Recurrent wheezing, allergic rhinitis, and maternal asthma as predictors of asthma in children

Background: Early prediction of asthma is crucial for asthma prevention. Objective: We estimated the odds ratio (OR) of recurrent wheezing during the first 3 years of life, atopic rhinitis, and maternal asthma for asthma in school-age children (ages ≥ 6 years). Methods: This case-control study was conducted in Salvador, Brazil. Medical records of children diagnosed with asthma (cases) and of children screened for pulmonary illnesses and without asthma (controls) were reviewed. Information was retrieved and registered in standardized forms. Results: We included 125 subjects (cases) and 375 controls, whose median (percentile 25th-percentile 75th) age was 8.1 years (6.6-10.0 years) and 9.2 years (7.0-11.9 years), respectively. The subjects (cases) and the controls had at least three episodes of wheezing during the first 3 years of life (69.7% and 1.4%, respectively), a maternal history of asthma (36.0% and 4.0%, respectively), and atopic rhinitis (95.9% and 35.1%, respectively). The adjusted OR of three or more episodes of wheezing during the first 3 years of life was OR 132.5 (95% confidence interval [CI], 36.8-477.1), of a personal history of atopic rhinitis was OR 21.3 (95% CI, 5.3-85.0), and of maternal asthma was OR 10.2 (95% CI, 3.1-33.6) for asthma in a logistic regression (which also included age, gender, and maternal history of allergic rhinitis [OR insignificant for these factors]). Conclusion: Children with a history of three or more episodes of wheezing during the first 3 years of life were at least 37 times more likely to develop asthma than children without this history. A maternal history of asthma and a personal history of atopic rhinitis are also predictors of asthma in children.