Sex and Pubertal Status in Relation to Wheezing, Asthma, and Lung Function Development in a Multi-Ethnic Population-Based Prospective Cohort

Abstract

Aim: We examined if sex and puberty are associated with respiratory health, and if associations were modified by ethnicity, body mass index or allergic sensitization. Methods: Among 3418 children of a multi-ethnic population-based cohort study, medical records provided information on sex. Questionnaires provided information on pubertal stages, wheezing from birth until age 13 years and current asthma at age 13 years. Pre/early, mid, and late developmental stages of breast (girls only), genital (boys only), and pubic hair were based on Tanner stages 1–2, 3–4, and 5, respectively. Spirometry was performed at age 13 years. Results: Girls had a consistently lower risk of wheezing from birth until age 13 years than boys (overall OR (95% CI) 0.86 (0.74, 0.98)). Additionally, allergic girls had a lower risk of current asthma at age 13 years (0.66 (0.46, 0.94)). Only underweight and overweight/obese girls had lower and higher, respectively, FEV1 and FVC (Z-score difference (95% CI): −0.25 (−0.40, −0.10) and −0.23 (−0.38, −0.08); 0.26 (0.09, 0.42) and 0.24 (0.09, 0.40), respectively). Girls with a late breast stage, boys with a late genital stage, and both sexes with a late pubic hair stage had higher FEV1, FVC and/or FEF75, compared with those with pre/early pubertal stages at school age (range 0.18 (0.01, 0.34)–0.22 (0.03, 0.41)). Conclusion: Our findings suggest a different risk of respiratory morbidity between girls and boys partly modified by BMI or allergic sensitization, not ethnicity, and that puberty has a positive effect on lung function measures in both sexes.