TY - JOUR
T1 - Early-life determinants of asthma from birth to age 20 years
T2 - A German birth cohort study
AU - Grabenhenrich, Linus B.
AU - Gough, Hannah
AU - Reich, Andreas
AU - Eckers, Nora
AU - Zepp, Fred
AU - Nitsche, Oliver
AU - Forster, Johannes
AU - Schuster, Antje
AU - Schramm, Dirk
AU - Bauer, Carl Peter
AU - Hoffmann, Ute
AU - Beschorner, John
AU - Wagner, Petra
AU - Bergmann, Renate
AU - Bergmann, Karl
AU - Matricardi, Paolo Maria
AU - Wahn, Ulrich
AU - Lau, Susanne
AU - Keil, Thomas
N1 - Funding Information:
Disclosure of potential conflict of interest: L. B. Grabenhenrich, A. Reich, N. Eckers, F. Zepp, D. Schramm, U. Hoffmann, J. Beschorner, P. Wagner, R. Bergmann, K. Bergmann, U. Wahn, and T. Keil have received research support from the German Federal Ministry of Education and Research , the German Research Foundation , and the Obesity Competence Network . H. Gough has received research support from the German Federal Ministry of Education and Research , the German Research Foundation , and the Obesity Competence Network and has received travel support from the European Academy of Allergology and Clinical Immunology. O. Nitsche has received research support from the German Federal Ministry of Education and Research , the German Research Foundation , and the Obesity Competence Network ; has received payment for lectures from Allergopharma; and has received payment for manuscript preparation from Novartis; and has received travel support from Chiesi, Allergopharma, Abbott, Infectopharm, and Novartis. J. Forster has received research support from the German Federal Ministry of Education and Research , the German Research Foundation , and the Obesity Competence Network and has received payment for expert testimony from Infectopharm. A. Schuster has received research support from the German Federal Ministry of Education and Research , the German Research Foundation , and the Obesity Competence Network ; has consultant arrangements from HAL Allergy/Leiden and ALK-Abelló; and has received payment for lectures from GlaxoSmithKline, Merck Sharp Dohme, Forest Labs, Roche, Novartis, ALK-Abelló, HAL Allergy, Grunenthal, Asche-Chiesi, and Thermo Fisher Scientific. C.-P. Bauer has received research support from the German Federal Ministry of Education and Research , the German Research Foundation , and the Obesity Competence Network and has received payment for lectures from Nestlé, Merck Sharp Dohme, and Medapharm. P. M. Matricardi has received research support from the German Federal Ministry of Education and Research , the German Research Foundation , the Obesity Competence Network , and Trial Form Support and has received payment for lectures from Allergopharma and Trial Form Support. S. Lau has received research support from the German Federal Ministry of Education and Research , the German Research Foundation , the Obesity Competence Network , Symbiopharm Herborn , Germany, and Allergopharma and has received payment for lectures from Symbiopharm and GlaxoSmithKline.
Funding Information:
The Multicenter Allergy Study (MAS) was funded by grants from the German Federal Ministry of Education and Research ( 07015633 , 07 ALE 27 , 01EE9405/5 , and 01EE9406 ) and the German Research Foundation ( KE 1462/2-1 ). This work was further supported by the Kompetenznetz Adipositas (Obesity Competence Network) funded by the German Federal Ministry of Education and Research (FKZ: 01GI1121A ).
