Longitudinal Study on the Development of Respiratory and Allergic Disorders Among Paris Birth Cohort Infants

Abstract

ISEE-822 Objective: The Paris prospective birth cohort study was undertaken to determine the incidence of respiratory/allergic manifestations in Paris children up to the age of 6 and investigate the impact of behavioral/ environmental factors. This work describes the onset of respiratory/allergic outcomes in the first year of age. Materials and Methods: Data were collected by repeated self-administered standardized questionnaires. Questions concerned asthma-like symptoms, allergic rhinoconjunctivitis, atopic dermatitis (AD), food allergy, and infectious diseases. A discriminant analysis was used to separate wheezers from nonwheezers, and recurrent from infrequent wheezers. Results: Results are given for 1910 infants. AD, allergic rhinoconjunctivitis, and food allergy respectively occurred in 17%, 9%, and 3% of infants. The main respiratory symptoms were wheeze (22%), nocturnal dry cough (16%), and shortness of breath (4%). Wheeze onset mainly resulted from a respiratory infection. Lower respiratory tract infections (LRTI), bronchial obstructive symptoms, parental asthma, male gender, and AD increased risk of wheeze. Recurrent wheezers accounted for 20% of wheezers, and had signs of severity more frequently, together with associated bronchial obstructive symptoms. LRTI, bronchial obstructive symptoms, birth during spring, and AD discriminated between infrequent and recurrent wheezers. Conclusions: Descriptive epidemiology of respiratory/allergic symptoms is consistent with data from birth cohort studies. We highlighted a phenotype of recurrent wheeze, characterized by repeated LRTI, bronchial obstructive symptoms, and personal history of AD. Thanks to repeated questionnaires, detailed information on the occurrence of respiratory and allergic disorders was collected. Health data were prospectively recorded at frequent intervals so that the risk of recall bias was limited. Importantly, the study design was suitable for describing the inception and chronology of respiratory and allergic manifestations during infancy. Recurrent wheezers deserve to be followed-up very carefully because they could be at higher risk of asthma onset later in life, and be more susceptible to environmental risk factors.