Trajectories of early‐onset rhinitis in the Singapore GUSTO mother‐offspring cohort

Abstract

Background The natural history of childhood rhinitis is not well described. Objective This study aimed to identify different rhinitis trajectories in early childhood and their predictors and allergic associations. Methods Rhinitis symptoms were ascertained prospectively from birth until 6 years using standardized questionnaires in 772 participants. Rhinitis was defined as one or more episodes of sneezing, runny and/or blocked nose >2 weeks duration. Latent trajectories were identified using group‐based modelling, and their predictive risk factors and allergic associations were examined. Results Three rhinitis trajectory groups were identified: 7.6% (n = 59) were termed early transient rhinitis, 8.6% (n = 66) late transient rhinitis, and 6.6% (n = 51) persistent rhinitis. The remaining 77.2% (n = 596) were classified as non‐rhinitis/reference group. Early transient rhinitis subjects were more likely of Indian ethnicity, had siblings, reported childcare attendance, early wheezing and eczema in the first 3 years of life. Late transient rhinitis was associated with antenatal exposure to smoking, higher maternal education levels, and wheezing at age 36‐72 months. Persistent rhinitis was associated with male gender, paternal and maternal history of atopy, eczema, and house dust mite sensitization. Conclusions & Clinical Relevance Risk factors for early transient rhinitis involve a combination of genetic and early environmental exposures, whereas late transient rhinitis may relate to maternal factors and early respiratory infections independent of atopy. In contrast, persistent rhinitis is strongly associated with atopic risk and likely represents the typical trajectory associated with allergic disorders. Allergic rhinitis symptoms may commence as early as the first year of life and may inform development of early interventive strategies.

Maternal polyunsaturated fatty acids and allergic disease development in the offspring

“…The effect of maternal PUFAs might also be outweighed by other environmental factors which are more relevant to allergy development in our cohort, such as smoking exposure and childcare center attendance during infancy. 6 We observed that higher maternal total n-3:total n-6 PUFAs and (DHA + EPA):AA ratios were associated with a higher risk of early life wheeze by 18 months, especially in non-atopic children.…”

Prevalence of allergic rhinitis symptoms and associated factors in six-year-old children in a municipality in southern Brazil

“…In this context, it can be assumed that social status might be a proxy measure for behavioral patterns 27 . Loo et al 28 also found that higher maternal education was a risk factor for allergic rhinitis. These results agree with a systematic review of 183 studies showing a higher prevalence of rhinitis in higher socioeconomic status groups 29 .…”

“…Likewise, the use of the ISAAC does not allow for the diagnosis of rhinitis, but for the reporting of symptoms. However, most epidemiological studies have been performed in school-age children using the ISAAC questionnaire 28 .…”

Development of allergic rhinitis in early life: A prospective cohort study in high‐risk infants

“…5 Recent cohort studies suggest that childhood AR is heterogenous in its development. 6,7 Although classical hypothesis stated that AR is a risk factor for asthma in atopic march, 7 complete manifestation of the march was found only in a small population. 6 Precise process of the onset of AR in children is still to be studied because most of the epidemiological studies relied on questionnaire in the absence of definitive diagnostic criteria.…”

“…to 13–14 y.o 5 . Recent cohort studies suggest that childhood AR is heterogenous in its development 6,7 . Although classical hypothesis stated that AR is a risk factor for asthma in atopic march, 7 complete manifestation of the march was found only in a small population 6 …”