Early-life determinants of asthma from birth to age 20 years: A German birth cohort study Linus B. Grabenhenrich, MD, MPH, Hannah Gough, Andreas Reich,

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Presentation transcript:

Early-life determinants of asthma from birth to age 20 years: A German birth cohort study Linus B. Grabenhenrich, MD, MPH, Hannah Gough, Andreas Reich, Nora Eckers, Fred Zepp, MD, Oliver Nitsche, MD, Johannes Forster, MD, Antje Schuster, MD, Dirk Schramm, MD, Carl-Peter Bauer, MD, Ute Hoffmann, MD, John Beschorner, MD, Petra Wagner, Renate Bergmann, MD, Karl Bergmann, MD, Paolo Maria Matricardi, MD, Ulrich Wahn, MD, Susanne Lau, MD, Thomas Keil, MD, MSc Journal of Allergy and Clinical Immunology Volume 133, Issue 4, Pages 979-988.e3 (April 2014) DOI: 10.1016/j.jaci.2013.11.035 Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Study population sampling (upper part) and follow-up (lower part). *High-risk study population defined through a positive family history, increased cord IgE levels, or both. Journal of Allergy and Clinical Immunology 2014 133, 979-988.e3DOI: (10.1016/j.jaci.2013.11.035) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Age at incidence by case definitions: primary outcome asthma (at least 2 of: physician's diagnosis, indicative symptom, or asthma drugs; open diamonds); secondary outcome asthma symptoms (at least 2 of: wheezing, shortness of breath, or dry cough; open squares); and secondary outcome allergic asthma (primary outcome asthma plus aeroallergen sensitization, open circles). Journal of Allergy and Clinical Immunology 2014 133, 979-988.e3DOI: (10.1016/j.jaci.2013.11.035) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Influence of socioeconomic factors and heredity on asthma development in offspring. Raw (open diamonds) and adjusted (solid diamonds and error bars, exact numbers are shown at right) HRs for the primary outcome asthma (at least 2 of: physician's diagnosis, indicative symptom, or asthma drugs) and adjusted HRs for secondary outcomes asthma symptoms (squares: at least 2 of: symptoms of wheezing, shortness of breath, or dry cough) and allergic asthma (circles: primary outcome asthma plus aeroallergen sensitization). Details on model building, including adjustment and proportionality assessment, are in Table E1. aHR, Adjusted HR; BMI, body mass index. Journal of Allergy and Clinical Immunology 2014 133, 979-988.e3DOI: (10.1016/j.jaci.2013.11.035) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 Onset of asthma (at least 2 of: physician's diagnosis, indicative symptom, or asthma drugs) stratified by parental history of allergic disease (asthma, allergic rhinitis, or eczema). Black step function depicts real data; bands and gray steps represent trajectory estimates and 95% CIs based on the Cox proportional model. Journal of Allergy and Clinical Immunology 2014 133, 979-988.e3DOI: (10.1016/j.jaci.2013.11.035) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 5 Onset of asthma (at least 2 of: physician's diagnosis, indicative symptom, or asthma drugs) stratified by wheezing within first 3 years. Black step function depicts real data; bands and gray steps represent trajectory estimates and 95% CIs based on the Cox proportional model. Journal of Allergy and Clinical Immunology 2014 133, 979-988.e3DOI: (10.1016/j.jaci.2013.11.035) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 6 Influence of pregnancy and environmental and behavioral factors in the first 3 years of life on asthma development. Raw (open diamonds) and adjusted (solid diamonds and error bars, exact numbers are shown at right) HRs for the primary outcome of asthma (2 of physician's diagnosis, indicative symptom, or asthma drugs) and adjusted HRs for secondary outcomes of asthma symptoms (squares: 2 of wheezing, shortness of breath, or dry cough) and allergic asthma (circles: based on physician's diagnosis and aeroallergen sensitization) are shown. Details on model building, including adjustment and proportionality assessment, are shown in Table E1. aHR, Adjusted HR; APGAR, postnatal adaptation score; MMR, measles, mumps, and rubella vaccine; SDS, standard deviation score; TBE, tick-borne encephalitis vaccine. Journal of Allergy and Clinical Immunology 2014 133, 979-988.e3DOI: (10.1016/j.jaci.2013.11.035) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E1 Missingness patterns, distribution, and appropriate methodology. With all 19 time points accounted for, the overall number of participants was 1314. Journal of Allergy and Clinical Immunology 2014 133, 979-988.e3DOI: (10.1016/j.jaci.2013.11.035) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions