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Preschool wheezing and prognosis at 10
Insights
Most children experiencing wheezing attacks before age 5 do not wheeze at age 10. However, frequent wheezing episodes or an asthma diagnosis by age 5 increase the risk of persistent wheezing in childhood.
Area of Science:
- Pediatric Respiratory Health
- Epidemiology
- Childhood Asthma
Background:
- Wheezing is a common symptom in early childhood.
- Predicting the persistence of childhood wheezing is crucial for effective management.
- Longitudinal data are needed to understand wheezing trajectories.
Purpose of the Study:
- To investigate the long-term prognosis of childhood wheezing.
- To identify factors associated with persistent wheezing at age 10.
- To compare outcomes for children with and without an asthma diagnosis.
Main Methods:
- Utilized data from the Child Health and Education Study, a national cohort.
- Collected information at birth, 5, and 10 years of age.
- Compared wheezing history before age 5 with wheezing status at age 10 in 11,465 children.
Main Results:
- 80% of children with wheezing attacks before age 5 were wheeze-free at age 10.
- The frequency of wheezing attacks before age 5 correlated with persistent wheezing at age 10.
- Children diagnosed with asthma at age 5 were significantly more likely to wheeze at age 10.
Conclusions:
- Childhood wheezing often resolves by age 10, particularly with infrequent episodes.
- An asthma diagnosis by age 5 is a strong predictor of persistent wheezing.
- Further follow-up is required to determine long-term relapse rates after remission.
Abstract:
Information was collected at birth and at 5 and 10 years of age on the national cohort of children born in one week of April 1970 (the Child Health and Education Study). For 11 465 children, information on wheezing attacks before 5 years was compared with reports of wheezing occurring in the 12 months before the interview at 10 years. Of 2345 children who had had at least one wheezing attack before their fifth birthday, 80% (1869) were free of wheeze at 10 years; only 8% of children who had just one wheezing attack by 5 years wheezed in their 10th year. The more attacks the child had had by the age of 5 the higher the risk of continuing to wheeze at the age of 10, but there were no major differences in prognosis according to the age of the first attack. Half of the children who had been labelled asthmatic at the age of 5 were wheezing at the age of 10 compared with an eighth of those with wheezing not so labelled. There was little evidence to suggest that the prognosis of wheezing with bronchitis was markedly different from that of children with other episodes of wheezing provided they were not said to be asthmatic. A longer follow up is necessary to ascertain whether remission at the age of 10 is followed by relapse later.