Dynamics of respiratory symptoms during infancy and associations with wheezing at school age.

Usemann, Jakob; Xu, Binbin; Delgado-Eckert, Edgar; Korten, Insa Christina Severine; Anagnostopoulou, Pinelopi; Gorlanova, Olga; Kuehni, Claudia; Röösli, Martin; Latzin, Philipp; Frey, Urs; study group, BILD (2018). Dynamics of respiratory symptoms during infancy and associations with wheezing at school age. ERJ Open Research, 4(4), 00037. European Respiratory Society 10.1183/23120541.00037-2018

[img]
Preview
Text
Usemann ERJOpenRes 2018.pdf - Published Version
Available under License Creative Commons: Attribution-Noncommercial (CC-BY-NC).

Download (720kB) | Preview

Children with frequent respiratory symptoms in infancy have an increased risk for later wheezing, but the association with symptom dynamics is unknown. We developed an observer-independent method to characterise symptom dynamics and tested their association with subsequent respiratory morbidity. In this birth-cohort of healthy neonates, we prospectively assessed weekly respiratory symptoms during infancy, resulting in a time series of 52 symptom scores. For each infant, we calculated the transition probability between two consecutive symptom scores. We used these transition probabilities to construct a Markov matrix, which characterised symptom dynamics quantitatively using an entropy parameter. Using this parameter, we determined phenotypes by hierarchical clustering. We then studied the association between phenotypes and wheezing at 6 years. In 322 children with complete data for symptom scores during infancy (16 864 observations), we identified three dynamic phenotypes. Compared to the low-risk phenotype, the high-risk phenotype, defined by the highest entropy parameter, was associated with an increased risk of wheezing (odds ratio (OR) 3.01, 95% CI 1.15-7.88) at 6 years. In this phenotype, infants were more often male (64%) and had been exposed to environmental tobacco smoke (31%). In addition, more infants had siblings (67%) and attended childcare (38%). We describe a novel method to objectively characterise dynamics of respiratory symptoms in infancy, which helps identify abnormal clinical susceptibility and recovery patterns of infant airways associated with persistent wheezing.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Usemann, Jakob; Korten, Insa Christina Severine; Anagnostopoulou, Pinelopi; Kühni, Claudia and Latzin, Philipp

Subjects:

300 Social sciences, sociology & anthropology > 360 Social problems & social services
600 Technology > 610 Medicine & health

ISSN:

2312-0541

Publisher:

European Respiratory Society

Language:

English

Submitter:

Tanya Karrer

Date Deposited:

30 Nov 2018 11:15

Last Modified:

24 Oct 2019 05:09

Publisher DOI:

10.1183/23120541.00037-2018

PubMed ID:

30474038

BORIS DOI:

10.7892/boris.121892

URI:

https://boris.unibe.ch/id/eprint/121892

Actions (login required)

Edit item Edit item
Provide Feedback