Abstract
BackgroundRhinoconjunctivitis is a global health problem and one of the most common chronic conditions in children. Development of rhinoconjunctivitis depends on both genetic and environmental factors. Many studies have investigated rhinoconjunctivitis, but only few studies have evaluated the risk factors for non-allergic rhinoconjunctivitis in children finding family history of atopic diseases and gender to be of importance. The aim of this study was to investigate possible risk factors in early life for rhinoconjunctivitis, allergic as well as non-allergic, in adolescence.MethodsThe children in the Danish Allergy Research Center cohort were examined eight times from birth to 14 years of age. Visits included questionnaire-based interview, clinical examination, skin prick test and specific IgE. We used univariate and multivariate logistic regression to investigate the relationship between early-life risk factors and the development of rhinoconjunctivitis, allergic as well as non-allergic, in adolescence.ResultsFollow-up rate at 14-years was 66.2%. The prevalence of rhinoconjunctivitis was 32.8%. Family history of atopic diseases (aOR 2.25), atopic dermatitis (aOR 3.24), food allergy (aOR 3.89), early sensitization to inhalant and food allergens (aOR 2.92 and aOR 3.13) and male gender (aOR 1.90) were associated with allergic rhinoconjunctivitis but not with non-allergic rhinoconjunctivitis. Early environmental tobacco exposure was inversely associated with rhinoconjunctivitis (aOR 0.42), allergic (aOR 0.47) as well as non-allergic (aOR 0.43).ConclusionDifferent patterns of associations were revealed when stratifying rhinoconjunctivitis in allergic and non-allergic suggesting that allergic rhinoconjunctivitis and non-allergic-rhinoconjunctivitis are different phenotypes.
Highlights
Rhinoconjunctivitis is a global health problem and one of the most common chronic conditions in children
Allergic rhinoconjunctivitis at 14 years was defined as having symptoms of RC and s-cord blood IgE (IgE) ≥ 0.35 kU/l (ImmunoCAP, Thermo Fisher Scientific, Sweden) and/or a positive skin prick test (SPT) (ALK-ABELLO, Copenhagen, Denmark) with a mean wheal diameter ≥3 mm larger than the negative control to at least one of the inhalant allergens: grass, birch, mugwort, horse, dog, cat, Dermatophagoides pteronyssinus, Dermatophagoides farinae, Cladosporium herbarum and Alternaria alternata
We found no association between early wheeze, maternal smoking in pregnancy, pets, breastfeeding, elevated cord blood IgE ≥ 0.3 kU/l (CB-IgE), social class, overweight at 3 years, cesarean section and RC and allergic RC in adolescence
Summary
Rhinoconjunctivitis is a global health problem and one of the most common chronic conditions in children. Many studies have investigated rhinoconjunctivitis, but only few studies have evaluated the risk factors for non-allergic rhinoconjuncti‐ vitis in children finding family history of atopic diseases and gender to be of importance. Studies have indicated that gender [5, 6], family atopy [2, 4,5,6], early sensitization [4, 7, 8], food allergy [9] and atopic dermatitis [4, 9] are risk factors for subsequent development of rhinoconjunctivitis. A few studies have evaluated the prevalence [3, 18] and risk factors [17, 19] for non-allergic RC in children and they found family history of atopic diseases and gender to be of importance The association between breastfeeding [2, 5], having pets [10], early exposure to tobacco smoke [2, 11, 12], social class [4], early wheeze [13], obesity [14], older sibling(s) [15,16,17] and allergic RC in adolescence is more contradictory.
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