TY - JOUR

T1 - Risk Factors and Age-Related Patterns of Asthma-Like Symptoms in Early Childhood

AU - Kyvsgaard, Julie Nyholm

AU - Chawes, Bo Lund

AU - Horner, David Lyle George

AU - Hesselberg, Laura Marie

AU - Melgaard, Mathias Elsner

AU - Jensen, Signe Kjeldgaard

AU - Schoos, Ann Marie M.

AU - Thorsen, Jonathan

AU - Pedersen, Casper Emil Tingskov

AU - Brustad, Nicklas

AU - Bønnelykke, Klaus

AU - Bisgaard, Hans

AU - Stokholm, Jakob

N1 - Publisher Copyright: © 2023 American Academy of Allergy, Asthma & Immunology

PY - 2023

Y1 - 2023

N2 - Background: Episodes of asthma-like symptoms in young children are common, but little is known about risk factors and their patterns for the daily symptom burden. Objective: We investigated a variety of possible risk factors and their age-related impact on the number of asthma-like episodes during age 0 to 3 years. Methods: The study population included 700 children from the Copenhagen Prospective Studies on Asthma in Childhood2010 mother-child cohort followed prospectively from birth. Asthma-like symptoms were recorded until age 3 by daily diaries. Risk factors were analyzed by quasi-Poisson regressions, and interaction with age was explored. Results: Diary data were available in 662 children. Male sex, maternal asthma, low birth weight, maternal antibiotic use, high asthma exacerbation polygenic risk score, and high airway immune score were associated with a higher number of episodes in a multivariable analysis. Maternal asthma, preterm birth, caesarean section, and low birth weight showed an increasing impact with age, whereas sibling(s) at birth showed a decreased association with age. The remaining risk factors had a stable pattern during age 0 to 3 years. For every additional clinical risk factor (male sex, low birth weight, and maternal asthma) a child had, we found 34% more episodes (incidence rate ratio: 1.34, 95% confidence interval: 1.21-1.48; P < .001). Conclusion: Using unique day-to-day diary recordings, we identified risk factors for the burden of asthma-like symptoms in the first 3 years of life and described their unique age-related patterns. This provides novel insight into the origin of asthma-like symptoms in early childhood that potentially pave a path for personalized prognostics and treatment.

AB - Background: Episodes of asthma-like symptoms in young children are common, but little is known about risk factors and their patterns for the daily symptom burden. Objective: We investigated a variety of possible risk factors and their age-related impact on the number of asthma-like episodes during age 0 to 3 years. Methods: The study population included 700 children from the Copenhagen Prospective Studies on Asthma in Childhood2010 mother-child cohort followed prospectively from birth. Asthma-like symptoms were recorded until age 3 by daily diaries. Risk factors were analyzed by quasi-Poisson regressions, and interaction with age was explored. Results: Diary data were available in 662 children. Male sex, maternal asthma, low birth weight, maternal antibiotic use, high asthma exacerbation polygenic risk score, and high airway immune score were associated with a higher number of episodes in a multivariable analysis. Maternal asthma, preterm birth, caesarean section, and low birth weight showed an increasing impact with age, whereas sibling(s) at birth showed a decreased association with age. The remaining risk factors had a stable pattern during age 0 to 3 years. For every additional clinical risk factor (male sex, low birth weight, and maternal asthma) a child had, we found 34% more episodes (incidence rate ratio: 1.34, 95% confidence interval: 1.21-1.48; P < .001). Conclusion: Using unique day-to-day diary recordings, we identified risk factors for the burden of asthma-like symptoms in the first 3 years of life and described their unique age-related patterns. This provides novel insight into the origin of asthma-like symptoms in early childhood that potentially pave a path for personalized prognostics and treatment.

KW - Asthma

KW - Child

KW - Respiratory pattern

KW - Respiratory symptoms

KW - Risk Factors

KW - Wheeze

U2 - 10.1016/j.jaip.2023.02.031

DO - 10.1016/j.jaip.2023.02.031

M3 - Journal article

C2 - 36889671

AN - SCOPUS:85152536642

VL - 11

SP - 1773-1784.e10

JO - The Journal of Allergy and Clinical Immunology: In Practice

JF - The Journal of Allergy and Clinical Immunology: In Practice

SN - 2213-2198

IS - 6

ER -