TY - JOUR
T1 - Association of Severe Bronchiolitis during Infancy with Childhood Asthma Development
T2 - An Analysis of the ECHO Consortium
AU - on behalf of the Environmental Influences on Child Health Outcomes (ECHO) Investigators
AU - Nanishi, Makiko
AU - Chandran, Aruna
AU - Li, Xiuhong
AU - Stanford, Joseph B.
AU - Alshawabkeh, Akram N.
AU - Aschner, Judy L.
AU - Dabelea, Dana
AU - Dunlop, Anne L.
AU - Elliott, Amy J.
AU - Gern, James E.
AU - Hartert, Tina
AU - Herbstman, Julie
AU - Hershey, Gurjit K.Khurana
AU - Hipwell, Alison E.
AU - Karagas, Margaret R.
AU - Karr, Catherine J.
AU - Leve, Leslie D.
AU - Litonjua, Augusto A.
AU - McEvoy, Cindy T.
AU - Miller, Rachel L.
AU - Oken, Emily
AU - O’Shea, T. Michael
AU - Paneth, Nigel
AU - Weiss, Scott T.
AU - Wright, Robert O.
AU - Wright, Rosalind J.
AU - Carroll, Kecia N.
AU - Zhang, Xueying
AU - Zhao, Qi
AU - Zoratti, Edward
AU - Camargo, Carlos A.
AU - Hasegawa, Kohei
N1 - Funding Information:
This work was supported by grants from the National Institutes of Health (UG3/UH3 OD023244, UG3/UH3 OD023248, UG3/UH3 OD023253, UG3/UH3 OD023268, UG/UH3 OD023271, UG3/UH3 OD023275, UG3/UH3 OD023279, UG3/UH3 OD023282, UH3/UH3 OD023286, UG3/UH3 OD023288, UG3/UH3 OD023290, UG3/UH3 OD023318, UG3/UH3 OD023337, UG3/UH3 OD023348, and UG3/UH3 OD023389). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funding organizations were not involved in the collection, management, or analysis of the data; the preparation or approval of the manuscript; or the decision to submit the manuscript for publication.
Publisher Copyright:
© 2022 by the authors.
PY - 2023/1
Y1 - 2023/1
N2 - Objective: Many studies have shown that severe (hospitalized) bronchiolitis during infancy is a risk factor for developing childhood asthma. However, the population subgroups at the highest risk remain unclear. Using large nationwide pediatric cohort data, namely the NIH Environmental influences on Child Health Outcomes (ECHO) Program, we aimed to quantify the longitudinal relationship of bronchiolitis hospitalization during infancy with asthma in a generalizable dataset and to examine potential heterogeneity in terms of major demographics and clinical factors. Methods: We analyzed data from infants (age <12 months) enrolled in one of the 53 prospective cohort studies in the ECHO Program during 2001–2021. The exposure was bronchiolitis hospitalization during infancy. The outcome was a diagnosis of asthma by a physician by age 12 years. We examined their longitudinal association and determined the potential effect modifications of major demographic factors. Results: The analytic cohort consisted of 11,762 infants, 10% of whom had bronchiolitis hospitalization. Overall, 15% subsequently developed asthma. In the Cox proportional hazards model adjusting for 10 patient-level factors, compared with the no-bronchiolitis hospitalization group, the bronchiolitis hospitalization group had a significantly higher rate of asthma (14% vs. 24%, HR = 2.77, 95%CI = 2.24–3.43, p < 0.001). There was significant heterogeneity by race and ethnicity (Pinteraction = 0.02). The magnitude of the association was greater in non-Hispanic White (HR = 3.77, 95%CI = 2.74–5.18, p < 0.001) and non-Hispanic Black (HR = 2.39, 95%CI = 1.60–3.56; p < 0.001) infants, compared with Hispanic infants (HR = 1.51, 95%CI = 0.77–2.95, p = 0.23). Conclusions: According to the nationwide cohort data, infants hospitalized with bronchiolitis are at a higher risk for asthma, with quantitative heterogeneity in different racial and ethnic groups.
AB - Objective: Many studies have shown that severe (hospitalized) bronchiolitis during infancy is a risk factor for developing childhood asthma. However, the population subgroups at the highest risk remain unclear. Using large nationwide pediatric cohort data, namely the NIH Environmental influences on Child Health Outcomes (ECHO) Program, we aimed to quantify the longitudinal relationship of bronchiolitis hospitalization during infancy with asthma in a generalizable dataset and to examine potential heterogeneity in terms of major demographics and clinical factors. Methods: We analyzed data from infants (age <12 months) enrolled in one of the 53 prospective cohort studies in the ECHO Program during 2001–2021. The exposure was bronchiolitis hospitalization during infancy. The outcome was a diagnosis of asthma by a physician by age 12 years. We examined their longitudinal association and determined the potential effect modifications of major demographic factors. Results: The analytic cohort consisted of 11,762 infants, 10% of whom had bronchiolitis hospitalization. Overall, 15% subsequently developed asthma. In the Cox proportional hazards model adjusting for 10 patient-level factors, compared with the no-bronchiolitis hospitalization group, the bronchiolitis hospitalization group had a significantly higher rate of asthma (14% vs. 24%, HR = 2.77, 95%CI = 2.24–3.43, p < 0.001). There was significant heterogeneity by race and ethnicity (Pinteraction = 0.02). The magnitude of the association was greater in non-Hispanic White (HR = 3.77, 95%CI = 2.74–5.18, p < 0.001) and non-Hispanic Black (HR = 2.39, 95%CI = 1.60–3.56; p < 0.001) infants, compared with Hispanic infants (HR = 1.51, 95%CI = 0.77–2.95, p = 0.23). Conclusions: According to the nationwide cohort data, infants hospitalized with bronchiolitis are at a higher risk for asthma, with quantitative heterogeneity in different racial and ethnic groups.
KW - asthma
KW - bronchiolitis
KW - children
KW - cohort
KW - generalizability
KW - heterogeneity
UR - http://www.scopus.com/inward/record.url?scp=85146754956&partnerID=8YFLogxK
U2 - 10.3390/biomedicines11010023
DO - 10.3390/biomedicines11010023
M3 - Article
AN - SCOPUS:85146754956
SN - 2227-9059
VL - 11
JO - Biomedicines
JF - Biomedicines
IS - 1
M1 - 23
ER -