Epidemiology of physician-diagnosed allergic rhinitis in childhood.
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.


CONCLUSIONS
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.
Department of Pediatrics, University of Arizona, Tucson.
A L
AL
Wright
C J
CJ
Holberg
F D
FD
Martinez
M
M
Halonen
W
W
Morgan
L M
LM
Taussig
D017668:Age of Onset; D001130:Arizona / Q000453:epidemiology; D002648:Child; D006801:Humans; D010820:Physicians; D015995:Prevalence; D011446:Prospective Studies; D012221:Rhinitis, Allergic, Perennial / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D006255:Rhinitis, Allergic, Seasonal / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D013223:Statistics as Topic; D011795:Surveys and Questionnaires