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Association between allergy and asthma from childhood to middle adulthood in an Australian cohort study
R Wolfe1, J B Carlin, H Oswald
1Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Insights
Childhood asthma and atopic conditions like eczema and hay fever are linked. Early atopic conditions increase the risk of severe asthma later in life, and childhood asthma severity correlates with later atopic conditions.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Epidemiology
Background:
- Asthma and atopic conditions (eczema, hay fever) often coexist.
- Longitudinal data on the association between childhood asthma and later atopic conditions are limited.
Purpose of the Study:
- To investigate the long-term association between childhood asthma and the development/persistence of atopic conditions.
- To quantify the relationship between childhood asthma severity and later atopic conditions.
Main Methods:
- A cohort of 378 children with asthma was followed from age 7 to 35 years.
- Data on asthma severity, eczema, hay fever, and skin test reactivity were collected every 7 years.
- Statistical analysis, including odds ratios (OR) and 95% confidence intervals (CI), was used to assess associations.
Main Results:
- Childhood atopic conditions were associated with increased odds of more severe asthma later in life (e.g., eczema OR=1.66, hay fever OR=1.39, skin test reactivity OR=2.25).
- Childhood asthma severity correlated with increased odds of developing eczema and hay fever later in life.
- Significant associations were observed between childhood asthma and later atopic conditions, with quantitative measures provided.
Conclusions:
- Childhood asthma and atopic conditions exhibit a significant bidirectional association throughout development into adulthood.
- Early identification and management of atopic conditions in asthmatic children may be crucial for long-term asthma outcomes.
- This study provides novel quantitative insights into the complex interplay between asthma and atopy over time.
Abstract:
A cohort of 378 asthmatic children was studied from 7 to 35 yr of age at 7-yr intervals. On selection for inclusion in the study sample, the children had a wide range of severity of wheezing. At each 7-yr review, asthma severity, the presence of eczema or hay fever, and skin test reactivity to house dust mite or rye grass were recorded by questionnaire or clinical interview. We report on the course of asthma and these atopic conditions over the study period and discuss associations between the two phenomena. The presence of an atopic condition in childhood was found to increase the odds of more severe asthma in later life (odds ratio [OR] = 1.66, 95% confidence interval [CI]: 1.17 to 2.36 in the case of eczema; OR = 1. 39, 95% CI: 1.00 to 1.92 for hay fever; and OR = 2.25, 95% CI: 1.49 to 3.39 for skin test reactivity). Additionally, the odds of eczema and hay fever in later life increased with severity of asthma in childhood. The findings of this study provide substantially new quantitative information on the extent of association between asthma and atopic conditions from childhood into middle adulthood.