Risk factors for early, persistent, and late-onset wheezing in young children. SIDRIA Collaborative Group

Am J Respir Crit Care Med. 1999 Nov;160(5 Pt 1):1617-22. doi: 10.1164/ajrccm.160.5.9811002.


Wheezing in childhood is not a single disorder and different wheezing-associated respiratory illnesses have been recently described. We investigated the association between wheezing conditions and familial, pre-, peri-, and postnatal risk factors. We studied 16,333 children, 6 to 7 yr old, enrolled in a population-based study. Standardized questionnaires were filled in by parents. A total of 1,221 children had transient early wheezing, 671 had persistent wheezing, 918 had late-onset wheezing, and 13,523 never had wheezing or asthma (control group). Maternal asthma or chronic obstructive airway disease were significantly (p < 0.0001) more associated with persistent wheezing than with transient early and late-onset wheezing. The same pattern was observed for exposure to maternal smoke during pregnancy. Having a mother > 35 yr old was protective against transient early wheezing (odds ratio [OR]: 0.68, 95% confidence intervals [95% CI]: 0.53 to 0.86). Breast feeding >/= 6 mo was slightly protective against transient early wheezing (OR: 0.82, 95% CI: 0.68 to 0.97), whereas it was a moderate risk factor for late-onset wheezing (OR: 1.22, 95% CI: 0.99 to 1.50). On the contrary, having siblings and attending a day care center were both risk factors for transient early wheezing (OR: 1.41 [95% CI: 1.21 to 1.64] and 1.70 [95% CI: 1.48 to 1.96], respectively) and protective factors against wheezing of late onset (OR: 0.83 [95% CI: 0.70 to 0.97] and 0.72 [95% CI: 0.59 to 0.88]). There was a stronger (p < 0.0001) positive association between personal history of eczema or allergic rhinitis and persistent and late-onset wheezing than transient early wheezing. Our findings suggest a different contribution of risk factors to wheezing conditions in childhood.

Publication types

  • Multicenter Study

MeSH terms

  • Asthma / genetics
  • Breast Feeding
  • Child
  • Child Day Care Centers
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Lung Diseases, Obstructive / genetics
  • Male
  • Maternal Age
  • Pregnancy
  • Prenatal Exposure Delayed Effects
  • Respiratory Sounds / etiology*
  • Rhinitis, Allergic, Seasonal / genetics
  • Risk Factors
  • Smoking / adverse effects
  • Surveys and Questionnaires