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Infant weight trajectories and early childhood wheezing: the NINFEA birth cohort study
  1. Maja Popovic1,
  2. Costanza Pizzi1,
  3. Franca Rusconi2,
  4. Claudia Galassi3,
  5. Luigi Gagliardi4,
  6. Laura De Marco3,
  7. Enrica Migliore3,
  8. Franco Merletti1,3,
  9. Lorenzo Richiardi1,3
  1. 1Department of Medical Sciences, University of Turin, Turin, Italy
  2. 2Unit of Epidemiology, ‘Anna Meyer’ Children's University Hospital, Florence, Italy
  3. 3AOU Città della Salute e della Scienza, CPO Piemonte, Turin, Italy
  4. 4Pediatrics and Neonatology Division, Department of Woman and Child Health, Ospedale Versilia, Viareggio, Italy
  1. Correspondence to Dr Maja Popovic, Department of Medical Sciences, University of Turin, Via Santena 7, Turin 10126, Italy; maja_popovic{at}


Background Rapid postnatal weight gain has been associated with wheezing and asthma in children, but it remains unclear whether it acts independently of overweight. We aimed to disentangle the roles of infant's size and weight gain velocity in the development of wheezing in early childhood using a novel method that allows for mutual adjustment for different aspects of growth.

Methods Data were obtained from the NINFEA questionnaires where weight measurements from birth up to 18 months of age were assessed in 4492 term singletons. Wheezing was defined as at least one episode of wheezing/whistling in the chest occurring between 6 and 18 months of age. The SuperImposition by Translation And Rotation model was used to estimate individual weight trajectories defined by three child-specific parameters: size, velocity and tempo, that is age at peak weight velocity. These parameters were standardised and related to wheezing using logistic regression with effects expressed as an increase of one SD.

Results A median of five weight measurements per child were obtained. Infant size (OR=1.28; 95% CI 1.12 to 1.46) and weight gain velocity (OR=1.30; 95% CI 1.15 to 1.48) were independently positively associated with wheezing. We found no evidence of an effect of tempo on infant wheezing. The estimates were changed only minimally after adjustment for potential confounders.

Conclusions Faster growth and larger size in the first 18 months of life are both independently associated with an increased risk of wheezing. These findings suggest that early growth patterns play a role in shaping the occurrence of wheezing.

  • Paediatric asthma
  • Asthma Epidemiology
  • Asthma Mechanisms

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  • Contributors All authors made substantial contributions to the conception and design of the study, acquisition, analysis and interpretation of data. All authors were involved in drafting the manuscript and revising it critically for important intellectual content and all have approved the version to be published.

  • Funding The NINFEA study was partially funded by the Compagnia San Paolo Foundation. MP was funded by the Erasmus Mundus for Western Balkans (ERAWEB) programme (reference number: M2.12.012) and the present work was a part of her Master thesis.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The NINFEA study was approved by the Ethical Committee of the San Giovanni Battista Hospital and CTO/CRF/Maria Adelaide Hospital of Turin (approval N.0048362 and following amendments).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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