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Published on: May 10, 2024
Wheezy babies--wheezy adults? Review on long-term outcome until adulthood after early childhood wheezing
Eija Piippo-Savolainen1, Matti Korppi
1Department of Paediatrics, Kuopio University and University Hospital, FIN-70210 Kuopio, Finland. eija.piippo-savolainen@kuh.fi
Insights
Most children with early wheezing outgrow symptoms, but asthma relapses are common in young adults. Parental asthma and early viral infections predict adult asthma development.
Area of Science:
- Pediatric respiratory health
- Epidemiology of childhood asthma
Background:
- Wheezing affects approximately 30% of children before age three.
- While most children outgrow early wheezing, long-term studies reveal significant asthma relapse rates in young adulthood.
Purpose of the Study:
- To identify predictors of adult asthma based on early childhood wheezing episodes.
- To understand the long-term implications of bronchiolitis and associated risk factors.
Main Methods:
- Analysis of population-based birth cohort studies and long-term follow-up studies post-bronchiolitis.
- Identification of key predictors including parental asthma, atopy, eosinophilia, and early-life exposures.
Main Results:
- Parental asthma, early-life atopy, and eosinophilia are principal predictors for later asthma.
- Early passive smoking and wheezing induced by viruses other than respiratory syncytial virus (RSV) are also significant risk factors.
Conclusions:
- While many children outgrow wheezing, asthma relapses are frequent in young adults.
- Parental asthma, maternal smoking, and specific viral triggers are crucial predictive factors for adult-onset asthma.
Unlabelled:
Population-based birth cohort studies have documented that about 30% of children suffer from wheezing during respiratory infection before their third birthday. Recurrent wheezing is common in early childhood, but most patients outgrow their symptoms by school age. However, recent long-term postbronchiolitis follow-up studies from Sweden and Finland have revealed that asthma is present in about 40% of young adults and over half of the cases are relapses after many symptom-free years. In population studies, the principal predictors for later asthma have been parental asthma, recurrent wheezing, atopy and eosinophilia. In the Swedish postbronchiolitis study, atopic diathesis through the development of clinical atopy, and early passive smoking through bronchial hyper-reactivity or later active smoking led to adult asthma. The Finnish postbronchiolitis follow-up stressed early recurrence of wheezing, wheezing induced by less invasive viruses than respiratory syncytial virus (RSV), early-life atopy and eosinophilia and parental asthma as predictors for adult asthma.
Conclusion:
The majority of wheezing infants and children outgrow their symptoms by school age, but based on recent long-term follow-up studies, asthma relapses are common in young adults. These studies have highlighted parental asthma, maternal smoking and wheezing induced by other viruses than RSV as predictive factors for later asthma.
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