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Published on: August 7, 2017
[Risk factors in the pre-, perinatal and early life (first year) for wheezing in young children]
Franca Rusconi1, Claudia Galassi, Marta Bellasio
1AOU Meyer, Firenze.
Insights
Childhood wheezing presents diverse phenotypes, each linked to distinct early-life risk factors. Understanding these associations is key to asthma prevention and management.
Area of Science:
- Pediatric respiratory health
- Epidemiology of childhood asthma
- Phenotyping of wheezing disorders
Context:
- Asthma pathogenesis is complex, with growing evidence implicating early-life exposures.
- Wheezing in early childhood is a common concern, but its diverse trajectories are not fully understood.
- The SIDRIA-2 project provides a valuable dataset for investigating early-life influences on respiratory health.
Purpose:
- To investigate the hypothesis that childhood wheezing comprises distinct phenotypes.
- To identify specific pre, perinatal, and early-life risk factors associated with different wheezing phenotypes.
- To differentiate the etiological pathways leading to transient early, persistent, and late-onset wheezing.
Summary:
- Maternal smoking during pregnancy correlated with early and persistent wheezing.
- Prematurity, neonatal respiratory issues, and early infections linked to early wheezing.
- Childhood infections and daycare attendance showed mixed effects, while breastfeeding and home dampness were also associated with wheezing phenotypes.
Impact:
- Findings highlight the heterogeneity of childhood wheezing, suggesting phenotype-specific interventions.
- Identifies key risk factors for targeted prevention strategies in pediatric respiratory diseases.
- Informs public health initiatives aimed at reducing the burden of childhood asthma and wheezing disorders.
Abstract:
In recent years some studies have focused attention on the contribution of early life risk factors in the pathogenesis of asthma and wheezing. In our study we tested the hypothesis that wheezing in childhood is not a single disorder and that different wheezing phenotypes (called transient early wheezing, persistent wheezing and late-onset wheezing) are associated with different risk factors. We evaluated the association between pre, perinatal and early life (1st year) risk factors and different wheezing phenotypes in children 6-7 years old enrolled in the SIDRIA-2 project. Maternal smoking in pregnancy is associated with early and persistent wheezing; prematurity, child's admission to hospital shortly after birth for respiratory problems, indicators of respiratory infections during the child's first year of life are associated with early wheezing. An increase in childhood infections from contact with siblings or day care attendance is a risk factor for early wheezing but protective against late-onset wheezing, while an opposite pattern was observed for breastfeeding. Finally, mould or dampness in the child's bedroom during his first year of life is associated with all wheezing phenotypes. The risk factors studied are differently associated with different wheezing phenotypes.
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