High risk of adult asthma following severe wheezing in early life

Abstract

Summary. Background: Severe wheezing in early life is associated with an increased risk of asthma during childhood and adolescence. The aim of the present follow-up was to investigate the asthma prevalence and risk factors for asthma in adulthood. Methods: We have prospectively studied asthma development in 101 children hospitalized due to severe wheezing before the age of 24 months. The cohort was re-investigated at a mean age of 27 years and tested for bronchial hyper-responsiveness and allergic sensitization. The response rate in adulthood was 81% (82/ 101). The results were compared with a population-based, age-matched control group (n ¼ 1,210) recruited from the West Sweden Asthma Study. Results: Current doctor-diagnosed asthma was found in 37% (30/82) compared with 7% (82/1,210) in the control group. The risk of adult asthma in the cohort compared with the control group was increased 10-fold (adjusted OR 10.0, 95% CI 5.3-18.7), independently of allergic rhinitis, gender, smoking and heredity. Within the cohort, current allergy (aOR 9.6, 95% CI 3.0-31.2) and female gender (aOR 3.2, 95% CI 1.1-9.3) independently increased the risk of adult asthma. Females with current allergy had the highest risk of adult asthma (OR 29.4, 95% CI 5.0-173.3), compared with males without allergy. When separately adjusting for factors present at admission in early life within the cohort, a family history of asthma was a significant risk factor for asthma in adulthood (aOR 4.0, 95% CI 1.3-12.5). Conclusion: Subjects with severe early wheezing have a 10-fold increase in the risk of adult asthma compared to an agematched control group, adjusted for allergic rhinitis, gender, smoking and heredity. Pediatr Pulmonol. 2015;50:789-797. ß

Asthma and lung function in adulthood after a viral wheezing episode in early childhood

“…2,3,23,24 However, many prospective cohorts have demonstrated that early-childhood wheezers have an increased risk of suffering from asthma later in childhood, 15,16,[25][26][27][28][29] adolescence, 4,17,30,31 and even in adulthood. 2,3,23,24 However, many prospective cohorts have demonstrated that early-childhood wheezers have an increased risk of suffering from asthma later in childhood, 15,16,[25][26][27][28][29] adolescence, 4,17,30,31 and even in adulthood.…”

Special Considerations in Preschool Age

“…Overtreatment of wheezing among preschoolers is gratuitous and increases the total disease burden and risk of potential side effects -this should especially be noted as a large portion of wheezing preschoolers only experience transient periods with respiratory symptoms that ultimately resolve. Severe wheezing at preschool age is, however, associated with decreased lung function and an increased risk of later asthma not only into adolescence but also into adulthood and should thus be optimally prevented, monitored, and aptly treated [80,[129][130][131].…”

Pediatric pulmonology year in review 2015: Part 3

“…Boudewijn et al used data from the PIAMA birth cohort to show that early nocturnal cough and wheeze were associated with asthma at 8 years; co‐existence of these symptoms at 1 year of age doubled the risk. Similarly, Goksör et al, in their prospective cohort study on 101 children admitted with severe wheeze before 2 years age, reported that risk of asthma at age 27 years was increased ten times compared to a healthy control group even after adjustment for allergic rhinitis, gender, and heredity . Klaassen et al investigated the use of exhaled breath biomarkers and expression of inflammation in conjunction with the asthma predictive index (API) in young wheezers, to predict asthma at 6 years age.…”

“…Similarly, Goks€ or et al, in their prospective cohort study on 101 children admitted with severe wheeze before 2 years age, reported that risk of asthma at age 27 years was increased ten times compared to a healthy control group even after adjustment for allergic rhinitis, gender, and heredity. 14 Klaassen et al 15 investigated the use of exhaled breath biomarkers and expression of inflammation in conjunction with the asthma predictive index (API) 16 in young wheezers, to predict asthma at 6 years age. They reported that the combination of exhaled breath volatile organic compounds and peripheral blood mononuclear cell expression of toll-like receptor 4, catalase, and TNF-a significantly improved the reliability of the API.…”