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Published on: April 14, 2010
Early childhood respiratory symptoms and the subsequent diagnosis of asthma
R Dodge1, F D Martinez, M G Cline
1Respiratory Sciences Center, University of Arizona College of Medicine, Tucson 85724, USA.
Insights
Early childhood respiratory symptoms are not strong predictors of later asthma. However, symptoms like wheezing or shortness of breath appearing or persisting between ages 3-4 significantly increase asthma risk.
Area of Science:
- Pediatric respiratory health
- Asthma epidemiology
- Longitudinal cohort studies
Background:
- Respiratory symptoms are common in early childhood.
- The link between early symptoms and later asthma development is not well understood.
Purpose of the Study:
- To investigate the natural history of respiratory symptoms in young children.
- To determine the association between early respiratory symptoms and the later diagnosis of asthma.
Main Methods:
- Prospective observation of a community-based sample of children under 5.
- Data collected via parent-administered mail surveys over 3 to 11 years.
- Utilized data from the Tucson Epidemiologic Study of Airways Obstructive Disease.
Main Results:
- No significant asthma risk from single symptoms in infants under 1 year.
- Wheezing with colds (OR=2.1) and shortness of breath with wheezing in 1-2 year olds increased asthma risk.
- Stronger asthma association for symptoms at ages 3-4 (OR=7.2 for shortness of breath with wheezing).
Conclusions:
- Parent-reported respiratory symptoms in infancy do not significantly predict future asthma.
- Respiratory symptoms emerging or persisting at ages 3-4 years are strongly associated with subsequent asthma diagnosis.
Background:
Respiratory symptoms are frequent in very young children, and the relation of these symptoms to later asthma in some of these children is unknown.
Objective:
The aim of the study was to describe the natural history of respiratory symptoms in a community-based sample of young children who were prospectively observed for as long as 11 years.
Methods:
Subjects were participants in the Tucson Epidemiologic Study of Airways Obstructive Disease. They were under 5 years of age at enrollment and were studied by means of a parent-administered mail survey instrument every 1 to 2 years for 3 to 11 years.
Results:
Among subjects younger than 1 year of age, no single respiratory symptom, such as cough or wheeze only with colds, significantly increased the risk of a subsequent diagnosis of asthma. Among 1- and 2-year-olds, however, those with wheeze only with colds and those with attacks of shortness of breath with wheeze were more likely to be diagnosed with asthma later when compared with children without those symptoms (odds ration = 2.1; p < 0.05 for wheeze only with colds). At ages 3 to 4 years, symptoms were even more strongly associated with subsequent asthma (odds ratio = 7.2; p < 0.0001 for attacks of shortness of breath with wheeze).
Conclusion:
Although respiratory symptoms reported by parents very early in life are not significantly associated with future asthma, those symptoms that begin at or persist through ages 3 to 4 years are.
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