Year: 2023
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Childhood wheezing is a highly heterogeneous condition with an incomplete understanding of the characteristics of wheeze trajectories, particularly for persistent wheeze. OBJECTIVE: To characterize predictors and allergic comorbidities of distinct wheeze trajectories in a multiethnic Asian cohort. METHODS: A total of 974 mother-child pairs from the prospective Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort were included in this study. Wheeze and allergic comorbidities in the first 8 years of life were assessed using the modified International Study of Asthma and Allergies in Childhood questionnaires and skin prick tests. Group-based trajectory modeling was used to derive wheeze trajectories and regression was used to assess associations with predictive risk factors and allergic comorbidities. RESULTS: There were 4 wheeze trajectories derived, including the following: (1) early-onset with rapid remission from age 3 years (4.5%); (2) late-onset peaking at age 3 years and rapidly remitting from 4 years (8.1%); (3) persistent with a steady increase to age 5 years and high wheeze occurrence until 8 years (4.0%); and (4) no or low wheeze (83.4%). Early-onset wheezing was associated with respiratory infections during infancy and linked to subsequent nonallergic rhinitis throughout childhood. Late-onset and persistent wheeze shared similar origins characterized by parent-reported viral infections in later childhood. However, persistent wheezing was generally more strongly associated with a family history of allergy, parent-reported viral infections in later childhood, and allergic comorbidities as compared with late-onset wheezing. CONCLUSION: The timing of viral infection occurrence may determine the type of wheeze trajectory development in children. Children with a family history of allergy and viral infections in early life may be predisposed to persistent wheeze development and the associated comorbidities of early allergic sensitization and eczema.
Institutions: Agency for Science, Technology and Research, Singapore Institute for Clinical Sciences, National University of Singapore, Khoo Teck Puat Hospital, National University Hospital, National University Health System, KK Women's and Children's Hospital, Nanyang Technological University, Duke-NUS Medical School, National Health Service, University Hospital Southampton NHS Foundation Trust, National Institute for Health and Care Research, NIHR Southampton Biomedical Research Centre, MRC Lifecourse Epidemiology Unit, University of Southampton, University of Helsinki, Folkhälsans Forskningscentrum
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,000
Funders: Danone, National Institute for Health and Care Research, British Heart Foundation, European Commission, National Research Foundation, Singapore Institute for Clinical Sciences, National Research Foundation Singapore, National University Health System, National Institute for Health Research Southampton Biomedical Research Centre, Medical Research Council, National Medical Research Council, Erasmus+
Awards: G103267656, G1321528303, G1503713314, G1659327504, Children of UPBEAT: a study of cardiovascular function in 10-year-old children of obese women who participated in an antenatal lifestyle intervention, G183778332, G1882858428, G1917706474, G1956390128, G2125390887, G213766589, G2368920978, G2596139817, G2693923786, G2780654756, G2838213439, G3015108477, G3210728687, G3264401604, G3424013768, NIHR Senior Investigator Award, G3521509650, G3552626036, G3563071610, G3637715992, G3778457340, G3873828540, G3883922659, G389277099, G4213458000, G427574963, G4331660922, G434559078, NIHR Senior Investigator Award, Capacity Building to Improve Early Nutrition and Health in South Africa, G486207801, G4964355645, G5023485246, G5068482306, G5090859494, G5196117068, G524590474, G5285226399, G5318721926, G5435949906, G5490188102, G5755632036, G587834012, G606602278, G6153309438, G6206044308, G6408020244, G645171559, G6528848405, G6603704606, G6719865625, G71336211, G7295670324, G7348633402, G7388601084, G740803340, G7420601327, G7643966348, G7671148335, G7852524164, G7915200173, G8306461559, G8307928819, G8346907872, Nutrition, Development and Lifelong Health: Studies in European Populations, G8537882575, G854637805, G8606453147, G8651793750
OpenAlex ID: W4383215333