TY - JOUR
T1 - Prediction and prevention of allergic rhinitis
T2 - A birth cohort study of 20 years
AU - Grabenhenrich, Linus B.
AU - Keil, Thomas
AU - Reich, Andreas
AU - Gough, Hannah
AU - Beschorner, John
AU - Hoffmann, Ute
AU - Bauer, Carl Peter
AU - Forster, Johannes
AU - Schuster, Antje
AU - Schramm, Dirk
AU - Nitsche, Oliver
AU - Zepp, Fred
AU - Lee, Young Ae
AU - Bergmann, Renate
AU - Bergmann, Karl
AU - Wahn, Ulrich
AU - Lau, Susanne
N1 - Publisher Copyright:
© 2015 American Academy of Allergy, Asthma & Immunology.
PY - 2015/10
Y1 - 2015/10
N2 - Background Allergic rhinitis (AR) is one of the most common chronic diseases, usually starting in the first 2 decades of life. Information on predictors, risk, and protective factors is missing because of a lack of long-term prospective studies. Objective Our aim was to examine early-life environmental and lifestyle determinants for AR up to age 20 years. Methods In 1990, the Multicenter Allergy Study included 1314 newborns in 5 German cities. Children were evaluated at 19 time points. A Cox regression model examined the associations between 41 independent early-life factors and onset of AR (as the primary outcome), including sensitization against aeroallergens and the secondary outcomes of nonallergic rhinitis and AR plus asthma. Results Two hundred ninety subjects had AR within 13,179 person years observed. The risk of AR was higher with a parental history of AR (adjusted hazard ratio [aHR], 2.49; 95% CI, 1.93-3.21), urticaria (aHR, 1.32; 95% CI, 1.00-1.74), or asthma (aHR, 1.29; 95% CI, 0.95-1.75). Early allergic sensitization (aHR, 4.53; 95% CI, 3.25-6.32), eczema within the first 3 years of life (aHR, 1.83; 95% CI, 1.38-2.42), male sex (aHR, 1.28; 95% CI, 1.02-1.61), and birthday in summer or autumn (aHR, 1.26; 95% CI, 1.00-1.58) were independent predictors of AR up to age 20 years. None of the other socioeconomic, environmental, lifestyle, pregnancy, and birth-related factors were associated with AR. Conclusion Only nonmodifiable factors, particularly early allergic sensitization or eczema and parental AR, predicted AR up to age 20 years. No modifiable aspects of early-life environment or lifestyle were identified as targets for primary prevention.
AB - Background Allergic rhinitis (AR) is one of the most common chronic diseases, usually starting in the first 2 decades of life. Information on predictors, risk, and protective factors is missing because of a lack of long-term prospective studies. Objective Our aim was to examine early-life environmental and lifestyle determinants for AR up to age 20 years. Methods In 1990, the Multicenter Allergy Study included 1314 newborns in 5 German cities. Children were evaluated at 19 time points. A Cox regression model examined the associations between 41 independent early-life factors and onset of AR (as the primary outcome), including sensitization against aeroallergens and the secondary outcomes of nonallergic rhinitis and AR plus asthma. Results Two hundred ninety subjects had AR within 13,179 person years observed. The risk of AR was higher with a parental history of AR (adjusted hazard ratio [aHR], 2.49; 95% CI, 1.93-3.21), urticaria (aHR, 1.32; 95% CI, 1.00-1.74), or asthma (aHR, 1.29; 95% CI, 0.95-1.75). Early allergic sensitization (aHR, 4.53; 95% CI, 3.25-6.32), eczema within the first 3 years of life (aHR, 1.83; 95% CI, 1.38-2.42), male sex (aHR, 1.28; 95% CI, 1.02-1.61), and birthday in summer or autumn (aHR, 1.26; 95% CI, 1.00-1.58) were independent predictors of AR up to age 20 years. None of the other socioeconomic, environmental, lifestyle, pregnancy, and birth-related factors were associated with AR. Conclusion Only nonmodifiable factors, particularly early allergic sensitization or eczema and parental AR, predicted AR up to age 20 years. No modifiable aspects of early-life environment or lifestyle were identified as targets for primary prevention.
KW - Infant
KW - adolescent
KW - epidemiologic factors
KW - heredity
KW - preschool child
KW - primary prevention
KW - risk factors
KW - survival analysis
UR - http://www.scopus.com/inward/record.url?scp=84943456205&partnerID=8YFLogxK
U2 - 10.1016/j.jaci.2015.03.040
DO - 10.1016/j.jaci.2015.03.040
M3 - Article
C2 - 25976706
AN - SCOPUS:84943456205
SN - 0091-6749
VL - 136
SP - 932-940.e12
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
IS - 4
ER -