Age-related changes in childhood wheezing characteristics: A whole population study.

Maja Jurca,Myrofora Goutaki,Ben D Spycher,Claudia E Kuehni,Caroline S Beardsmore,Anina M Pescatore

doi:10.1002/ppul.23783

Maja Jurca, Myrofora Goutaki + Show 4 more

Open Access

https://doi.org/10.1002/ppul.23783

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Abstract

Wheezing illnesses are characterized by phenotypic variability, which changes with age, but few studies report on a wide age range of children. We studied how prevalence, severity, and triggers of wheeze vary throughout childhood. We analyzed data from a large population-based cohort of children from Leicestershire, UK, who were followed from infancy through late adolescence using postal questionnaires. We used generalized estimating equations to describe age-related changes in prevalence of any wheeze: episodic viral and multiple trigger wheeze; wheeze triggered by exercise, aeroallergens, food/drinks, laughing/crying; and of severe wheeze (frequent attacks, shortness of breath, sleep disturbance, disturbance of daily activities) from age 1-18 years. We analyzed this in the entire cohort (absolute prevalence) and separately among children with wheeze (relative prevalence). This study included 7670 children. Current wheeze was most common in 1-year-olds (36%) and then decreased in prevalence to reach 17% in children aged 14-17 years. Absolute prevalence of episodic viral wheeze (EVW) decreased with age (from 24% to 7%), while multiple trigger wheeze (MTW) remained relatively constant throughout childhood (8-12%). Among children with wheeze, the proportion with EVW decreased, and the proportion with MTW increased with age. In older children, wheeze triggered by exercise or aeroallergens, and wheeze accompanied by shortness of breath became more frequent, while wheeze triggered by food or laughter, and sleep disturbance decreased in prevalence. Knowledge of these age-related changes in wheezing illness is informative for health care planning and the design of future research projects and questionnaires.

Highlights

The clinical characteristics of wheezing illness in children are variable and change with age.[1,2,3,4]Some children wheeze only during respiratory infections, a phenotype called episodic viral wheeze (EVW).[5]
The proportion with EVW decreased, and the proportion with multiple trigger wheeze (MTW) increased with age
Wheeze triggered by exercise or aeroallergens, and wheeze accompanied by shortness of breath became more frequent, while wheeze triggered by food or laughter, and sleep disturbance decreased in prevalence

Summary

Introduction

Some children wheeze only during respiratory infections, a phenotype called episodic viral wheeze (EVW).[5] Other children wheeze without having infections and their episodes can be triggered by different factors The wheezing in these children is commonly called multiple trigger wheeze (MTW).[5, 6] Trigger factors for MTW include physical exercise,[3, 7,8,9] other activities associated with increased breathing effort (laughing or crying), contact with r aeroallergens[7, 10, 11] (such as pollen, house dust, or pets), and ingestion of certain food or drink items,[7] which lead to wheeze through varying mechanisms

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