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Epidemiology of physician-diagnosed allergic rhinitis in childhood
A L Wright1, C J Holberg, F D Martinez
1Department of Pediatrics, University of Arizona, Tucson.
Insights
Allergic rhinitis in children is common by age 6, with early onset linked to asthma and environmental triggers. Maternal allergies, child asthma, and high IgE levels are key risk factors for developing this condition.
Area of Science:
- Pediatrics
- Allergy Immunology
- Environmental Health
Background:
- Allergic rhinitis (AR) is a prevalent condition affecting children worldwide.
- Understanding the natural history and risk factors for AR is crucial for early intervention and prevention.
Purpose of the Study:
- To investigate the natural history of allergic rhinitis in children during their first 6 years of life.
- To identify risk factors associated with the development of physician-diagnosed allergic rhinitis (PDAR).
Main Methods:
- Prospective cohort study of 747 children followed from birth to age 6.
- Parental questionnaires collected data on PDAR, symptoms, onset, and environmental exposures.
- Immunoglobulin E (IgE) levels and skin-test reactivity assessed at age 6.
Main Results:
- 42% of children had PDAR by age 6.
- Early-onset rhinitis (first year) associated with more respiratory symptoms, asthma diagnosis, and parental allergic disorders.
- Significant risk factors included maternal allergy history, child asthma, and elevated IgE levels (>100 IU/mL).
- Early food introduction, maternal smoking, and dog ownership were also linked to early rhinitis development.
Conclusions:
- Allergic rhinitis in early childhood signifies an atopic predisposition.
- Environmental exposures in early life may trigger the development of allergic rhinitis.
Objective:
To investigate the natural history of and risk factors for allergic rhinitis in the first 6 years of life.
Methods:
Parents of 747 healthy children followed from birth completed a questionnaire when the child was 6 years old. Data were obtained regarding physician-diagnosed allergic rhinitis (PDAR), associated symptoms, and age at onset. Risk-factor data were taken from earlier questionnaires, and data regarding immunoglobulin E (IgE) and skin-test reactivity were obtained at age 6.
Results:
By the age of 6, 42% of children had PDAR. Children whose rhinitis began in the first year of life had more respiratory symptoms at age 6 and were more likely to have a diagnosis of asthma. Early introduction of foods or formula, heavy maternal cigarette smoking in the first year of life, and higher IgE, as well as parental allergic disorders, were associated with early development of rhinitis. Risk factors for PDAR that remained significant in a multivariate model included maternal history of physician-diagnosed allergy (odds ratio: 2.2, 95% confidence interval: 1.35-3.54), asthma in the child (4.06, 2.06-7.99), and IgE greater than 100 IU/mL at age 6 (1.93, 1.18-3.17). The odds for atopic as opposed to nonatopic PDAR were significantly higher only among those with high IgE and those who had dogs.
Conclusion:
Allergic rhinitis developing in the first years of life is an early manifestation of an atopic predisposition, which may be triggered by early environmental mental exposures.