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Published on: August 7, 2017

Recurrent wheeze in early childhood and asthma among children at risk for atopy

Ngoc P Ly1, Diane R Gold, Scott T Weiss

  • 1Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Pediatrics
|June 3, 2006
PubMed

Insights

Children with recurrent early wheeze face a fourfold increase in asthma risk. Frequent early wheeze significantly elevates asthma risk, highlighting the need for close clinical follow-up in at-risk children.

Area of Science:

  • Pediatric Allergy and Immunology
  • Respiratory Medicine
  • Epidemiology

Background:

  • The natural history of wheezing disorders in children at risk for atopy is not well understood.
  • Children with a parental history of asthma or allergies are at increased risk for developing atopic diseases.

Purpose of the Study:

  • To investigate the relationship between early wheezing patterns and the development of asthma by age 7 in high-risk children.
  • To identify early indicators of childhood asthma in genetically predisposed individuals.

Main Methods:

  • Prospective cohort study of children with parental history of asthma or allergies, followed from birth.
  • Wheezing was monitored bimonthly until age 2, then every 6 months until age 7.
  • Recurrent early wheeze defined as >=2 episodes in the first 3 years; frequent early wheeze as >=2 episodes/year.
  • Asthma at age 7 defined as physician diagnosis with prior year wheezing.

Main Results:

  • Over 50% of children experienced wheeze before age 3.
  • Recurrent early wheeze was observed in 26% and frequent early wheeze in 2.7% of participants.
  • Children with recurrent early wheeze had a fourfold increased odds of asthma at age 7.
  • Children with frequent early wheeze had a twelvefold increased odds of asthma at age 7.

Conclusions:

  • Absence of recurrent early wheeze suggests a low risk of school-age asthma in children with atopic predisposition.
  • Early wheezing patterns, particularly frequent early wheeze, are strong predictors of childhood asthma.
  • Close clinical monitoring is recommended for children with frequent early wheeze and a family history of atopy.
Abstract

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