Original ArticleEarly-Life Risk Factors for Childhood Wheeze Phenotypes in a High-Risk Birth Cohort
Section snippets
Methods
The MACS began as a randomized controlled trial investigating associations between 3 infant formulas at weaning on subsequent allergies.9 It comprised 620 infants enrolled by recruiting pregnant women from Melbourne, Australia between 1990 and 1994. Eligible infants had at least 1 first-degree family member with a history of eczema, asthma, allergic rhinitis, and/or severe food allergy. The recruitment process has been described previously.10 The Mercy Maternity Hospital Ethics Committee
Results
Baseline demographic and clinical characteristics are presented in Table I. Parents were predominantly Australian born (85%) and of high socioeconomic status (1 or both parents tertiary educated in 72% of couples). Approximately one-half of the children (51%) were male. All children had at least 1 immediate family member with “allergic disease,” and 74% had 2 or more affected family members.
During the first 2 years of life, the 4-week current wheeze prevalence (ie, wheeze in the previous 4
Discussion
This study established a distinct profile of potentially etiologically important early-life risk factors for each childhood wheeze phenotype identified using LCA. All wheeze phenotypes except early transient predicted current wheeze at age 12 years, the time at which children have outgrown transient wheeze and remaining wheeze is likely to persist.19 Importantly, the risk factor profiles, in combination with existing mechanistic hypothesis, identify possible causative mechanisms for each of
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Funding for the first 6 years of the study was from Nestec (a subsidiary of Nestlé Australia). The 12-year follow-up was supported by the Asthma Foundation of Victoria. C.L. is funded by the Sidney Myer Health Fund. C.L. A.L., L.G., M.M., and S.D. are funded by the National Health and Medical Research Council of Australia. K.A. is funded by the Charles and Sylvia Viertel Charitable Foundation. M.A. holds an investigator initiated grant from Pfizer for unrelated research. The other authors declare no conflicts of interest.