Sex Differences in Factors Associated with Childhood- and Adolescent-Onset Wheeze
Piush J. Mandhane,
Justina M. Greene,
Jan O. Cowan,
D. Robin Taylor and
Malcolm R. Sears
Firestone Institute for Respiratory Health, St. Joseph's Healthcare; Department of Medicine, McMaster University, Hamilton, Ontario, Canada; and Department of Medicine, University of Otago, Dunedin, New Zealand
Correspondence and requests for reprints should be addressed to Malcolm Sears, M.B., Firestone Institute for Respiratory Health, St. Joseph's Healthcare, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6 Canada. E-mail: searsm{at}mcmaster.ca
Rationale: Factors predicting the development of wheeze maydiffer between sexes and between childhood and adolescence.Methods: A New Zealand birth cohort of 1,037 children was followedto age 26. For this analysis, those reporting recurrent wheezingat two or more assessments were classified as "wheezers." Weexamined risk factors for development of wheeze before age 10(childhood) and subsequently (adolescent-onset) for males andfor females separately using Cox regression modeling. Results:Males more often developed childhood wheeze (p = 0.002) andfemales adolescent-onset wheeze (p < 0.001). Maternal atopy(asthma or hay fever) was a risk factor for childhood wheezein both sexes (hazard ratio [HR], 1.48, p < 0.05 for males;HR, 2.37, p < 0.001 for females). Paternal atopy also influencedchildhood wheeze, significantly for males (HR, 1.72; p = 0.01),and similarly but not significantly for females (HR, 1.70; p= 0.08). For adolescent-onset wheeze, neither maternal (HR,1.41; p = 0.19) nor paternal history (HR, 0.73; p = 0.42) wasa risk factor in males, but maternal history (HR, 2.08; p <0.01) was a significant risk factor for females. When both ageranges were combined, providing greater power for analysis,paternal history was a stronger risk factor for wheeze in females(HR, 1.62; p = 0.02) than in males (HR, 1.35; p = 0.12). Conclusion:The influence of parental atopy on the development for wheezediffers between males and females and between childhood- andadolescent-onset wheeze.
Key Words: age of onset • asthma • parental history • risk factors • sex
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