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Prediction of early-onset asthma in genetically at-risk children
D A Mrazek1, M Klinnert, P J Mrazek
1Children's National Medical Center, Washington, DC 20010, USA. DMRAZEK@gwis2.circ.gwu.edu
Insights
Children born to mothers with asthma face increased risk. Frequent illness, high IgE levels, and parenting challenges by age 3 predict early asthma onset in at-risk infants.
Area of Science:
- Pediatrics
- Immunology
- Environmental Health
Background:
- Asthma is a significant childhood respiratory illness.
- Genetic predisposition plays a role in asthma development.
- Identifying early risk factors is crucial for intervention.
Purpose of the Study:
- To prospectively examine children at genetically increased risk for asthma.
- To assess the contributions of environmental and biological factors to early asthma onset.
- To identify predictors of asthma development in high-risk infants.
Main Methods:
- Prospective inception cohort study of 150 families.
- Children born to asthmatic mothers were followed for 3 years.
- Risk factors including illness frequency, IgE levels, parenting, and eczema were assessed.
Main Results:
- 14 out of 150 children developed asthma by age 3.
- Frequent illness, IgE levels at 6 months, parenting difficulties, and early eczema were associated with asthma onset.
- Frequent illness, elevated IgE, and parenting difficulties independently predicted asthma development.
Conclusions:
- Early life factors significantly influence asthma development in genetically at-risk children.
- Frequent illness, elevated IgE, and parenting difficulties are key predictors.
- These findings can inform targeted prevention strategies for childhood asthma.
Abstract:
The W.T. Grant Foundation Asthma Risk Study was designed to prospectively examine children who were considered at a genetically increased risk for the development of asthma. The respective contributions of 11 potential risk factors, both environmental and biological, were assessed in order to determine their relative roles in affecting the early onset of asthma. This is a report of an inception cohort of children born to asthmatic mothers and followed for a 3-year period. All 150 families were recruited from the general community and living within 2 h of the National Jewish Center for Immunology and Respiratory Medicine (Denver, CO). Mothers in the index risk sample had been previously diagnosed with asthma and were recruited during their pregnancy through physician referrals and media solicitation. The index sample of 150 families was 92% Caucasian and predominantly middle class. The mean age of mothers was 29.3 years, and of fathers, 31.1 years. The main outcome was the determination of the early onset of asthma and its association with quantified risk factors. By age 3 years, 14 of the 150 children had developed asthma. Frequent illness, IgE levels at age 6 months, parenting difficulties, and early eczema were significantly associated with the onset of asthma (P = 0.003, P = 0.006, P = 0.01, and P = 0.03, respectively). Only frequent illness, elevated serum IgE levels, and parenting difficulties entered a predictive model where they were independently related to the development of asthma.