elizabeth Huiwen Tham

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