Childhood asthma in adult life: a further study at 28 years of age.

Abstract

Childhood asthma in adult life: a further study at 28 years of age W J W KELLY, I HUDSON, P D PHELAN, M C F PAIN, A OLINSKY Abstract A group of 323 subjects who had wheezed in childhood and 48 control subjects of the same age were studied prospectively from 7 to 28 years of age. A classification system based on wheezing frequency was found to correlate well with clinical and spirometric features of airway obstruction. The amount of wheezing in early adolescence seemed to be a guide for severity-in later life with 730/%ofthose with few symptoms at 14 continuing to have little or no asthma at 28 years. Similarly 68% of those with frequent wheezing at 14 still suffered from recurrent asthma at 28 years. Most subjects with frequent wheezing at 21 continued to have comparable asthma at 28 years. Of those with infrequent wheezing at 21, 44% had worsened at 28 years. Women fared better than men between 21 and 28 with 19% having worse symptoms compared with 28% ofmen. Treatment at all ages was generally inadequate. The number of smokers among those with asthma was of concern.

Asthma: from childhood to adulthood

“…In this study. women had more symptoms than men at the age of 21-29 years, an age range comparable to that in the study of Kelly et al (41). The study of Godden et al (58) is one of the investigations in which sex was not found to affect the outcome.…”

“…However, it is important to realize that there asthma. Seven of these studies did not find a are asymptomatic subjects who have bronchial difference in outcome (1,28,47,50,(58)(59)(60), another responsiveness, but do not perceive induced bronone found women to have a better prognosis than chial obstruction during histamine provocation men (41), and two found female sex to be associ- (64). The same is true of asthmatic subjects, some ated with a poor outcome (32,55).…”

“…Most patients with asthma have clinical and serologic evidence of atopy. The results of studies examining the relationship of allergy to the outcome of asthma from childhood to adulthood are conflicting: some investigators found no effect on the outcome (32,(75)(76)(77), whereas others did (39,41,48,56,78,79). The studies which have shown an effect all point to a negative association of atopy with the outcome of asthma.…”

“…Research into a link between eczema as a risk factor for the progression of asthma is complicated by the fact that eczema is generally defined as imprecisely as asthma itself. A further problem is that many studies did not include a physical examination to establish the presence of eczema, but based their findings on questionnaires only (28,32,41,47,55). Because eczema is a disease that changes in severity within hours or days, it is difficult to determine its role in the persistence and severity of asthma.…”

“…Most follow-up studies from childhood to adulthood have shown that roughly 50% of children do "outgrow" their asthma (18, 41,47,55,56). One aspect related to outcome is age at onset of respiratory symptoms.…”