Abstract
Background. In recurrent wheezing infants, it is important to identify those likely to remain asthmatic in order to propose appropriate long-term management. Objective. To establish predictive factors for persistent asthma at adolescence in a population of recurrent wheezing infants. Methods. Retrospective study of 227 infants. Inclusion criteria were age under 36 months, a history of at least three wheezing episodes assessed via a doctor-led ISAAC questionnaire and a standardized allergy testing programme. At 13 years, active asthma was assessed by questionnaire. Results. Risk factors for asthma persisting into adolescence were allergic sensitization to multiple airborne allergens (OR 4.6, CI-95% (1.9–11.2) P = 0.001), initial atopic dermatitis (OR 3.4, CI-95% (1.9–6.3) P < 0.001), severe recurrent wheezing (OR 2.3, CI-95% (1.3–4.2) P = 0.007), and hypereosinophilia ≥470/mm3 (OR 2.2, CI-95% (1.07–4.7) P = 0.033). Conclusion. While it is still difficult to predict the long-term course of asthma, atopy remains the major risk factor for persistent asthma.
Highlights
The natural history of asthma is still poorly understood [1]
We performed a study of a cohort of wheezing infants in a tertiary care centre to determine long-term prognosis and to identify risk factors for asthma at adolescence
ISRN Allergy wheezing episodes and who had been assessed for respiratory wheezing disease via a doctor-led ISAAC questionnaire [10, 11] and a standardized allergy testing programme
Summary
The natural history of asthma is still poorly understood [1]. Diagnosis in infants often proves difficult treatment, well-codified, poses complex practical issues at such an early age [2]. Evidence from neonatal cohort studies suggests early-onset persistent asthma has the worst long-term prognosis [3], because of a faster decline in respiratory function during adolescence [6,7,8]. These studies were focused on the general population. Asthma predictive scores established in these populations are not necessarily transposable to the most severe cases of asthma followed by specialists in tertiary care [9] For these reasons, we performed a study of a cohort of wheezing infants in a tertiary care centre to determine long-term prognosis and to identify risk factors for asthma at adolescence. While it is still difficult to predict the long-term course of asthma, atopy remains the major risk factor for persistent asthma
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