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Dynamics of respiratory symptoms during infancy and associations with wheezing at school age.
- Source :
-
ERJ open research [ERJ Open Res] 2018 Nov 20; Vol. 4 (4). Date of Electronic Publication: 2018 Nov 20 (Print Publication: 2018). - Publication Year :
- 2018
-
Abstract
- Children with frequent respiratory symptoms in infancy have an increased risk for later wheezing, but the association with symptom dynamics is unknown. We developed an observer-independent method to characterise symptom dynamics and tested their association with subsequent respiratory morbidity. In this birth-cohort of healthy neonates, we prospectively assessed weekly respiratory symptoms during infancy, resulting in a time series of 52 symptom scores. For each infant, we calculated the transition probability between two consecutive symptom scores. We used these transition probabilities to construct a Markov matrix, which characterised symptom dynamics quantitatively using an entropy parameter. Using this parameter, we determined phenotypes by hierarchical clustering. We then studied the association between phenotypes and wheezing at 6 years. In 322 children with complete data for symptom scores during infancy (16 864 observations), we identified three dynamic phenotypes. Compared to the low-risk phenotype, the high-risk phenotype, defined by the highest entropy parameter, was associated with an increased risk of wheezing (odds ratio (OR) 3.01, 95% CI 1.15-7.88) at 6 years. In this phenotype, infants were more often male (64%) and had been exposed to environmental tobacco smoke (31%). In addition, more infants had siblings (67%) and attended childcare (38%). We describe a novel method to objectively characterise dynamics of respiratory symptoms in infancy, which helps identify abnormal clinical susceptibility and recovery patterns of infant airways associated with persistent wheezing.<br />Competing Interests: Conflict of interest: P. Latzin reports receiving personal fees from Vertex, Novartis, Roche, Polyphor, Vifor and Gilead outside the submitted work.
Details
- Language :
- English
- ISSN :
- 2312-0541
- Volume :
- 4
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- ERJ open research
- Publication Type :
- Academic Journal
- Accession number :
- 30474038
- Full Text :
- https://doi.org/10.1183/23120541.00037-2018