Asthme du nourrisson. Devenir à moyen terme et facteurs prédictifs de la persistance des symptômes à l’âge préscolaire

Abstract

Purpose. – The objective of this study is to analyse the outcome of the asthmatic infant and to identify factors predicting persistence of clinical symptoms. Methods. – In a prospective study, we enrolled between January 1996 and December 1997 107 asthmatic infants, 70 male and 37 female, with a mean age of 15.6 months (4.5–24 months). We were interested in the allergic background, clinical severity of the disease at the beginning, social and environmental factors, results of allergic skin tests and respiratory outcome. Results. – Only 84 infants (78.5%) were still being controlled for a mean period of 3.2 ± 0.63 years. Forty-eight infants (57.2%) had a persistent wheezing. Univariate analysis demonstrated that the risk factors of persistent wheezing at pre-school age were: mother’s allergy ( P = 0.0001); early exposure to tobacco smoke ( P = 0.005); early onset of disease ( P = 0.008); severity of the beginning of the disease ( P = 0.004); and skin test positivity to inhalant allergies ( P = 2.10 –5). In multivariante analysis, only mother’s allergy ( P < 0.005), nicotinism ( P = 0.01) and positive allergic skin tests ( P = 0.01) were statistically significant. Conclusion. – Family history of atopy, exposure to passive smoking and the positive skin tests to inhalant allergens are the main predictive factors of persistent wheezing.