Oren E, Rothers J, Stern D A, Morgan W J, Halonen M, Wright A L
Division of Epidemiology and Biostatistics, College of Public Health, University of Arizona Health Sciences Center, Tucson, AZ, USA.
College of Nursing, University of Arizona Health Sciences Center, Tucson, AZ, USA.
Clin Exp Allergy. 2015 Sep;45(9):1439-46. doi: 10.1111/cea.12573.
Wheezing in infancy has been associated with subsequent asthma, but whether cough similarly influences asthma risk has been little studied. We sought to determine whether prolonged cough and cough without cold in the first year of life are associated with childhood asthma.
Participants in the Infant Immune Study, a non-selected birth cohort, were surveyed 7 times in the first 9 months of life regarding the presence of wheeze and cough. Cough for more than 28 days was defined as prolonged. Parents were asked at 1 year if the child ever coughed without a cold. Asthma was defined as parental report of physician diagnosis of asthma, with symptoms or medication use between 2 and 9 years. Logistic regression was used to assess adjusted odds for asthma associated with cough characteristics.
A total of 24% (97) of children experienced prolonged cough and 23% (95) cough without cold in the first 9 months, respectively. Prolonged cough was associated with increased risk of asthma relative to brief cough (OR 3.57, CI: 1.88, 6.76), with the risk being particularly high among children of asthmatic mothers. Cough without cold (OR 3.13, 95% CI: 1.76, 5.57) was also independently associated with risk of childhood asthma. Both relations persisted after adjustment for wheeze and total IgE at age 1.
Prolonged cough in infancy and cough without cold are associated with childhood asthma, independent of infant wheeze. These findings suggest that characteristics of cough in infancy are early markers of asthma susceptibility, particularly among children with maternal asthma.
婴儿期喘息与后续哮喘相关,但咳嗽对哮喘风险的影响是否类似却鲜有研究。我们旨在确定出生后第一年的持续性咳嗽及无感冒时咳嗽是否与儿童哮喘相关。
婴儿免疫研究中的参与者为一个非选择性出生队列,在出生后头9个月内就喘息和咳嗽情况接受了7次调查。咳嗽超过28天被定义为持续性咳嗽。在孩子1岁时询问家长其是否曾无感冒时咳嗽。哮喘定义为家长报告医生诊断为哮喘,且在2至9岁期间有症状或使用药物。采用逻辑回归评估与咳嗽特征相关的哮喘调整后比值比。
在头9个月中,分别有24%(97名)儿童经历了持续性咳嗽,23%(95名)儿童有无感冒时咳嗽。与短暂咳嗽相比,持续性咳嗽与哮喘风险增加相关(比值比3.57,可信区间:1.88,6.76),在哮喘母亲的孩子中风险尤其高。无感冒时咳嗽(比值比3.13,95%可信区间:1.76,5.57)也与儿童哮喘风险独立相关。在调整1岁时的喘息和总IgE后,这两种关联依然存在。
婴儿期持续性咳嗽及无感冒时咳嗽与儿童哮喘相关,独立于婴儿喘息。这些发现表明婴儿期咳嗽特征是哮喘易感性的早期标志物,尤其是在有母亲哮喘的儿童中。