Dynamics of respiratory symptoms during infancy and associations with wheezing at school age. Issue 4 (20th November 2018)

• Record Type: Journal Article
• Authors: Usemann, Jakob; Xu, Binbin; Delgado-Eckert, Edgar; Korten, Insa; Anagnostopoulou, Pinelopi; Gorlanova, Olga; Kuehni, Claudia; Röösli, Martin; Latzin, Philipp; Frey, Urs
• Other Names: author non-byline.; Anagnostopoulou Pinelopi author non-byline.; Frey Urs author non-byline.; Fuchs Oliver author non-byline.; Gorlanova Olga author non-byline.; Korten Insa author non-byline.; Kuehni Claudia author non-byline.; Latzin Philipp author non-byline.; Proietti Elena author non-byline.; Röösli Martin author non-byline.; Schmidt Anne author non-byline.; Usemann Jakob author non-byline.
• Is Part Of: ERJ open research. Volume 4:Issue 4(2018)
• Publication Date: 2018-11-20
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; Respiration; Respiratory organs -- Diseases; Respiratory organs -- Diseases -- Treatment; Respiratory Tract Diseases; Electronic journals; Fulltext; Internet Resources; Periodicals; Periodical; 616.2005
• DOI: 10.1183/23120541.00037-2018
• Languages: English
• ISSNs: 2312-0541

Abstract

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. Unsupervised analysis of symptom dynamics during infancy identifies subjects susceptible to persistent airway disease http://ow.ly/r9xz30lDpHB