International Journal of Epidemiology 2001;30:1473-1484
© International Epidemiological Association 2001
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Risk factor associations with wheezing patterns in children followed longitudinally from birth to 3 
years
a Unit of Paediatric and Perinatal Epidemiology, Institute of Child Health,
b Department of Social Medicine,
c Institute of Child Health, Royal Hospital for Sick Children, University of Bristol, Bristol, UK.
d Department of Public Health Sciences, St George's Hospital Medical School, London.
Dr Andrea Sherriff, Unit of Paediatric and Perinatal Epidemiology, University of Bristol, 24 Tyndall Avenue, Bristol BS8 1TQ, UK. E-mail: Andrea.Sherriff{at}bris.ac.uk
Abstract
Background There is a paucity of detailed longitudinal data on wheeze in early childhood. Not all children who wheeze in early infancy will continue to wheeze into childhood and beyond. This study aims to investigate possible risk factors for different patterns of wheeze in the pre-school years.
Subjects and Methods Study participants were part of the Avon Longitudinal Study of Parents and Children (ALSPAC). Maternal reports of child wheeze between birth and 6 months and again between 30 and 42 months were gathered prospectively. Children were categorized into early wheeze, persistent wheeze or late onset wheeze. A large number of risk factors were assessed for each wheezing phenotype using multivariable logistic regression models.
Results Over 70% of children who wheezed in the first 6 months did not wheeze 3 years later. Wheezing between 0–6 months was independently associated with the presence of older siblings, male sex, delivery between April and December, bottle feeding, young maternal age, prenatal tobacco smoke exposure, atopy and parental history of asthma. From within this group of early wheezers, risk factors for wheeze that persisted beyond 6 months included pre-term delivery, young maternal age, living in rented local authority housing, atopy and a maternal (not paternal) history of asthma. Atopy and a family history of asthma emerged as the main predictors of wheeze that developed after 6 months of age.
Conclusion It is clear that a number of wheezing syndromes exist by 3
years, albeit with some degree of overlap. Detailed follow-up of this cohort is underway to determine whether risk factor associations determined in the first 3 years have long-term significance for the clinical entity termed ‘asthma’.
Keywords ALSPAC, infant wheeze, risk factors
Accepted 2 March 2001
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