Risk factors for early, persistent, and late-onset wheezing in young children. SIDRIA Collaborative Group.
Wheezing in childhood is not a single disorder and different wheezing-associated respiratory illnesses have been recently described. We investigated the association between wheezing conditions and familial, pre-, peri-, and postnatal risk factors. We studied 16,333 children, 6 to 7 yr old, enrolled in a population-based study. Standardized questionnaires were filled in by parents. A total of 1,221 children had transient early wheezing, 671 had persistent wheezing, 918 had late-onset wheezing, and 13,523 never had wheezing or asthma (control group). Maternal asthma or chronic obstructive airway disease were significantly (p < 0.0001) more associated with persistent wheezing than with transient early and late-onset wheezing. The same pattern was observed for exposure to maternal smoke during pregnancy. Having a mother > 35 yr old was protective against transient early wheezing (odds ratio [OR]: 0.68, 95% confidence intervals [95% CI]: 0.53 to 0.86). Breast feeding >/= 6 mo was slightly protective against transient early wheezing (OR: 0.82, 95% CI: 0.68 to 0.97), whereas it was a moderate risk factor for late-onset wheezing (OR: 1.22, 95% CI: 0.99 to 1.50). On the contrary, having siblings and attending a day care center were both risk factors for transient early wheezing (OR: 1.41 [95% CI: 1.21 to 1.64] and 1.70 [95% CI: 1.48 to 1.96], respectively) and protective factors against wheezing of late onset (OR: 0.83 [95% CI: 0.70 to 0.97] and 0.72 [95% CI: 0.59 to 0.88]). There was a stronger (p < 0.0001) positive association between personal history of eczema or allergic rhinitis and persistent and late-onset wheezing than transient early wheezing. Our findings suggest a different contribution of risk factors to wheezing conditions in childhood.
Rusconi
F
F
Department of Pediatrics, University of Milano, Milano, Italy. sail.ped@mailserver.csi.unimi.it
Galassi
C
C
Corbo
G M
GM
Forastiere
F
F
Biggeri
A
A
Ciccone
G
G
Renzoni
E
E
D001249:Asthma / Q000235:genetics; D001942:Breast Feeding; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008173:Lung Diseases, Obstructive / Q000235:genetics; D008297:Male; D008423:Maternal Age; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012135:Respiratory Sounds / Q000209:etiology*; D006255:Rhinitis, Allergic, Seasonal / Q000235:genetics; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires