{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:37:55Z","timestamp":1792791475869,"version":"4.5.0"},"reference-count":44,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2024,7,4]],"date-time":"2024-07-04T00:00:00Z","timestamp":1720051200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Medical Research Council","award":["no grant number"],"award-info":[{"award-number":["no grant number"]}]},{"name":"AstraZeneca Research Trust","award":["no grant number"],"award-info":[{"award-number":["no grant number"]}]},{"DOI":"10.13039\/501100001321","name":"National Research Foundation","doi-asserted-by":"crossref","award":["90550"],"award-info":[{"award-number":["90550"]}],"id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"crossref"}]},{"name":"UKZN Flagships Programme","award":["no grant number"],"award-info":[{"award-number":["no grant number"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Thorax"],"accepted":{"date-parts":[[2024,5,29]]},"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Antenatal factors and environmental exposures contribute to recurrent wheezing in early childhood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To identify antenatal and environmental factors associated with recurrent wheezing in children from birth to 48 months in the mother and child in the environment cohort, using time-to-event analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Maternal interviews were administered during pregnancy and postnatally and children were followed up from birth to 48 months (May 2013\u2013October 2019). Hybrid land-use regression and dispersion modelling described residential antenatal exposure to nitrogen dioxide (NO<jats:sub>2<\/jats:sub>) and particulate matter of 2.5\u2009\u00b5m diameter (PM<jats:sub>2.5<\/jats:sub>). Wheezing status was assessed by a clinician. The Kaplan-Meier hazard function and Cox-proportional hazard models provided estimates of risk, adjusting for exposure to environmental tobacco smoke (ETS), maternal smoking, biomass fuel use and indoor environmental factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 520 mother\u2013child pairs, 85 (16%) children, had a single wheeze episode and 57 (11%) had recurrent wheeze. Time to recurrent wheeze (42.9 months) and single wheeze (37.8 months) among children exposed to biomass cooking fuels was significantly shorter compared with children with mothers using electricity (45.9 and 38.9 months, respectively (p=0.03)). Children with mothers exposed to antenatal ETS were 3.8 times more likely to have had recurrent wheeze compared with those not exposed (adjusted HR 3.8, 95%\u2009CI 1.3 to 10.7). Mean birth month NO<jats:sub>2<\/jats:sub>was significantly higher among the recurrent wheeze category compared with those without wheeze. NO<jats:sub>2<\/jats:sub>and PM<jats:sub>2.5<\/jats:sub>were associated with a 2%\u20134% adjusted increased wheezing risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Control of exposure to ETS and biomass fuels in the antenatal period is likely to delay the onset of recurrent wheeze in children from birth to 48 months.<\/jats:p><\/jats:sec>","DOI":"10.1136\/thorax-2023-221150","type":"journal-article","created":{"date-parts":[[2024,7,4]],"date-time":"2024-07-04T17:22:09Z","timestamp":1720113729000},"page":"953-960","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Environmental exposures associated with early childhood recurrent wheezing in the mother and child in the environment birth cohort: a time-to-event study"],"prefix":"10.1136","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6007-1092","authenticated-orcid":false,"given":"Kareshma","family":"Asharam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aweke A Abebaw","family":"Mitku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Ramsay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakash Mohan","family":"Jeena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2318-4004","authenticated-orcid":false,"given":"Rajen N","family":"Naidoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,7,4]]},"reference":[{"key":"2025012402150922000_79.10.953.1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23030"},{"key":"2025012402150922000_79.10.953.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414123"},{"key":"2025012402150922000_79.10.953.3","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1097\/ACI.0000000000000516","article-title":"Phenotypes of wheezing and asthma in preschool children","volume":"19","author":"Kwong","year":"2019","journal-title":"Curr Opin Allergy Clin Immunol"},{"key":"2025012402150922000_79.10.953.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2013.12.001"},{"key":"2025012402150922000_79.10.953.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01450-1"},{"key":"2025012402150922000_79.10.953.6","doi-asserted-by":"crossref","DOI":"10.1183\/23120541.00150-2016","article-title":"Variations in the prevalence of childhood asthma and wheeze in Medall cohorts in Europe","volume":"3","author":"Uphoff","year":"2017","journal-title":"ERJ Open Res"},{"key":"2025012402150922000_79.10.953.7","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.aller.2016.08.011","article-title":"Meta-analysis of prevalence of wheezing and recurrent wheezing in infants","volume":"46","author":"Alvarez-Alvarez","year":"2018","journal-title":"Allergol Immunopathol (Madr)"},{"key":"2025012402150922000_79.10.953.8","first-page":"31","article-title":"Recurrent wheezing in children","volume":"5","author":"Tenero","year":"2016","journal-title":"Transl Pediatr"},{"key":"2025012402150922000_79.10.953.9","doi-asserted-by":"publisher","DOI":"10.2147\/JAA.S128319"},{"key":"2025012402150922000_79.10.953.10","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph8030875"},{"key":"2025012402150922000_79.10.953.11","doi-asserted-by":"crossref","first-page":"e328","DOI":"10.1016\/S2542-5196(17)30134-1","article-title":"Early-life exposure to indoor air pollution or tobacco smoke and lower respiratory tract illness and wheezing in African infants: a longitudinal birth cohort study","volume":"1","author":"Vanker","year":"2017","journal-title":"Lancet Planet Health"},{"key":"2025012402150922000_79.10.953.12","unstructured":"World Health Organization . 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