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Published on: August 7, 2017
Childhood wheezing phenotypes and their association to perinatal factors: a longitudinal study
Teresa de la Calle Cabrera1, Sonia de Arriba Méndez2, Mª Mar López González3
1Gerencia de Atención Primaria de Salamanca, C.S.Tamames, Salamanca; delacalleteresa@gmail.com.
Insights
Infantile wheezing phenotypes are linked to specific perinatal risk factors. Exclusive breastfeeding offers protection, highlighting modifiable factors for early intervention in childhood respiratory health.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Epidemiology
Background:
- Infantile wheezing is influenced by various gestational and early life factors.
- Understanding wheezing phenotypes and their associated risks is crucial for early intervention.
Purpose of the Study:
- To investigate the long-term evolution of wheezing phenotypes in children up to 9-10 years of age.
- To identify relationships between distinct wheezing phenotypes and perinatal risk factors.
Main Methods:
- A longitudinal cohort study followed 1164 infants from the International Study of Wheezing in Infants.
- Children were classified into transient early, early persistent, and late-onset wheezing phenotypes.
- Univariate and multivariable analyses assessed associations between phenotypes and perinatal factors.
Main Results:
- Of 531 children, 31.8% had transient early wheezing, 18.8% early persistent, and 5.3% late-onset.
- Cesarean delivery, early infections, atopic eczema, and paternal smoking were linked to transient wheezing.
- Family history of allergy, smoking, and obstetric diseases were associated with persistent wheezing; exclusive breastfeeding was protective.
- Late-onset wheezing correlated with male gender and maternal allergic history.
Conclusions:
- Wheezing phenotypes in children are associated with distinct perinatal risk factors.
- Identifying these factors is key to targeting modifiable risks for better respiratory health outcomes.
Introduction:
Multiple gestational and early life factors have been described as the variables that increase the risk for each phenotype of infantile wheezing. Our objective was to study the evolution of wheezing in a cohort of children followed up to 9-10 years of age and its relationship with different perinatal risk factors.
Methods:
A longitudinal study was made on the evolution of wheezing, over time, in 1164 children from Salamanca (Spain) included in the International Study of Wheezing in Infants, when the children were 12 months old. They were classified into three phenotypes: transient early wheezing (last episode before 3 years of age), early persistent wheezing (start before 3 years age and persisting thereafter), and late-onset wheezing (first episode after 3 years of age). Univariate and multivariable analyses were performed to establish associations between the different phenotypes and perinatal factors.
Results:
Data were obtained corresponding to a total of 531 children. Of these, 169 (31.8%) had experienced transient early wheezing, 100 (18.8%) early persistent wheezing, 28 (5.3%) late-onset wheezing, and 234 (44.1%) had never experienced wheezing. Cesarean delivery, early exposure to infections, the presence of atopic eczema, and a smoking father were associated with transient early wheezing. Early persistent wheezing was associated with a family history of allergy, smoking, and obstetric diseases. Exclusive breastfeeding was identified as a protective factor in both transient and persistent early wheezing. Late-onset wheezing was associated with the male gender and with maternal history of rhinitis and eczema.
Conclusions:
Wheezing phenotypes were associated with different risk perinatal factors. Knowledge in the field is essential in order to influence the modifiable factors.
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