Sex-specific risk factors for childhood wheeze and longitudinal phenotypes of wheeze - 18/04/17
, Sheryl L. Rifas-Shiman, MPH b, Brent A. Coull, PhD c, Augusto A. Litonjua, MD, MPH d, Emily Oken, MD, MPH b, Diane R. Gold, MD, MPH dAbstract |
Background |
Although sexual dimorphism in wheeze and asthma prevalence are well documented, sex-specific risk factors for wheeze and longitudinal wheeze phenotypes have not been well elucidated.
Objective |
By using a large prebirth cohort, this study aimed to identify sex-specific risk factors for wheeze from birth through midchildhood and identify distinct longitudinal wheeze phenotypes and the sex-specific risk factors associated with these phenotypes.
Methods |
Mothers reported child wheeze symptoms over the past year approximately yearly on 9 occasions starting at age 1 year. We identified sex-specific predictors of wheeze, wheeze phenotypes, and sex-specific predictors of these phenotypes by using generalized estimating equations, latent class mixed models, and multinomial logistic analysis, respectively.
Results |
A total of 1623 children had information on wheeze at 1 or more time points. Paternal asthma was a stronger predictor of ever wheezing in boys (odds ratio [OR], 2.15; 95% CI, 1.74-2.66) than in girls (OR, 1.53; 95% CI, 1.19-1.96; P for sex by paternal asthma interaction = .03), whereas being black or Hispanic, birth weight for gestational age z score, and breast-feeding duration had stronger associations among girls. We identified 3 longitudinal wheeze phenotypes: never/infrequent wheeze (74.1%), early transient wheeze (12.7%), and persistent wheeze (13.1%). Compared with never/infrequent wheeze, maternal asthma, infant bronchiolitis, and atopic dermatitis were associated with persistent wheeze in both sexes, but paternal asthma was associated with persistent wheeze in boys only (OR, 4.27; 95% CI, 2.33-7.83; P for sex by paternal asthma interaction = .02), whereas being black or Hispanic was a predictor for girls only.
Conclusion |
We identified sex-specific predictors of wheeze and longitudinal wheeze patterns, which might have important prognostic value and allow for a more personalized approach to wheeze and asthma treatment.
Le texte complet de cet article est disponible en PDF.Key words : Asthma, sex differences, parental asthma, bronchiolitis
Abbreviations used : GEE, OR
Plan
| This article is subject to the National Institutes of Health (NIH) Public Access Policy (publicaccess.nih.gov). Project Viva is funded by R01 HL064925, R01 AI102960, and R37 HD 034568. E.O. received funding from the NIH (K24 HD069408 and P30 DK092924). |
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| Disclosure of potential conflict of interest: S. L. Rifas-Shiman, E. Oken, and D. R. Gold have received research support from the National Institutes of Health (NIH). B. A. Coull has received research support from the NIH, US Environmental Protection Agency, and Health Effects Institute and is employed by Harvard University. A. A. Litonjua has received research support from the NIH and receives royalties from UpToDate and Springer Humana Press. S. M. Tse declares no relevant conflicts of interest. |
Vol 138 - N° 6
P. 1561 - décembre 2016 Retour au numéro
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