Published ahead of print on April 1, 2005, doi:10.1164/rccm.200412-1738OC Am. J. Respir. Crit. Care Med., Volume 172, Number 1, July 2005, 45-54 A more recent version of this article appeared on July 1, 2005
Submitted on December 23, 2004 Sex Differences in Factors Associated with Childhood and Adolescent Onset WheezePiush J Mandhane1,1 Department of Medicine, McMaster University, Firestone Institute for Respiratory Health, St. Joseph's Healthcare, Hamilton, Ontario, Canada, 2 Department of Medicine, University of Otago, Dunedin, New Zealand * To whom correspondence should be addressed. E-mail: searsm{at}mcmaster.ca.
RATIONALE: Factors predicting the development of wheeze may differ between genders and between childhood and adolescence. METHODS: A New Zealand birth cohort of 1037 children was followed to age 26. For this analysis, those reporting recurrent wheezing at two or more assessments were classified as wheezers. We examined risk factors for development of wheeze before age 10 (childhood) and subsequently (adolescent-onset), for males and for females separately using Cox regression modelling. RESULTS: Males more often developed childhood wheeze (p = 0.002) and females adolescentonset wheeze (p < 0.001). Maternal atopy (asthma or hayfever) was a risk factor for childhood wheeze in both sexes (HR 1.48, p <0.05 for males; HR 2.37, p < 0.001 for females). Paternal atopy also influenced childhood 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) were risk factors in males but maternal history (HR 2.08, p < 0.01) was a significant risk factor for females. When both age ranges 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 = 1.12). CONCLUSION: The influence of parental atopy on the development for wheeze differs between males and females and between childhood and adolescent-onset wheeze. Key words: Asthma, risk factors, sex, age of onset, parental history
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