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. 2022 Dec 12;8(4):00074-2022.
doi: 10.1183/23120541.00074-2022. eCollection 2022 Oct.

Early-life risk factors for development of asthma from 8 to 28 years of age: a prospective cohort study

Linnéa Hedman  1   2 , Linnéa Almqvist  1   2 , Anders Bjerg  3 , Martin Andersson  1 , Helena Backman  1 , Matthew S Perzanowski  4 , Eva Rönmark  1
Affiliations

Early-life risk factors for development of asthma from 8 to 28 years of age: a prospective cohort study

Linnéa Hedman et al. ERJ Open Res. .

Abstract

Background: The objective was to estimate the incidence rate of asthma from age 8 to 28 years and evaluate early-life risk factors for asthma onset at different ages.

Methods: In 1996, within the Obstructive Lung Disease in Northern Sweden (OLIN) studies, a cohort of 3430 schoolchildren (97% of invited) was recruited at age 8 years to a prospective study about asthma. The cohort was followed annually from age 8 to 19 years and at 28 years by questionnaire surveys (67% of the original cohort participated). Asthma was categorised as never-asthma, onset age ≤8 years, onset age 9-13 years, onset age 14-19 years or onset age >19 years.

Results: Of the 3430 individuals in the cohort, 690 (20.1%) reported asthma in any survey. The average incidence rate was 10.0/1000 per year at ≤8 years, 11.9/1000 per year at 9-13 years, 13.3/1000 per year at 14-19 years and 6.1/1000 per year at >19 years. The incidence was higher among boys until age 10 years, but from age 15 years, it became higher among girls. Family history of asthma, allergic sensitisation and breastfeeding <3 months were associated with asthma onset throughout the study. Low birthweight, maternal smoking during pregnancy, severe respiratory infection, rhinoconjunctivitis and eczema were associated with asthma onset ≤8 and 9-13 years.

Conclusions: The incidence of asthma was high during childhood and the teenage period, and decreased substantially during young adulthood. Early-life factors were associated with asthma onset throughout childhood but had also a lasting effect on asthma incidence until adulthood.

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Conflict of interest statement

Conflict of interest: H. Backman has received payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from AstraZeneca and Boehringer Ingelheim, outside the submitted work. The remaining authors have nothing to disclose.

Figures

FIGURE 1
FIGURE 1
Incidence rates of asthma up to 28 years of age. The incidence rates before 8 and after 19 years, respectively, are average annual estimates based on reports of asthma at age 8 and 28 years, respectively. The incidence rates from 8 to 19 years are based on annual questionnaire reports of asthma.
FIGURE 2
FIGURE 2
Prevalence of eczema, allergic sensitisation and rhinoconjunctivitis at age 8 years in relation to asthma development.
See this image and copyright information in PMC

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