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Infant weight trajectories and early childhood wheezing: the NINFEA birth cohort study
Maja Popovic1, Costanza Pizzi1, Franca Rusconi2
1Department of Medical Sciences, University of Turin, Turin, Italy.
Insights
Rapid infant growth and larger size in the first 18 months are independently linked to increased wheezing risk in children. These early growth patterns influence wheezing occurrence.
Area of Science:
- Pediatric respiratory health
- Infant growth and development
- Epidemiology of childhood diseases
Background:
- Postnatal weight gain is linked to childhood wheezing and asthma.
- The independent role of infant size and weight gain velocity in wheezing development requires clarification.
- Novel methods are needed to disentangle various aspects of early growth in relation to wheezing.
Purpose of the Study:
- To differentiate the independent contributions of infant size and weight gain velocity to early childhood wheezing.
- To investigate the role of growth tempo (age at peak weight velocity) in infant wheezing.
- To analyze early growth patterns using a novel modeling approach.
Main Methods:
- Utilized NINFEA questionnaire data from 4492 term singletons with weight measurements up to 18 months.
- Defined wheezing as chest wheezing/whistling between 6 and 18 months.
- Employed the SuperImposition by Translation And Rotation (STIR) model to derive child-specific size, velocity, and tempo parameters.
Main Results:
- Infant size (OR=1.28) and weight gain velocity (OR=1.30) were independently associated with increased wheezing risk.
- No significant association was found between growth tempo and infant wheezing.
- Results remained largely unchanged after adjusting for potential confounders.
Conclusions:
- Both accelerated growth and larger infant size in the first 18 months are independently associated with higher wheezing risk.
- Early life growth trajectories appear to play a significant role in the development of wheezing.
- Findings highlight the importance of monitoring infant growth patterns for respiratory health outcomes.
Background:
Rapid postnatal weight gain has been associated with wheezing and asthma in children, but it remains unclear whether it acts independently of overweight. We aimed to disentangle the roles of infant's size and weight gain velocity in the development of wheezing in early childhood using a novel method that allows for mutual adjustment for different aspects of growth.
Methods:
Data were obtained from the NINFEA questionnaires where weight measurements from birth up to 18 months of age were assessed in 4492 term singletons. Wheezing was defined as at least one episode of wheezing/whistling in the chest occurring between 6 and 18 months of age. The SuperImposition by Translation And Rotation model was used to estimate individual weight trajectories defined by three child-specific parameters: size, velocity and tempo, that is age at peak weight velocity. These parameters were standardised and related to wheezing using logistic regression with effects expressed as an increase of one SD.
Results:
A median of five weight measurements per child were obtained. Infant size (OR=1.28; 95% CI 1.12 to 1.46) and weight gain velocity (OR=1.30; 95% CI 1.15 to 1.48) were independently positively associated with wheezing. We found no evidence of an effect of tempo on infant wheezing. The estimates were changed only minimally after adjustment for potential confounders.
Conclusions:
Faster growth and larger size in the first 18 months of life are both independently associated with an increased risk of wheezing. These findings suggest that early growth patterns play a role in shaping the occurrence of wheezing.
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