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Wheezing phenotypes in young children: an historical cohort study

Wheezing phenotypes in young children: an historical cohort study

Authors :
Alfredo Cano-Garcinuño
Isabel Mora-Gandarillas
Ángeles Cobo-Ruisánchez
Ignacio Pérez-Candás
Castañón-Rodríguez Carmen
Isabel Carballo-Castillo
Aidé Aladro-Antuña
Felipe Gonzáez-Rodríguez
Zoa García-Amorín
Luís Miguel Fernández-Cuesta
María García-Adaro
Agustina Alonso-Álvarez
María Ángeles Ordóñez-Alonso
Francisco Fernández-Ló\pez
Fernando Nuño-Martín
Rosa Rodríguez-Posada
Milagros Moreno-Sierra
Mar Coto-Fuente
Luz María Alonso-Bernardo
Leonor Merino-Ramos
Rosa Buznego-Sánchez
Ana Pérez-Vaquero
María Luisa García-Balbuena
María Fernández-Francés
Carolina Ruano-Fajardo
Begoña Domínguez-Aurrecoechea
Ignacio Carvajal-Urueña
Ana Arranz-Velasco
Águeda García-Merino
Yáñez-Meana Begoña
Encarnación Díaz Estrada
Ángel Costales-Álvarez
Source :
Primary Care Respiratory Journal: Journal of the General Practice Airways Group
Publication Year :
2014
Publisher :
Springer Science and Business Media LLC, 2014.

Abstract

Background: Wheezing phenotypes in young children have usually been described on the basis of questionnaire surveys instead of prospectively doctor-diagnosed episodes, and have never been described in terms of incidence rates. Aims: To identify wheezing phenotypes in the first three years and describe their incidence trends, and to investigate their relationship with asthma at six years of age. Methods: Doctor-diagnosed wheezing episodes in the first 36 months and active asthma at six years were identified in a historical cohort of 3,739 children followed from birth in 29 primary care health centres in Spain. Wheezing phenotypes were identified by means of latent class analysis. Changes in incidence rates of wheezing were identified through joinpoint regression models and their predictive ability for asthma was analysed. Results: One never/infrequent wheeze phenotype and three wheezing phenotypes were identified. There were two early phenotypes which started wheezing at a median age of six months, one of which was transient while the other had a heavy recurrence of episodes. A third phenotype exhibited a delayed onset of wheezing, a constant rise in incidence through the first 36 months, and a relationship with allergic asthma. These three phenotypes had a higher prevalence of active asthma at six years than the never/infrequent wheeze phenotype, but the classification had a weak predictive ability for asthma due to low sensitivity. Conclusions: The use of incidence rates contributes to the clarification of the natural history of infant wheezing.

Details

ISSN :
14751534 and 14714418
Volume :
23
Database :
OpenAIRE
Journal :
Primary Care Respiratory Journal
Accession number :
edsair.doi.dedup.....efbc76704211d77dfd941163025e5005
Full Text :
https://doi.org/10.4104/pcrj.2014.00008