Risk Factors in Preschool Children for Predicting Asthma During the Preschool Age and the Early School Age: a Systematic Review and Meta-Analysis

Abstract

A total of 17 studies were included in the analysis. Factors associated with developing asthma in children ≤ 10 years of age (both pre-school and early school age) included male gender (pooled OR = 1.70, P < 0.001), atopic dermatitis (pooled OR = 2.02, P < 0.001), a family history of asthma (pooled OR = 2.20, P < 0.001), and serum IgE levels ≥ 60 kU/l or having specific IgE (pooled OR = 2.36, P < 0.001). A history of exposure to smoke or wheezing was also associated with persistent asthma in early school age (pooled OR = 1.51, P = 0.030 and pooled OR = 2.59, P < 0.001, respectively). In general, asthma predictive models (e.g., API, PIAMA, PAPS) had relatively low sensitivity (range, 21% to 71.4%) but high specificity (range, 69% to 98%). The study found that male gender, exposure to smoke, atopic dermatitis, family history of asthma, history of wheezing, and serum IgE level ≥ 60 kU/l or having specific IgE were significantly associated with developing asthma by either preschool or early school age. Asthma predictive models can be developed by those risk factors.

Risk factors for asthma among schoolchildren who participated in a case-control study in urban Uganda

“…The other important risk factors for asthma, that have been previously described, included parental history of allergic disease(46), a child's atopy status and concomitant other allergic disease (47). The strength of this study was to demonstrate that having a combination of any two of these known risk factors for asthma had an additive effect of asthma risk, and that this risk also increased in relation to area of residence in early life, with an increasing rural-town-city gradient.…”

Agreement between a health claims algorithm and parent‐reported asthma in young children

“…See Table . These are well‐established predictors of asthma suggesting that children identified by the OASIS algorithm and not by parent‐reported asthma may represent future asthma cases (ie, those who have not yet received a formal diagnosis by their primary care physician). A statistically significant factor associated with asthma identified by parent‐report but not OASIS was male sex (aOR: 0.86; 95% CI: 0.77‐0.96).…”

“…Children who have a family history of allergies or family history of asthma were more likely to be diagnosed with asthma compared to children who do not have these risk factors . These well‐established predictors of asthma suggest that children identified by the OASIS algorithm and not by parent‐reported asthma may represent children who utilized health services similar to children diagnosed with asthma but were not yet formally diagnosed by their primary care physician (ie, future asthma cases). The original OASIS algorithm validation study in children also found a relatively high number of cases (84/630) coded as asthma based on the administrative data but assigned a non‐asthma diagnosis based on the review of the clinical record .…”

“…Child factors included age, sex, and body mass index (zBMI) . A parent completed questionnaire, adapted from the Canadian Community Health Survey, was used to define parental and household factors which included median household income, parental smoking, child's history of atopy (eczema or atopic dermatitis), child's history of allergies, daycare attendance, and family history of asthma . Median after tax neighbourhood household income was calculated using the Statistics Canada Postal Code Conversion File and data from the 2006 Canadian Census .…”

The efficacy of mometasone furoate for children with asthma: a meta-analysis of randomized controlled trials

“…Asthma has become one of the most common chronic medical conditions and about 300 million people globally are estimated to suffer from asthma [1][2][3]. Asthma is also regarded as the most common chronic disorder in children [4,5]. This disease can result in considerable morbidity and remarkably reduced quality of life in paediatric populations, and hospitalizations and urgent medical care is sometimes required for these patients [6,7].…”