Association of early life factors with wheezing phenotypes in preterm-born children compared to term-born children

Abstract

Although respiratory symptoms, including wheezing, are common in preterm-born subjects, the natural history of the wheezing-phenotypes and the influence of early life factors and characteristics on phenotypes are unclear. Participants from the Millennium Cohort Study born between 2000-2002 were studied at 9 months, 3, 5, 7, and 11 years. We used datadriven methods to define wheezing-phenotypes in preterm-born children and investigated if the association of early life factors and characteristics on wheezing-phenotypes were similar between preterm-and term-born children. 1,049/1502 (70%) preterm-born children, and 12,307/17,063 (72%) term-born had recent wheeze data for three or four time-points.Recent-wheeze was greater at all time-points in preterm-born than term-born group. Four wheezing-phenotypes were defined: no/infrequent, early, persistent and late for both groups. Early life factors and characteristics, especially antenatal smoking, atopy, male gender, were associated with increased rates for all phenotypes in both groups breast feeding was protective in both groups, except late-wheeze in the preterm group. Pretermborn children had similar phenotypes to term-born children. Although early life factors and characteristics were similarly associated with the wheezing-phenotypes in both groups, the preterm group had higher rates of early and persistent-wheeze. However, a large proportion of preterm-born children had early-wheeze which resolved with time.

Key paediatric messages from the 2018 European Respiratory Society International Congress

“…K otecha et al . [48] presented data from the Millennium Cohort Study [49] to identify wheezing phenotypes using machine learning to estimate different latent class models. Recent wheeze was greater in the preterm-born group at ages 3, 5, 7 and 11 years and four wheezing phenotypes were found, which were similar for both groups: 1) no/infrequent wheeze; 2) early wheeze which disappeared in later years; 3) persistent wheeze throughout the study period; and 4) late wheeze which appeared later in childhood.…”