title: Social inequalities in wheezing in children: findings from the UK Millennium Cohort Study.
abstract: Wheezing in childhood is socially patterned, but it is unclear what factors explain the social differences.Regression analysis of the UK Millennium Cohort Study, based on 11 141 singleton children who participated at ages 9 months and 3, 5 and 7 years. Relative risk ratios (RRR) for early and persistent/relapsing wheeze were estimated using multinomial regression, according to measures of socioeconomic circumstances. Maternal, antenatal and early-life characteristics were assessed as potential mediators.Children of mothers with no educational qualifications were more likely to have both wheeze types, compared to children of mothers with degree-level qualifications (RRR 1.53, 95% CI 1.26-1.86 for early wheeze; 1.32 95% CI 1.04-1.67 for persistent/relapsing wheeze). Controlling for maternal age, smoking during pregnancy and breastfeeding removed the elevated risk of wheezing. Male sex, maternal age, body mass index, atopy, smoking during pregnancy, preterm birth, breastfeeding, exposure to other children and furry pets were independently associated with wheezing, but the pattern of association varied between wheezing types.In this representative UK cohort, adjustment for maternal smoking during pregnancy and breastfeeding removed the socioeconomic inequalities in common wheezing phenotypes. Policies to reduce the social gradient in these risk factors may reduce inequalities in wheezing and asthma.
authors.affiliation: Dept of Public Health and Policy, University of Liverpool, Liverpool, UK UCL Institute of Child Health, London, UK dctr@liv.ac.uk.
authors.forename: David C
authors.initials: DC
authors.lastname: Taylor-Robinson
authors.affiliation: UCL Institute of Child Health, London, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Pearce
authors.affiliation: Dept of Public Health and Policy, University of Liverpool, Liverpool, UK.
authors.forename: Margaret
authors.initials: M
authors.lastname: Whitehead
authors.affiliation: UCL Institute of Child Health, London, UK.
authors.forename: Rosalind
authors.initials: R
authors.lastname: Smyth
authors.affiliation: UCL Institute of Child Health, London, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Law
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008423:Maternal Age; D018811:Maternal Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D010641:Phenotype; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000453:epidemiology*; D012044:Regression Analysis; D012135:Respiratory Sounds / Q000209:etiology*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D012959:Socioeconomic Factors; D006113:United Kingdom; D055815:Young Adult