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Prospective study of risk factors for early and persistent wheezing in childhood
S Lewis1, D Richards, J Bynner
1Division of Respiratory Medicine, University of Nottingham, UK.
Insights
Low birth weight and maternal smoking during pregnancy are key factors for early childhood wheezing. Most childhood wheezing resolves by age 16, but persistence is linked to young maternal age and higher socioeconomic status.
Area of Science:
- Pediatric respiratory health
- Epidemiology of childhood illnesses
Background:
- Wheezing illness in early childhood is a common concern.
- Understanding its risk factors and long-term persistence is crucial for public health.
Purpose of the Study:
- To identify the relative importance of various factors in the development of wheezing illness in children up to 5 years of age.
- To determine predictors for the persistence of wheezing symptoms up to 16 years of age.
Main Methods:
- Analysis of data from 15,712 children born in Britain in April 1970.
- Multivariate logistic regression was used to assess risk factors for wheezing by 5 years and persistence at 16 years.
Main Results:
- Independent risk factors for wheezing by 5 years included male sex, maternal smoking during pregnancy (OR 1.39 for 15+ cigarettes/day), and low birth weight (OR 1.26 for < 2.5 kg).
- Of those with early wheezing, 15% experienced symptoms at 16 years.
- Persistence of wheezing at 16 years was associated with younger maternal age (OR 1.96 for 20 vs 40 years) and higher socioeconomic status (OR 1.95).
Conclusions:
- Low birth weight and maternal smoking during pregnancy are significant independent risk factors for early childhood wheezing.
- While 85% of children with early wheezing see symptom resolution by age 16, persistence is linked to specific demographic factors.
Abstract:
The object of this study was to determine the relative importance of low birth weight, preterm birth, low maternal age, household size, exposure to maternal smoking, personal smoking at 16 yrs of age, early termination of breastfeeding and socioeconomic status in the aetiology of wheezing illness in the first 5 yrs of life, and on the persistence of this illness at 16 yrs of age. In 15,712 children born in Britain during one week of April 1970, the occurrence of wheezing by 5 yrs of age, and of wheezing in the past year at 16 yrs of age within this group were analysed in multivariate logistic regression against each potential risk factor. The independent determinants of wheezing by 5 yrs of age were male sex, maternal smoking during pregnancy (odds ratio (OR) for 15+ cigarettes.day-1 = 1.39; 95% confidence interval (95% CI) 1.22-1.58) and low birthweight (OR for birthweight < 2.5 kg = 1.26; 95% Cl 1.07-1.50). Of children who had wheezed by 5 yrs of age, 15% reported wheezing in the past 12 months at 16 yrs of age. The persistence of symptoms at 16 yrs of age was independently related to low maternal age (OR for 20 vs 40 yrs of age = 1.96; 95% CI 1.08-3.45) and to high social status (OR for most vs least advantaged = 1.95; 95% CI 1.13-3.38). We conclude that low birth weight and maternal smoking in pregnancy are independent risk factors for early childhood wheezing, but in 85% of children with early wheezing it resolves by 16 yrs of age.(ABSTRACT TRUNCATED AT 250 WORDS)