Wheeze trajectories: Determinants and outcomes in the CHILD Cohort Study Journal Articles uri icon

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  • BACKGROUND: Wheezing in early life is associated with asthma in adulthood; however, the determinants of wheezing trajectories and their associations with asthma and lung function in childhood remain poorly understood. OBJECTIVE: In the CHILD Cohort Study, we aimed to identify wheezing trajectories and examine the associations between these trajectories, risk factors, and clinical outcomes at age 5 years. METHODS: Wheeze data were collected at 8 time points from 3 months to 5 years of age. We used group-based trajectory models to derive wheeze trajectories among 3154 children. Associations with risk factors and clinical outcomes were analyzed by weighted regression models. RESULTS: We identified 4 trajectories: a never/infrequent trajectory, transient wheeze, intermediate-onset (preschool) wheeze, and persistent wheeze. Higher body mass index was a common risk factor for all wheeze trajectories compared with that in the never/infrequent group. The unique predictors for specific wheeze trajectories included male sex, lower respiratory tract infections, and day care attendance for transient wheeze; paternal history of asthma, atopic sensitization, and child genetic risk score of asthma for intermediate wheeze; and maternal asthma for persistent wheeze. Blood eosinophil counts were higher in children with the intermediate wheeze trajectory than in those children with the other trajectories at the ages of 1 and 5 years. All wheeze trajectories were associated with decreased lung function and increased risk of asthma at age 5 years. CONCLUSIONS: We identified 4 distinct trajectories in children from 3 months to 5 years of age, reflecting different phenotypes of early childhood wheeze. These trajectories were characterized by different biologic and physiologic traits and risk factors.


  • Dai, Ruixue
  • Miliku, Kozeta
  • Gaddipati, Sirisha
  • Choi, Jihoon
  • Ambalavanan, Amirthagowri
  • Tran, Maxwell M
  • Reyna, Myrtha
  • Sbihi, Hind
  • Lou, Wendy
  • Parvulescu, Paula
  • Lefebvre, Diana L
  • Becker, Allan B
  • Azad, Meghan B
  • Mandhane, Piush J
  • Turvey, Stuart E
  • Duan, Qingling
  • Moraes, Theo J
  • Sears, Malcolm
  • Subbarao, Padmaja

publication date

  • June 2022