PEDIATRICS Vol. 117 No. 6 June 2006, pp. e1132-e1138 (doi:10.1542/10.1542/peds.2005-2271)
Recurrent Wheeze in Early Childhood and Asthma Among Children at Risk for Atopy
a Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
b Division of Pediatric Pulmonary Medicine, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts
c Division of Pulmonary and Critical Care Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
OBJECTIVES. Little is known about the natural history of wheezing disorders among children at risk for atopy. We examined the relation between early wheeze and asthma at 7 years of age among children with parental history of asthma or allergies followed from birth.
METHODS. Information on wheeze was collected bimonthly from birth to age 24 months and every 6 months thereafter. Recurrent early wheeze was defined as 
2 reports of wheezing in the first 3 years of life. Frequent early wheeze was defined as 2 reports of wheezing per year in the first 3 years of life. At 7 years of age, asthma was defined as physician-diagnosed asthma and wheezing in the previous year.
RESULTS. Of the 440 participating children, 223 (50.7%) had 1 report of wheeze before 3 years old, 111 (26.0%) had recurrent early wheeze, and 12 (2.7%) had frequent early wheeze. Whereas only 31 (13.9%) of 223 children with 1 report of wheeze developed asthma at 7 years of age, 24 (21.6%) of 111 children with recurrent early wheeze developed asthma at 7 years of age. Among the 12 children with frequent early wheeze, 6 (50%) had asthma at 7 years of age. After adjustment for other covariates, recurrent early wheeze in children at risk for atopy was associated with a fourfold increase in the odds of asthma at 7 years of age, and frequent early wheeze was associated with an 
12-fold increase in the odds of asthma at 7 years of age. Most (94%) of the children without frequent early wheeze did not develop asthma at 7 years of age.
CONCLUSIONS. The absence of recurrent early wheeze indicates a very low risk of asthma at school age among children with parental history of asthma or allergies. Early identification of children who will develop asthma at school age is difficult, even in children at risk for atopy. However, children with parental history of asthma or allergies who have frequent early wheeze, in particular, are at greatly increased risk of asthma and merit close clinical follow-up.
Key Words: wheeze • asthma • atopy • parental asthma • early childhood
Abbreviations: OR—odds ratio • CI—confidence interval • LRI—lower respiratory illness
Accepted Nov 23, 2005.
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  S. Arslanoglu, G. E. Moro, J. Schmitt, L. Tandoi, S. Rizzardi, and G. Boehm Early Dietary Intervention with a Mixture of Prebiotic Oligosaccharides Reduces the Incidence of Allergic Manifestations and Infections during the First Two Years of Life J. Nutr., June 1, 2008; 138(6): 1091 - 1095. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. P. Ly, M. E. Soto-Quiros, L. Avila, G. M. Hunninghake, B. A. Raby, D. Laskey, J. S. Sylvia, and J. C. Celedon Paternal Asthma, Mold Exposure, and Increased Airway Responsiveness Among Children With Asthma in Costa Rica Chest, January 1, 2008; 133(1): 107 - 114. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. B. Panitch The Relationship Between Early Respiratory Viral Infections and Subsequent Wheezing and Asthma Clinical Pediatrics, June 1, 2007; 46(5): 392 - 400. [PDF]
|
|
|
|
 |
|
 A. A Litonjua, S. L Rifas-Shiman, N. P Ly, K. G Tantisira, J. W Rich-Edwards, C. A Camargo Jr, S. T Weiss, M. W Gillman, and D. R Gold Maternal antioxidant intake in pregnancy and wheezing illnesses in children at 2 y of age. Am. J. Clinical Nutrition, October 1, 2006; 84(4): 903 - 911. [Abstract] [Full Text] [PDF]
|
|
