Latent Class Growth Analysis of Rhinitis in an Inner-City Birth Cohort

Rhinitis is a chronic nasal condition associated with asthma and cough. However, its developmental trajectories, risk factors, and comorbid conditions remain poorly characterized. Here we describe (a) the natural course of rhinitis from infancy to adolescence and (b) the association between identified developmental trajectories of rhinitis and comorbid conditions. We collected rhinitis data in 22 repeat questionnaires among 688 children from infancy to 11 years (n = 9,579, average 6.1 months between questionnaires) and used latent class growth analyses (LCGA) to identify phenotypes. From ages 5-11, we collected information on four comorbid outcomes associated with asthma: any wheeze, exercised-induced wheeze, nighttime coughing, and emergency department visits (n = 2,163, average 7.7 months between questionnaires) and used LCGA to identify outcome phenotypes (ever/never). With logistic regression we described the association between rhinitis phenotype and each outcome phenotype overall and stratified by atopy predisposition and sex. LCGA identified five rhinitis trajectory groups: never/infrequent (37.7%), transient (19.6%), persistent (6.9%), and two late onset groups: group 1 (25.5%), and group 2 (10.2%). LCGA also identified two trajectories for each outcome, classified as ever and never. Individuals with persistent rhinitis and late onset group 2 phenotypes were more likely to belong to the ever phenotype for each outcome (p < .01). We identified interaction between sex and rhinitis phenotype, with elevated risks among boys versus girls, for wheeze (p = 0.03) and exercise-induced wheeze (p = 0.02). Persistent and late-onset rhinitis is associated with increased risk of asthma symptoms in a prospective, population-based birth cohort.