Association of growth trajectory profiles with asthma development in infants hospitalized with bronchiolitis.

ABSTRACT Background Little is known about the relationship of longitudinal growth trajectory in early life with asthma development, particularly in infants with bronchiolitis (a high-risk population). Objective Among infants with bronchiolitis, we aimed to identify growth trajectory profiles and to determine their longitudinal relationship with the risk for developing childhood asthma. Methods A multicenter prospective study enrolled infants (aged — derived from BMI-for-age at ages 0, 6, 12, 15, 18, 24, and 36 months by using a longitudinal clustering method. We examined associations between growth trajectory profiles and asthma development by age 5 years. Results The analytic cohort consists of 880 infants hospitalized for bronchiolitis (median age, 3 months). Overall, 26% developed asthma by age 5 years. The longitudinal clustering identified five distinct profiles: persistent low growth (27%), normative growth (33%), transient overweight (21%), late-onset overweight (16%), and persistent obesity (3%) profiles. In multivariable model, compared to children with a normative profile, those with a persistent obesity profile had significantly higher risks of developing asthma (24% vs. 38%, OR 2.55, 95%CI 1.07-6.09, P=0.03). Among children with a persistent obesity profile, those without allergic predisposition had significantly higher risks of asthma (OR 3.02, 95%CI 1.05-8.64, P=0.04 in the non-parental allergic history group; OR 3.18, 95%CI 1.02-9.92, P=0.047 in the non-IgE sensitization group) while those with allergic predisposition were not at increased risk. Conclusions This multicenter cohort study of infants with bronchiolitis demonstrated distinct growth trajectory profiles that have differential risks for developing asthma.