Prediction and prevention of allergic rhinitis: A birth cohort study of 20 years

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Item Type:	Article
Title:	Prediction and prevention of allergic rhinitis: A birth cohort study of 20 years
Creators Name:	Grabenhenrich, L.B., Keil, T., Reich, A., Gough, H., Beschorner, J., Hoffmann, U., Bauer, C.P., Forster, J., Schuster, A., Schramm, D., Nitsche, O., Zepp, F., Lee, Y.A., Bergmann, R., Bergmann, K., Wahn, U. and Lau, S.
Abstract:	BACKGROUND: Allergic rhinitis (AR) is one of the most common chronic diseases, usually starting in the first 2 decades of life. Information on predictors, risk, and protective factors is missing because of a lack of long-term prospective studies. OBJECTIVE: Our aim was to examine early-life environmental and lifestyle determinants for AR up to age 20 years. METHODS: In 1990, the Multicenter Allergy Study included 1314 newborns in 5 German cities. Children were evaluated at 19 time points. A Cox regression model examined the associations between 41 independent early-life factors and onset of AR (as the primary outcome), including sensitization against aeroallergens and the secondary outcomes of nonallergic rhinitis and AR plus asthma. RESULTS: Two hundred ninety subjects had AR within 13,179 person years observed. The risk of AR was higher with a parental history of AR (adjusted hazard ratio [aHR], 2.49; 95% CI, 1.93-3.21), urticaria (aHR, 1.32; 95% CI, 1.00-1.74), or asthma (aHR, 1.29; 95% CI, 0.95-1.75). Early allergic sensitization (aHR, 4.53; 95% CI, 3.25-6.32), eczema within the first 3 years of life (aHR, 1.83; 95% CI, 1.38-2.42), male sex (aHR, 1.28; 95% CI, 1.02-1.61), and birthday in summer or autumn (aHR, 1.26; 95% CI, 1.00-1.58) were independent predictors of AR up to age 20 years. None of the other socioeconomic, environmental, lifestyle, pregnancy, and birth-related factors were associated with AR. CONCLUSION: Only nonmodifiable factors, particularly early allergic sensitization or eczema and parental AR, predicted AR up to age 20 years. No modifiable aspects of early-life environment or lifestyle were identified as targets for primary prevention.
Keywords:	Infant, Preschool Child, Adolescent, Heredity, Risk Factors, Epidemiologic Factors, Survival Analysis, Primary Prevention
Source:	Journal of Allergy and Clinical Immunology
ISSN:	0091-6749
Publisher:	Elsevier / Mosby
Volume:	136
Number:	4
Page Range:	932-940
Date:	October 2015
Official Publication:	https://doi.org/10.1016/j.jaci.2015.03.040
PubMed:	View item in PubMed

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