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Severity of obstructive airways disease by age 2 years predicts asthma at 10 years of age

C S Devulapalli1, K C L Carlsen, G Håland

  • 1Department of Paediatrics, Division of Woman and Child, Ullevål University Hospital, Oslo, Norway.

Thorax
|July 7, 2007
PubMed

Insights

A high obstructive airways disease (OAD) severity score in early childhood strongly predicts school-age asthma. This simple scoring system can identify children at high risk for developing asthma by age 10.

Area of Science:

  • Pediatric Pulmonology
  • Epidemiology
  • Allergy and Immunology

Background:

  • Predicting school-age asthma from early-life obstructive airways disease (OAD) is challenging, even with family history.
  • Early identification of children at risk for persistent asthma is crucial for timely intervention.

Purpose of the Study:

  • To determine if the severity of OAD in the first two years of life predicts the development of asthma at age 10.
  • To evaluate a simple scoring system for OAD severity in early life as a predictive tool for childhood asthma.

Main Methods:

  • A nested case-control study followed 233 children with recurrent bronchial obstruction (rBO+) and 216 without (rBO-) from age 2 to 10.
  • OAD severity at age 2 was scored based on obstruction frequency, persistence, and hospital admissions.
  • At age 10, children underwent clinical evaluations, including treadmill tests and methacholine bronchial hyperresponsiveness (BHR) measurements.

Main Results:

  • Children with rBO+ had a significantly higher risk of current asthma at age 10 (OR 7.9).
  • A high OAD severity score (>5) at age 2 was a strong predictor of current asthma (OR 20.2) and severe BHR.
  • The OAD severity score demonstrated good predictive value, with an optimal cut-off at score 5.

Conclusions:

  • A simple OAD severity scoring system in early life is a powerful predictor of current asthma at age 10.
  • This scoring system can identify children at high risk for developing persistent asthma, enabling targeted management strategies.
Abstract

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