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Early-Life Wheezing and Childhood Cognition in the ECHO Cohort

Sima K Ramratnam1, Susan Korrick2, Anna Ross3

  • 1Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.

The Journal of Allergy and Clinical Immunology
|August 21, 2026
PubMed

Insights

Early childhood wheezing illnesses do not appear to impact school-age cognitive function. Socioeconomic factors, not wheeze, likely explain initial associations in children.

Area of Science:

  • Pediatric Health
  • Neurodevelopmental Science
  • Environmental Epidemiology

Background:

  • Preschool wheezing illnesses affect nearly half of children.
  • Wheezing may potentially impair cognitive development.

Purpose of the Study:

  • To determine if early-life wheezing illnesses are linked to reduced school-age cognitive function.
  • Investigate the association between childhood wheeze and cognitive outcomes.

Main Methods:

  • Utilized data from the Environmental influences on Child Health Outcomes (ECHO) Cohort study.
  • Included 1524 children with wheeze history before age 5 and cognitive assessments (Wechsler scales) between ages 6-12.
  • Employed multivariable linear mixed models, controlling for covariates.

Main Results:

  • Unadjusted analyses showed associations between early wheeze and lower cognitive index scores.
  • Multivariate analyses, accounting for socioeconomic and contextual variables, found no significant association between wheeze and cognitive function.
  • Socioeconomic factors like income, maternal education, and Childhood Opportunity Index explained initial observed associations.

Conclusions:

  • Early-life childhood wheeze is not associated with school-aged cognitive assessment scores in a broad U.S. population.
  • Highlights the critical role of socioeconomic context in understanding wheezing's impact on neurodevelopment.
Abstract

Keywords:
ChildWechsler scalescognitive functionrespiratory soundssocioeconomic factorswheezing

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