Gender‐ and age‐specific risk factors for wheeze from birth through adolescence

Abstract

Background and objective Cross-sectional gender differences in wheeze are well documented, but few studies have examined the gender-specific risk factors for wheeze longitudinally. This study aims to identify gender- and age-specific risk factors for wheeze from birth through adolescence. Methods The incidence of wheeze was ascertained every 6 months through age 14 years in a birth cohort consisting of 499 children with a parental history of atopy. Gender- and age-specific risk factors were identified through generalized estimating equations. Results A total of 454(91.0%) and 351(70.3%) children were followed past age 7 and 13 years, respectively. Maternal asthma was a risk factor for wheeze in girls (OR=2.05,95%CI 1.44–2.91,p<0.0001) and boys (OR=1.79,1.29–2.48,p=0.0004) and had a similar effect on wheeze throughout the ages. Paternal asthma (OR=1.83,1.38–2.57,p=0.0005) and infant bronchiolitis (OR=2.15,1.47–3.14,p<0.0001) were risk factors for boys only, with similar effects throughout the ages. Conclusion Using a prospective cohort, we identified gender- and age-specific risk factors for wheeze. The identification of gender-specific early life risk factors may allow for timely interventions and a more personalized approach to the treatment of asthma.

Sex-specific risk factors for childhood wheeze and longitudinal phenotypes of wheeze

“…Consistent with the findings of our current and previous study(13), another birth cohort documented that paternal asthma was associated with asthma in boys(27). However, while both our studies found that maternal asthma was associated with wheeze in both sexes, they documented this association with asthma among girls only, though the statistical interaction between sex and maternal asthma was not significant.…”

“…Furthermore, sex-specific risk factors for longitudinal wheeze phenotypes have not been examined. In a smaller recent study (n=499) of a birth cohort of children with a parental history of atopy(13), we found that while maternal asthma was a risk factor for wheeze in girls and boys, paternal asthma and infant bronchiolitis were risk factors for boys only. In the current study, using a similar analysis but a cohort of children not selected for risk of atopy and using multiple imputation to account for missing covariates, paternal asthma, but not infant bronchiolitis, showed a statistically significant sex-specific effect on wheeze, though the effect sizes were higher in boys for bronchiolitis.…”

“…An independent correlation structure was used and this model was compared to the unstructured and exchangeable structures using the Quasi-Akaike Information Criterion (QIC). We included the following exposures in the final model, based on our previous study and results from other studies (13, 20-23): maternal and paternal asthma, household income (>$70,000/year vs. ≤$70,000/year), child's age at the time of wheeze ascertainment, child's race/ethnicity, season of birth, gestational length, birthweight for gestational age z-score, breastfeeding duration, environmental smoke exposure before age 1 year, and bronchiolitis and atopic dermatitis before 1 year. Given the variation in ages at the time of yearly questionnaires, we used the exact age in years for each ascertainment time point for all analyses.…”

“…The identification of sex-specific risk factors has important implications for asthma prediction and prevention, as well as in our understanding of the genetic determinants of asthma. Using a large birth cohort of children with a parental history of allergy or asthma and follow-up to age 14 years, we found that paternal asthma and infant bronchiolitis were risk factors for wheeze in boys only, while maternal asthma was a risk factor for both sexes(13). Interestingly, the magnitude of the associations of paternal asthma and infant bronchiolitis with wheeze in boys persisted throughout childhood, suggesting the long-term impact of these factors on the longitudinal trajectory of wheeze may also be sex-specific.…”

Gender-Specific Differences of Bronchial Asthma Phenotypes in Children Depending on Puberty Status

“…The sex difference in the prevalence of BA is reflected in the sex difference in the hospitalization rate and BA severity [3]. While much focus has been placed on extrinsic environmental stimuli, intrinsic environment such as sex can interact with genes to influence BA risk [6,7]. The impact of a BA may be different according to gender in terms of different BA clinical phenotypes manifestations in children and adolescents [8][9][10].…”