Risk Factors for Chronic Cough in Young Children: A Cohort Study

Yin To Au-Yeung,Jennie Anderson,Kerry-Ann F O'Grady,Keith Grimwood,Michelle Kaus,Anne B Chang,Maree Toombs,Sarah Parfitt,Sheree Rablin,Dan Arnold,Jack Roberts,Yolanda Lovie-Toon

doi:10.3389/fped.2020.00444

Abstract

Background and Objective: Data on the predictors of chronic cough development in young children are scarce. Our primary objective was to examine the factors associated with young children developing a chronic cough, with a focus on childcare attendance.Methods: A secondary analysis of data collected in a prospective cohort study of children presenting to three emergency departments and three primary healthcare centers in southeast Queensland, Australia. Eligible children where those aged <6-years presenting with cough and without known underlying chronic lung disease other than asthma. Children were followed for 4 weeks to ascertain cough duration. The primary outcome was persistent cough at day-28. Logistic regression models were undertaken to identify independent predictors of chronic cough including sensitivity analyses that accounted for children with unknown cough status at day-28.Results: In 362 children, 95 (26.2%) were classified as having chronic cough. In models that included only children for whom cough status was known at day-28, symptom duration at enrolment, age <12 months [adjusted odds ratio (aOR) 4.5, 95% confidence interval (CI) 1.1, 18.7], gestational age (aOR 3.2, 95%CI 1.4, 7.9), underlying medical conditions (aOR 2.6, 95% CI 1.3, 5.5), a history of wheeze (aOR 2.6, 95% CI 1.4, 4.8) and childcare attendance (aOR 2.3, 95% CI 1.2, 4.4) were independent predictors of chronic cough. Amongst childcare attendees only, 64 (29.8%) had chronic cough at day-28. The strongest predictor of chronic cough amongst childcare attendees was continued attendance at childcare during their illness (aOR = 12.9, 95% CI 3.9, 43.3).Conclusion: Gestational age, underlying medical conditions, prior wheeze and childcare attendance are risk factors for chronic cough in young children. Parents/careers need to be aware of the risks associated with their child continuing to attend childcare whilst unwell and childcare centers should reinforce prevention measures in their facilities.

Highlights

Cough, one of the most common reasons for primary healthcare attendances in the community [1], is a key symptom of acute respiratory illnesses (ARIs)
This was a secondary analysis of data collected in a multi-center cohort study of children aged
Cough status at day-28 was unknown in 85 children; the baseline characteristics of children who did and did not have a known cough status at day-28 are presented in Supplementary Table 1

Summary

Introduction

One of the most common reasons for primary healthcare attendances in the community [1], is a key symptom of acute respiratory illnesses (ARIs). Intervening early in the transitional stage from acute to chronic cough improves cough outcomes [7], and may reduce the burden on families [8] and the healthcare sector [2]. Primary-care studies have reported 10% of children with an ARI are still coughing after day25 [9], there are little data on the predictors of chronic cough in children. In our previous study, restricted to a single low-socioeconomic site, predictors of chronic cough were age

Methods

Results

Conclusion