Wheezing phenotypes and risk factors in early life: The ELFE cohort

• Published in: PloS one Vol. 13; no. 4; p. e0196711
• Main Authors: Hallit, Souheil, Leynaert, Benedicte, Delmas, Marie Christine, Rocchi, Steffi, De Blic, Jacques, Marguet, Christophe, Scherer, Emeline, Dufourg, Marie Noelle, Bois, Corinne, Reboux, Gabriel, Millon, Laurence, Charles, Marie Aline, Raherison, Chantal
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 27.04.2018; Public Library of Science (PLoS)
• Subjects: Age; Allergies; Asthma; Biology and Life Sciences; Children; Complications and side effects; Consent; Correlation analysis; Cough; Demographic aspects; Exposure; Families & family life; Gastroesophageal reflux; Genetic aspects; Hospitals; Human health and pathology; Hypersensitivity; Infants; Infections; Life Sciences; Longitudinal studies; Medicine and Health Sciences; Parasitology; Parents; Pediatrics; People and Places; Phenotypes; Pregnancy; Pulmonology and respiratory tract; Research and Analysis Methods; Respiratory syncytial virus; Rhinitis; Risk analysis; Risk assessment; Risk factors; Santé publique et épidémiologie; Secretion; Secretions; Smoking; Surveys; Systematic review; Viral infections; Wheezing; France
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0196711

Different phenotypes of wheezing have been described to date but not in early life. We aim to describe wheezing phenotypes between the ages of two months and one year, and assess risk factors associated with these wheezing phenotypes in a large birth cohort. We studied 18,041 infants from the ELFE (French Longitudinal Study of Children) birth cohort. Parents reported wheezing and respiratory symptoms at two and 12 months, and answered a complete questionnaire (exposure during pregnancy, parental allergy). Children with no symptoms (controls) accounted for 77.2%, 2.1% had had wheezing at two months but no wheezing at one year (intermittent), 2.4% had persistent wheezing, while 18.3% had incident wheezing at one year. Comparing persistent wheezing to controls showed that having one sibling (ORa = 2.19) or 2 siblings (ORa = 2.23) compared to none, nocturnal cough (OR = 5.2), respiratory distress (OR = 4.1) and excess bronchial secretions (OR = 3.47) at two months, reflux in the child at 2 months (OR = 1.55), maternal history of asthma (OR = 1.46) and maternal smoking during pregnancy (OR = 1.57) were significantly associated with persistent wheezing. These same factors, along with cutaneous rash in the child at 2 months (OR = 1.13) and paternal history of asthma (OR = 1.32) were significantly associated with increased odds of incident wheezing. Having one sibling (ORa = 1.9) compared to none, nocturnal cough at 2 months (OR = 1.76) and excess bronchial secretions at 2 months (OR = 1.65) were significantly associated with persistent compared to intermittent wheezing. Respiratory symptoms (cough, respiratory distress, and excessive bronchial secretion) were significantly associated with a high risk of persistent wheezing at one year. Smoking exposure during pregnancy was also a risk factor for persistent and incident wheezing.