Risk factors for asthma symptoms at school age: An 8-year prospective study

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Abstract:

Childhood recurrent wheezing is a very prevalent heterogeneous clinical entity. An 8-year prospective study was performed to correlate the clinical outcome of recurrent wheezing in the first years of life with prognostic risk factors. A cohort of 308 children with recurrent wheezing, aged <7 years, were enrolled in 1993, studied using a questionnaire, skin-prick tests, and serum total IgE. According to the study protocol, in 1996 and 2001, the cohort was assessed. In 2001, 81% of the initial sample was reevaluated (n = 249); 61% remained symptomatic. Prevalence of atopy was 48% in 1993, 65% in 1996, and 75% in 2001. By logistic regression analysis, we identified the following as independent risk factors for asthma symptoms in the last year of the follow-up: personal history of rhinitis (odds ratio [OR] = 15.8, 95% confidence interval [CI], 6.1–40.8; p < 0.001), paternal asthma (OR =, 7.2; 95% CI = 1.7–29.7; p = 0.007), personal history of atopic dermatitis (OR = 5.9, 95% CI = 2.2–15.7; p < 0.001), maternal asthma (OR = 5.4, 95% CI = 1.7–17.1; p = 0.004), allergen sensitization (OR = 3.4, 95% CI = 1.2–10.4; p = 0.03), and onset of symptoms in the 2nd year or later in preschool-aged children (OR = 2.1, 95% CI = 1.1–4.8; p = 0.04). Kindergarten attendance before 12 months was identified as a protective factor (OR = 0.4, 95% CI = 0.2– 0.9; p = 0.04). Among the 128 nonatopic children in 1993, 52% developed allergen sensitization. We identified as prognostic risk factors for asthma symptoms personal history of allergic disease, parental asthma, atopy, and late onset of symptoms. In a significant number of children clinical symptoms can occur years before allergen sensitization.

Keywords: ALLERGY; ASTHMA; LONG-TERM FOLLOWUP; PEDIATRICS; PROGNOSIS; RHINITIS; RISK FACTORS; SKIN TEST

Document Type: Research Article

DOI: http://dx.doi.org/10.2500/aap.2007.28.2953

Affiliations: Immunoallergy Department, Dona Estefânia Hospital, Lisbon, Portugal

Publication date: March 1, 2007

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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