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PLoS One. 2014 Nov 7;9(11):e111922. doi: 10.1371/journal.pone.0111922. eCollection 2014.

Asthma trajectories in early childhood: identifying modifiable factors.

Author information

1
Institut National d'Etudes Démographiques, Paris, France.
2
Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
3
International Centre for Lifecourse Studies, Department for Epidemiology and Population Health, University College London, London, United Kingdom.

Abstract

BACKGROUND:

There are conflicting views as to whether childhood wheezing represents several discreet entities or a single but variable disease. Classification has centered on phenotypes often derived using subjective criteria, small samples, and/or with little data for young children. This is particularly problematic as asthmatic features appear to be entrenched by age 6/7. In this paper we aim to: identify longitudinal trajectories of wheeze and other atopic symptoms in early childhood; characterize the resulting trajectories by the socio-economic background of children; and identify potentially modifiable processes in infancy correlated with these trajectories.

DATA AND METHODS:

The Millennium Cohort Study is a large, representative birth cohort of British children born in 2000-2002. Our analytical sample includes 11,632 children with data on key variables (wheeze in the last year; ever hay-fever and/or eczema) reported by the main carers at age 3, 5 and 7 using a validated tool, the International Study of Asthma and Allergies in Childhood module. We employ longitudinal Latent Class Analysis, a clustering methodology which identifies classes underlying the observed population heterogeneity.

RESULTS:

Our model distinguished four latent trajectories: a trajectory with both low levels of wheeze and other atopic symptoms (54% of the sample); a trajectory with low levels of wheeze but high prevalence of other atopic symptoms (29%); a trajectory with high prevalence of both wheeze and other atopic symptoms (9%); and a trajectory with high levels of wheeze but low levels of other atopic symptoms (8%). These groups differed in terms of socio-economic markers and potential intervenable factors, including household damp and breastfeeding initiation.

CONCLUSION:

Using data-driven techniques, we derived four trajectories of asthmatic symptoms in early childhood in a large, population based sample. These groups differ in terms of their socio-economic profiles. We identified correlated intervenable pathways in infancy, including household damp and breastfeeding initiation.

PMID:
25379671
PMCID:
PMC4224405
DOI:
10.1371/journal.pone.0111922
[Indexed for MEDLINE]
Free PMC Article

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