Risk Factors for Chronic Cough in Young Children: A Cohort Study

Abstract

Background and Objective: Data on the predictors of chronic cough development in young children are scarce. Our primary objective was to examine the factors associated with young children developing a chronic cough, with a focus on childcare attendance. Methods: A secondary analysis of data collected in a prospective cohort study of children presenting to three emergency departments and three primary healthcare centers in southeast Queensland, Australia. Eligible children where those aged <6-years presenting with cough and without known underlying chronic lung disease other than asthma. Children were followed for 4 weeks to ascertain cough duration. The primary outcome was persistent cough at day-28. Logistic regression models were undertaken to identify independent predictors of chronic cough including sensitivity analyses that accounted for children with unknown cough status at day-28. Results: In 362 children, 95 (26.2%) were classified as having chronic cough. In models that included only children for whom cough status was known at day-28, symptom duration at enrolment, age <12 months [adjusted odds ratio (aOR) 4.5, 95% confidence interval (CI) 1.1, 18.7], gestational age (aOR 3.2, 95%CI 1.4, 7.9), underlying medical conditions (aOR 2.6, 95% CI 1.3, 5.5), a history of wheeze (aOR 2.6, 95% CI 1.4, 4.8) and childcare attendance (aOR 2.3, 95% CI 1.2, 4.4) were independent predictors of chronic cough. Amongst childcare attendees only, 64 (29.8%) had chronic cough at day-28. The strongest predictor of chronic cough amongst childcare attendees was continued attendance at childcare during their illness (aOR = 12.9, 95% CI 3.9, 43.3). Conclusion: Gestational age, underlying medical conditions, prior wheeze and childcare attendance are risk factors for chronic cough in young children. Parents/careers need to be aware of the risks associated with their child continuing to attend childcare whilst unwell and childcare centers should reinforce prevention measures in their facilities. (Copyright © 2020 Au-Yeung, Chang, Grimwood, Lovie-Toon, Kaus, Rablin, Arnold, Roberts, Parfitt, Anderson, Toombs and O'Grady.)eCollection. Cited Medium: Print. NLM ISO Abbr: Front Pediatr. PubMed Central ID: PMC7435047. Linked References: Front Pediatr. 2017 Oct 31;5:228. (PMID: 29164080); Arch Dis Child. 2017 Nov;102(11):1044-1048. (PMID: 28814419); Chest. 2014 Jun;145(6):1271-1278. (PMID: 24435356); PLoS One. 2014 Jul 17;9(7):e101440. (PMID: 25032810); Pediatrics. 2010 Oct;126(4):632-7. (PMID: 20876173); BMJ Open. 2017 Sep 5;7(9):e014635. (PMID: 28877939); J Asthma. 2011 Oct;48(8):790-6. (PMID: 21838620); BMJ Open. 2017 Mar 3;7(3):e013796. (PMID: 28259853); Paediatr Respir Rev. 2015 Jun;16(3):182-8. (PMID: 25554628); PLoS One. 2012;7(8):e43214. (PMID: 22952649); Chest. 2006 May;129(5):1132-41. (PMID: 16685002); Pediatr Allergy Immunol. 2015 Dec;26(8):797-804. (PMID: 26031206); Pediatr Ann. 2019 Mar 1;48(3):e103-e109. (PMID: 30874817); Child Care Health Dev. 2018 Mar;44(2):326-331. (PMID: 28620959); Chest. 2016 Jan;149(1):106-19. (PMID: 26356242); Expert Rev Respir Med. 2010 Oct;4(5):593-604. (PMID: 20923339); Med J Aust. 2015 Jan 19;202(1):21-3. (PMID: 25588439); Pediatr Pulmonol. 2016 Dec;51(12):1336-1346. (PMID: 27228308); J Paediatr Child Health. 2019 Feb;55(2):181-187. (PMID: 30066972); J Paediatr Child Health. 2017 Jul;53(7):636-643. (PMID: 28436124); PLoS One. 2018 May 16;13(5):e0197274. (PMID: 29768461); Chest. 2008 Aug;134(2):303-309. (PMID: 18641100); Chest. 2017 Apr;151(4):875-883. (PMID: 28104362); Pulm Pharmacol Ther. 2019 Jun;56:51-55. (PMID: 30851475); Pediatr Infect Dis J. 2013 Aug;32(8):e334-40. (PMID: 23584578); Qual Life Res. 2018 Apr;27(4):891-903. (PMID: 29357027); Front Pediatr. 2018 Dec 03;6:379. (PMID: 30560110); BMJ. 2013 Dec 11;347:f7027. (PMID: 24335668); Vaccine. 2020 Feb 11;38(7):1601-1613. (PMID: 31932138); Allergol Immunopathol (Madr). 2018 Nov - Dec;46(6):578-584. (PMID: 30318106); Med J Aust. 2006 Apr 17;184(8):398-403. (PMID: 16618239); Pediatr Pulmonol. 2009 Nov;44(11):1093-9. (PMID: 19824048); Pediatr Pulmonol. 2017 Mar;52(3):373-381. (PMID: 27458795); Lancet Child Adolesc Health. 2019 Dec;3(12):889-898. (PMID: 31635952). Linking ISSN: 22962360. Subset: PubMed not MEDLINE; Date of Electronic Publication: 2020 Aug 12. ; Original Imprints: Publication: Lausanne : Frontiers Media SA, [2013]- <br />