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Risk Factors and Age-Related Patterns of Asthma-Like Symptoms in Early Childhood
25 Pages Posted: 16 Mar 2022
More...Abstract
Background: Episodes of asthma-like symptoms in young children are common, but little is known about patterns and risk factors for the daily symptom burden. We investigated a variety of possible risk factors and their age-related impact on the number of asthma-like episodes during the three first years of life.
Methods: The study population included 700 children from the COPSAC 2010 mother-child cohort followed prospectively from birth. Asthma-like symptoms were recorded until age three by daily diaries. Risk factors were analysed by quasi-Poisson regressions and interaction with age was explored.
Findings: 662 children had available diary data. Male sex, Maternal asthma, low birth weight, maternal antibiotic use, high asthma polygenic risk score, and high airway immune score associated with higher number of episodes in a multivariable analysis. For every additional clinical risk factor a child had, we found a 34% increased number of episodes (male sex, low birth weight, maternal asthma) (incidence rate ratio 1·34, 95% CI 1·21–1·48; p<0·001). Maternal asthma, preterm birth, caesarean section, low birth weight, and sibling(s) at birth significantly interacted with age, all showing increasing number of episodes through first, second, and third year of life except for siblings, where the symptom burden decreased with age.
Interpretation: We identified risk factors for symptom burden with different age-related patterns using unique day-to-day diary recordings of asthma-like symptoms in the first three years of life. This provides novel insight into the origin of early asthmatic symptoms and could aid the clinician for personalized prognostics.
Funding Information: This study was supported by The Danish Foundation for Lung Diseases in Children (Børnelungefonden), The Capital Region, and Region Zealand.
Declaration of Interests: All authors declare no potential, perceived, or real conflict of interest regarding the content of this manuscript.
Ethics Approval Statement: The study was approved by the Local Ethics Committee (H-B-2008-093), and the Danish Data Protection Agency (2015-41-3696). Both parents gave written and oral informed consent before enrolment.
Keywords: Respiratory symptoms, Wheeze, Asthma-like symptoms, Childhood asthma, Risk factors, Predictors
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