Early-life wheezing and childhood cognition in the ECHO cohort.

BACKGROUND

Nearly half of children experience wheezing illnesses in the preschool years, which could impair cognitive development.

OBJECTIVE

We investigated whether early-life wheezing illnesses are associated with reduced school-age cognitive function.

METHODS

Multivariable linear mixed models were run using data from the Environmental influences on Child Health Outcomes (ECHO) cohort. Participants included children (n = 1524) who were born at ≥34 weeks' gestational age or, if gestational age was missing, had a birth weight of ≥2500 g; had a wheeze history documented before 5 years of age; and underwent at least one Wechsler cognitive assessment between ages 6 and 12 years. Wheeze before age 5 years was measured via parental report, and cognitive function was assessed with the Wechsler scales between ages 6 and 12 years.

RESULTS

In unadjusted analysis, wheeze before age 5 years was associated with substantially lower Verbal Comprehension Index (-6.2 points [95% confidence interval, -7.9, -4.6]), Perceptual Reasoning Index (-2.7 points; 95% confidence interval, -4.2, -1.1), and Processing Speed Index (-1.8 points; 95% confidence interval, -3.3, -0.3) at ages 6-12 years. However, in multivariate analyses that accounted for cohort and multiple covariates, wheeze was not associated with school-age cognitive function. Socioeconomic and contextual variables, including annual household income, maternal education, and Childhood Opportunity Index, accounted for much of the association observed in unadjusted analyses.

CONCLUSION

In a broad US population, early-life childhood wheeze was not associated with school-age Wechsler cognitive assessment scores. These findings highlight the importance of considering the broader socioeconomic context when interpreting associations between early-life wheezing and school-age neurocognitive development.