PY - 2014/4
Y1 - 2014/4
N2 - Background The lack of longitudinal data analyses from birth to adulthood is hampering long-term asthma prevention strategies. Objective We aimed to determine early-life predictors of asthma incidence up to age 20 years in a birth cohort study by applying time-to-event analysis. Methods In 1990, the Multicenter Allergy Study included 1314 newborns in 5 German cities. Children were evaluated from birth to age 20 years at 19 time points. Using a Cox regression model, we examined the associations between 36 early-life factors and onset of asthma based on a doctor's diagnosis or asthma medication (primary outcome), typical asthma symptoms, or allergic asthma (including positive IgE measurements). Results Response at 20 years was 71.6%. Two hundred eighteen subjects met the primary outcome criteria within 16,257 person years observed. Asthma incidence was lower in participants who were vaccinated (measles, mumps, and rubella vaccine/tick-borne encephalitis vaccine/BCG vaccine: adjusted hazard ratio [HR], 0.66 [95% CI, 0.47-0.93]). Up to age 20 years, asthma incidence was higher in subjects who had parents with allergic rhinitis (adjusted HR, 2.24 [95% CI, 1.67-3.02]), started day care early or late (before 18 months: adjusted HR, 1.79 [95% CI, 1.03-3.10]; after 3 years: adjusted HR, 1.64 [95% CI, 0.96-2.79]), had mothers who smoked during pregnancy (adjusted HR, 1.79 [95% CI, 1.20-2.67]), had poor parents (adjusted HR, 1.55 [95% CI, 1.09-2.22]), and had parents with asthma (adjusted HR, 1.65 [95% CI, 1.17-2.31]). Not associated with asthma were aspects of diet and breast-feeding, pet ownership, presence of older siblings, and passive smoking. Conclusion Parental asthma and nasal allergy increase asthma incidence in offspring up to adulthood. Avoiding tobacco smoke exposure during pregnancy, receiving vaccinations in early childhood, and starting day care between 1.5 and 3 years of age might prevent or delay the development of asthma.
AB - Background The lack of longitudinal data analyses from birth to adulthood is hampering long-term asthma prevention strategies. Objective We aimed to determine early-life predictors of asthma incidence up to age 20 years in a birth cohort study by applying time-to-event analysis. Methods In 1990, the Multicenter Allergy Study included 1314 newborns in 5 German cities. Children were evaluated from birth to age 20 years at 19 time points. Using a Cox regression model, we examined the associations between 36 early-life factors and onset of asthma based on a doctor's diagnosis or asthma medication (primary outcome), typical asthma symptoms, or allergic asthma (including positive IgE measurements). Results Response at 20 years was 71.6%. Two hundred eighteen subjects met the primary outcome criteria within 16,257 person years observed. Asthma incidence was lower in participants who were vaccinated (measles, mumps, and rubella vaccine/tick-borne encephalitis vaccine/BCG vaccine: adjusted hazard ratio [HR], 0.66 [95% CI, 0.47-0.93]). Up to age 20 years, asthma incidence was higher in subjects who had parents with allergic rhinitis (adjusted HR, 2.24 [95% CI, 1.67-3.02]), started day care early or late (before 18 months: adjusted HR, 1.79 [95% CI, 1.03-3.10]; after 3 years: adjusted HR, 1.64 [95% CI, 0.96-2.79]), had mothers who smoked during pregnancy (adjusted HR, 1.79 [95% CI, 1.20-2.67]), had poor parents (adjusted HR, 1.55 [95% CI, 1.09-2.22]), and had parents with asthma (adjusted HR, 1.65 [95% CI, 1.17-2.31]). Not associated with asthma were aspects of diet and breast-feeding, pet ownership, presence of older siblings, and passive smoking. Conclusion Parental asthma and nasal allergy increase asthma incidence in offspring up to adulthood. Avoiding tobacco smoke exposure during pregnancy, receiving vaccinations in early childhood, and starting day care between 1.5 and 3 years of age might prevent or delay the development of asthma.
KW - Infant
KW - adolescent
KW - child
KW - epidemiologic factors
KW - heredity
KW - hypersensitivity
KW - immunization
KW - preschool
KW - risk factors
KW - survival analysis
UR - http://www.scopus.com/inward/record.url?scp=84897453245&partnerID=8YFLogxK
U2 - 10.1016/j.jaci.2013.11.035
DO - 10.1016/j.jaci.2013.11.035
M3 - Article
C2 - 24461583
AN - SCOPUS:84897453245
SN - 0091-6749
VL - 133
SP - 979-988.e3
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
IS - 4
ER -