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Vol. 48. Issue 3.
Pages 270-280 (May - June 2020)
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Vol. 48. Issue 3.
Pages 270-280 (May - June 2020)
Original Article
DOI: 10.1016/j.aller.2019.12.007
Relevance of the first thousand days of life to the development of wheezing in children aged 6–7 years
Karoliny dos Santosa,
Corresponding author

Corresponding author.
, Jefferson Traeberta, Anna Paula Piovezana, Jane da Silvab
a Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Av. Pedra Branca, 25, Cidade Universitária Pedra Branca, 88137-270, Palhoça, Santa Catarina, SC, Brazil
b Department of Internal Medicine and Allergy Clinic of Professor Polydoro Ernani de São Thiago University Hospital, Federal University of Santa Catarina (UFSC), Florianopolis, SC, Brazil
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Figures (1)
Tables (2)
Table 1. Associations between wheezing at ages 6–7 and early life exposures, demographics and family history of allergic diseases.
Table 2. Associations between wheezing at ages 6–7 adjusted according variables of the hierarchical framework.
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The first thousand days of life are a critical stage for the development of respiratory and immune systems. Many events in this period may be associated with wheezing in childhood. Objective: This study aimed to investigate the association between early life determinants and wheezing in children aged 6–7 years.

Materials and Methods

Population-based case-control study using early-life related questions. We used the International Study of Asthma and Allergies in Childhood questionnaire to assess wheezing symptoms. Multiple logistic regressions were performed according to a hierarchical framework, considering the complex dynamic of wheezing/asthma and potential interaction between different levels of determination.


A total of 820 children were included, from which 162 reported wheezing symptoms (19.7%). Multivariable analysis identified socioeconomic conditions (OR 2.08, 95% CI 1.08–4.00), family history of asthma (OR 2.28, 95% CI 1.37–3.75), vaginal discharge that required treatment during pregnancy (OR 1.68, 95% CI 1.00–2.83), neonatal hyperbilirubinemia (OR 2.00, 95% CI 1.17–3.42), anemia and intestinal parasitosis in the first two years (OR 2.28, 95% CI 1.22–4.25; OR 1.72, 95% CI 1.02–2.92, respectively) independently associated to wheezing at 6–7 years. Intended pregnancy was associated with reduced wheezing (OR 0.47, 95% CI 0.28–0.77).


Several factors were associated with wheezing in childhood. Considering that intended pregnancy reduced wheezing and other associated exposures are considered modifiable, these findings may guide the planning of strategies to decrease the susceptibility to asthma symptoms in childhood.

Child health
Child development
Epidemiologic factors
Odds ratio


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