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Am. J. Respir. Crit. Care Med., Volume 160, Number 5, November 1999, 1617-1622

Risk Factors for Early, Persistent, and Late-onset Wheezing in Young Children

FRANCA RUSCONI, CLAUDIA GALASSI, GIUSEPPE M. CORBO, FRANCESCO FORASTIERE, ANNIBALE BIGGERI, GIOVANNINO CICCONE, ELISABETTA RENZONI, and the SIDRIA Collaborative Group

Department of Pediatrics, University of Milano, Milano; Regional Health Documentation Center Emilia-Romagna, Bologna; Department of Respiratory Physiology, Catholic University, Roma; Department of Epidemiology, Regional Health Autority Lazio, Roma; Department of Statistics, University of Firenze, Firenze; Unit of Cancer Epidemiology, S. Giovanni B. Hospital and Center for Cancer Prevention Piemonte, Torino; and Institute of Respiratory Diseases, University of Siena, Siena, Italy

Wheezing in childhood is not a single disorder and different wheezing-associated respiratory illnesses have been recently described. We investigated the association between wheezing conditions and familial, pre-, peri-, and postnatal risk factors. We studied 16,333 children, 6 to 7 yr old, enrolled in a population-based study. Standardized questionnaires were filled in by parents. A total of 1,221 children had transient early wheezing, 671 had persistent wheezing, 918 had late-onset wheezing, and 13,523 never had wheezing or asthma (control group). Maternal asthma or chronic obstructive airway disease were significantly (p < 0.0001) more associated with persistent wheezing than with transient early and late-onset wheezing. The same pattern was observed for exposure to maternal smoke during pregnancy. Having a mother > 35 yr old was protective against transient early wheezing (odds ratio [OR]: 0.68, 95% confidence intervals [95% CI]: 0.53 to 0.86). Breast feeding >=  6 mo was slightly protective against transient early wheezing (OR: 0.82, 95% CI: 0.68 to 0.97), whereas it was a moderate risk factor for late-onset wheezing (OR: 1.22, 95% CI: 0.99 to 1.50). On the contrary, having siblings and attending a day care center were both risk factors for transient early wheezing (OR: 1.41 [95% CI: 1.21 to 1.64] and 1.70 [95% CI: 1.48 to 1.96], respectively) and protective factors against wheezing of late onset (OR: 0.83 [95% CI: 0.70 to 0.97] and 0.72 [95% CI: 0.59 to 0.88]). There was a stronger (p < 0.0001) positive association between personal history of eczema or allergic rhinitis and persistent and late-onset wheezing than transient early wheezing. Our findings suggest a different contribution of risk factors to wheezing conditions in childhood. Rusconi F, Galassi C, Corbo GM, Forastiere F, Biggeri A, Ciccone G, Renzoni E, and the SIDRIA Collaborative Group. Risk factors for early, persistent, and late-onset wheezing in young children.




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