PEDIATRICS Vol. 94 No. 6 December 1994, pp. 895-901
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Epidemiology of Physician-Diagnosed Allergic Rhinitis in Childhood

Anne L. Wright PhD1, Catharine J. Holberg MSc1, Marilyn Halonen PhD1, Fernando D. Martinez MD2, Wayne Morgan MD2, and Lynn M. Taussig MD3

1 Respiratory Sciences Center, University of Arizona, Tucson, Arizona
2 Department of Pediatrics and the Steele Memorial Children's Research Center, Respiratory Sciences Center, University of Arizona, Tucson, Arizona
3 National Jewish Center for Immunology and Respiratory Medicine, Denver, Colorado

Objective. To investigate the natural history of and risk factors for allergic rhinitis in the first 6 years of life.

Methods. Parents of 747 healthy children followed from birth completed a questionnaire when the child was 6 years old. Data were obtained regarding physician-diagnosed allergic rhinitis (PDAR), associated symptoms, and age at onset. Risk-factor data were taken from earlier questionnaires, and data regarding immunoglobulin E (IgE) and skin-test reactivity were obtained at age 6.

Results. By the age of 6, 42% of children had PDAR. Children whose rhinitis began in the first year of life had more respiratory symptoms at age 6 and were more likely to have a diagnosis of asthma. Early introduction of foods or formula, heavy maternal cigarette smoking in the first year of life, and higher IgE, as well as parental allergic disorders, were associated with early development of rhinitis. Risk factors for PDAR that remained significant in a multivanate model included maternal history of physician-diagnosed allergy (odds ratio: 2.2, 95% confidence interval: 1.35-3.54), asthma in the child (4.06, 2.06-7.99), and IgE greater than 100 IU/mL at age 6 (1.93, 1.18-3.17). The odds for atopic as opposed to nonatopic PDAR were significantly higher only among those with high IgE and those who had dogs.

Conclusion. Allergic rhinitis developing in the first years of life is an early manifestation of an atopic predisposition, which may be triggered by early environmental exposures.

Submitted on November 9, 1993
Accepted on May 3, 1994




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