Early Life Wheezing and Childhood Cognition in the Environmental Influences on Child Health Outcomes (ECHO) Program

Our objective was to determine if children with early life wheeze are at increased risk of lower cognitive ability. We analyzed data from the Environmental Influences on Child Health Outcomes (ECHO) consortium including early childhood wheeze (before 5 years of age) and four cognitive domains (verbal ability, non-verbal ability, working memory, and information processing speed) measured between 6-12 years of age using Weschler assessments (Wechsler Intelligence Scale for Children [WISC], Wechsler Preschool and Primary Scale of Intelligence [WPPSI], Wechsler Abbreviated Scale of Intelligence [WASI]). We used unadjusted and multi-variable linear mixed models to examine the association between early childhood wheeze and each of the four cognitive domains, adjusting for maternal age and education, birth order and weight, gestational age, daycare, health insurance, income, environmental smoke exposure, and the childhood opportunity index (COI) using cohort as a fixed effect and repeated cognitive assessments as random effects. Of 1524 study participants, 29% reported wheeze before age 5 years. Parental marital status, maternal education and age, insurance status, and COI were all significantly associated with wheeze. In the univariate analysis, wheeze was significantly associated with lower verbal comprehension (-6.1, p<0.0001) and perceptual reasoning scores (-2.6 points, p<0.001). After adjusting for potential confounders, early life wheeze was not significantly associated with any of cognitive outcomes examined. Early life wheeze may be associated with poorer verbal and perceptual reasoning. However, these associations appear to be confounded by sociodemographic and childhood opportunity factors.