Wheeze trajectories are modifiable through early-life intervention and predict asthma in adolescence

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dc.contributor.authorOwora, Arthur
dc.contributor.authorBecker, Allan B
dc.contributor.authorChan-Yeung, Moira
dc.contributor.authorChan, Edmond S
dc.contributor.authorChooniedass, Rishma
dc.contributor.authorRamsey, Clare
dc.contributor.authorWatson, Wade
dc.contributor.authorAzad, Meghan
dc.date.accessioned2022-08-18T14:53:32Z
dc.date.available2022-08-18T14:53:32Z
dc.date.issued2018-05-05
dc.date.submitted2022-08-17T20:47:22Zen_US
dc.description.abstractBackground The objectives of this study were to identify developmental trajectories of wheezing using data-driven methodology, and to examine whether trajectory membership differentially impacts the effectiveness of primary preventive efforts that target modifiable asthma risk factors. Methods Secondary analysis of the Canadian Asthma Primary Prevention Study (CAPPS), a multifaceted prenatal intervention among children at high risk of asthma, followed from birth to 15 years. Wheezing trajectories were identified by latent class growth analysis. Predictors, intervention effects, and asthma diagnoses were examined between and within trajectory groups. Results Among 525 children, 3 wheeze trajectory groups were identified: Low-Progressive (365, 69%), Early-Transient (52, 10%), and Early-Persistent (108, 21%). The study intervention was associated with lower odds of Early-Transient and Early-Persistent wheezing (P < .01). Other predictors of wheeze trajectories included, maternal asthma, maternal education, city of residence, breastfeeding, household pets, infant sex and atopy at 12 months. The odds of an asthma diagnosis were three-fold to six-fold higher in the Early-Persistent vs Low-Progressive group at all follow-up assessments (P = .03), whereas Early-Transient wheezing (limited to the first year) was not associated with asthma. In the Early-Persistent group, the odds of wheezing were lower among intervention than control children (adjusted odds ratio: 0.67; 95% CI: 0.48; 0.93) at 7 years. Conclusions Using data-driven methodology, children can be classified into clinically meaningful wheeze trajectory groups that appear to be programmed by modifiable and non-modifiable factors, and are useful for predicting asthma risk. Early-life interventions can alter some wheeze trajectories (ie, Early-Persistent) in infancy and reduce wheezing prevalence in mid-childhood.en_US
dc.description.sponsorshipThis research was funded by the Heart and Stroke Foundation and Canadian Lung Association Emerging Research Leaders Initiative, in partnership with the Canadian Respiratory Research Network and the Allergy, Genes and Environment Network of Centres of Excellence (AllerGenNCE).The Study was funded by the Canadian Institute of Health Research, the British Columbia Lung Association, and the Manitoba Medical Service Foundation.en_US
dc.identifier.doi10.1111/pai.12922
dc.identifier.urihttp://hdl.handle.net/1993/36704
dc.language.isoengen_US
dc.publisherPediatric Allergy and Immunologyen_US
dc.rightsopen accessen_US
dc.subjectAsthmaen_US
dc.titleWheeze trajectories are modifiable through early-life intervention and predict asthma in adolescenceen_US
dc.typepreprinten_US
local.author.affiliationRady Faculty of Health Sciences::Max Rady College of Medicine::Department of Pediatrics and Child Healthen_US
oaire.citation.endPage621en_US
oaire.citation.issue6en_US
oaire.citation.startPage612en_US
oaire.citation.titlePediatric Allergy and Immunologyen_US
oaire.citation.volume29en_US
project.funder.identifierhttp://dx.doi.org/10.13039/100004411en_US
project.funder.nameHeart and Stroke Foundationen_US
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