Wheezing requiring hospitalization in early childhood: Predictive factors for asthma in a six‐year follow‐up

Abstract

Although asthma is common after wheezing in early childhood, the risk factors for and the prevention of later asthma are poorly understood. During the present follow-up study, a range of possible predictive factors for school-age asthma was evaluated. The study group consisted of 82 children hospitalized for wheezing at age< 2 years in 1992-93. The baseline data were collected on entry to the study. In 1999, the children were re-examined at the median age of 7.2 years. A structured questionnaire was applied to chart the symptoms suggestive of asthma, and the children were examined clinically. An exercise challenge test, as well as skin prick tests (SPT) to common inhalant allergens, was performed. Asthma was present in 33 (40%) children, 30 (91%) having continuous medication for asthma. The significant asthma-predictive factors, present on entry to the study, were blood eosinophilia (p = 0.0008), atopic dermatitis (p = 0.0089), elevated total serum immunoglobulin E (IgE) (p = 0.0452), and a history of earlier episodes of wheezing in infancy (p = 0.0468). SPT positivity in early childhood was also associated with school-age asthma (p = 0.002). In contrast, respiratory syncytial virus (RSV) identification during the index episode of wheezing played a minor role as a predictive factor for asthma. In conclusion, if hospitalization for wheezing occurs in infancy, more than every third child will suffer from asthma at early school age; the risk is significantly increased with recurrent wheezing in infancy and the development of allergic manifestations.

Preschool asthma after bronchiolitis in infancy

“…Finally, confirming the study hypothesis, asthma at preschool age was more common after non-RSV bronchiolitis (24%) than after RSV bronchiolitis (8%) in infancy. This observation is in line with previous studies after early-life wheezing from Finland and Wisconsin, USA [9,20,23], but we were not able to confirm the specific role of rhinovirus aetiology of bronchiolitis as an asthma predictive factor.…”

“…First, asthma prevalence was only 12.7% at a mean age of 6.5 yrs. This figure is lower than the previously reported prevalence figures up to 48% after bronchiolitis in infancy [11][12][13][14]20]. Secondly, atopic dermatitis in infancy was a significant risk factor for asthma, in line with earlier postbronchiolitis studies [12,21,22].…”

“…The prevalence of preschool asthma has varied from 15% to 48% in previous post-bronchiolitis studies [11][12][13][14]20], which means a four-to 10-fold increase in asthma prevalence compared with nonselected populations [24]. In earlier post-bronchiolitis studies from Finland and Sweden, the prevalence of asthma was 30% when the infants were hospitalised at ,12 months of age [13] and 25-47% when hospitalised at ,24 months of age [11,12,20].…”

Prevalência de sibilância e fatores de risco associados em crianças no primeiro ano de vida, residentes no Município de Recife, Pernambuco, Brasil

“…Estudo documentou serem 44% as crianças menores de um ano de vida atendidas por sintomas respiratórios em unidades de emergência 4 . Outros, demonstraram taxas elevadas de hospitalização para crianças menores de um ano com sintomas respiratórios, além de verificarem taxas de hospitalização até três vezes maiores que as de crianças que não apresentavam sibilância 5 .…”

İnfantlarda Sık Hışıltı Gelişimini Öngörmede Erken Yaşam Belirteçleri; Gizemli Bir Yolda Eski Dost, ‘’Eozinofil’’ ile Devam Etmek

“…Literatürde geç başlangıçlı veya persistan hışıltı atakları olan infantların ortalama serum total IgE düzeylerinin hışıltı atakları olmayanlara göre önemli derecede daha yüksek olduğu bildirilmektedir (33). Kotaniemi-Syrjanen ve ark.nın (25) çalışmasında, serum ECP, kan eozinofil sayısı, RSV, atopik dermatit, parental astım ve atopi öyküsü, serum IgE düzeyinden oluşan modelde, 60 IU/L üzerindeki serum IgE düzeyini astımı öngörmede önemli bir prediktif değer olarak bulmuşlardır (OR=3.41) . Bizim çalışmamızda da 154 IU/ml üzerindeki serum total IgE düzeyinin sık hışıltılı çocukları belirlemede önemli bir prediktif değeri olduğu saptandı (OR=9.2).…”