What Are the Predictors of Asthma in the Early Years of Life?

Based on the results of an empirical study, a prediction cannot be made until after the age of 12 months. Childhood asthma shows a number of symptoms in the early year(s) including having a history of "wheezing” and “atopic dermatitis”, skin prick test positivity at the age of 16 months significantly predicts asthma, and all children who are sensitive to pet fur develop asthma.

Created on November 21 2015 at 08: 00 AM


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References:

1: "Predictors Of Asthma Three Years After Hospital Admission For Wheezing In Infancy," Pediatrics, 2000, by TM Reijonen, A Kotaniemi-Syrjnen, K Korhonen. (Citations: 140).

Objective. To evaluate the influence of early antiinflammatory therapy in the development of asthma 3 years after hospitalization for wheezing in infancy. In addition, the effects of allergic sensitization and respiratory syncytial virus (RSV) infection on the development of asthma were investigated. Design and Setting. A randomized, controlled follow-up study in a university hospital that provides primary hospital care for all pediatric patients in a defined area. Patients. Eighty-nine infants under 2 years of age who had been hospitalized for infection associated with wheezing and followed up for 3 years. Intervention. Early antiinflammatory therapy was given for 16 weeks; 29 patients received cromolyn sodium and 31 received budesonide. Twenty-nine control patients received no therapy. Outcome Measures. Clinical diagnosis of current asthma, defined as having at least 3 episodes of physician-diagnosed wheezing and either a wheezing episode during the preceding year or ongoing antiinflammatory medication for asthma. Results. Fourteen (48%) patients in the former cromolyn group, 15 (48%) in the former budesonide group, and 16 (55%) in the control group had current asthma. The significant predictors of asthma were age over 12 months (risk ratio [RR] 4.1; 95% confidence interval [CI] = 1.59–10.35), history of wheezing (RR 6.8; CI = 1.35–34.43), and atopic dermatitis on study entry (RR 3.4; CI = 1.17–9.39). Skin prick test positivity at the age of 16 months significantly predicted asthma (RR 9.5; CI = 2.45–36.72). In addition, all of the 18 (20%) children sensitized with furred pet developed asthma. RSV identification (RR 0.3; CI = 0.08–0.80) and early furred pet contact at home (RR 0.3; CI 0.10–0.79) were associated with the decreased occurrence of asthma. Conclusions. Antiinflammatory therapy for 4 months has no influence on the occurrence of asthma 3 years after wheezing in infancy. Early sensitization to indoor allergens, especially to pets, and atopic dermatitis predict subsequent development of asthma. RSV infection in wheezing infants may have a better outcome than other infections.


References:

1: "Predictors Of Asthma Three Years After Hospital Admission For Wheezing In Infancy," Pediatrics, 2000, by TM Reijonen, A Kotaniemi-Syrjnen, K Korhonen. (Citations: 140).

Objective. To evaluate the influence of early antiinflammatory therapy in the development of asthma 3 years after hospitalization for wheezing in infancy. In addition, the effects of allergic sensitization and respiratory syncytial virus (RSV) infection on the development of asthma were investigated. Design and Setting. A randomized, controlled follow-up study in a university hospital that provides primary hospital care for all pediatric patients in a defined area. Patients. Eighty-nine infants under 2 years of age who had been hospitalized for infection associated with wheezing and followed up for 3 years. Intervention. Early antiinflammatory therapy was given for 16 weeks; 29 patients received cromolyn sodium and 31 received budesonide. Twenty-nine control patients received no therapy. Outcome Measures. Clinical diagnosis of current asthma, defined as having at least 3 episodes of physician-diagnosed wheezing and either a wheezing episode during the preceding year or ongoing antiinflammatory medication for asthma. Results. Fourteen (48%) patients in the former cromolyn group, 15 (48%) in the former budesonide group, and 16 (55%) in the control group had current asthma. The significant predictors of asthma were age over 12 months (risk ratio [RR] 4.1; 95% confidence interval [CI] = 1.59–10.35), history of wheezing (RR 6.8; CI = 1.35–34.43), and atopic dermatitis on study entry (RR 3.4; CI = 1.17–9.39). Skin prick test positivity at the age of 16 months significantly predicted asthma (RR 9.5; CI = 2.45–36.72). In addition, all of the 18 (20%) children sensitized with furred pet developed asthma. RSV identification (RR 0.3; CI = 0.08–0.80) and early furred pet contact at home (RR 0.3; CI 0.10–0.79) were associated with the decreased occurrence of asthma. Conclusions. Antiinflammatory therapy for 4 months has no influence on the occurrence of asthma 3 years after wheezing in infancy. Early sensitization to indoor allergens, especially to pets, and atopic dermatitis predict subsequent development of asthma. RSV infection in wheezing infants may have a better outcome than other infections.


References:

1: "Predictors Of Asthma Three Years After Hospital Admission For Wheezing In Infancy," Pediatrics, 2000, by TM Reijonen, A Kotaniemi-Syrjnen, K Korhonen. (Citations: 140).

Objective. To evaluate the influence of early antiinflammatory therapy in the development of asthma 3 years after hospitalization for wheezing in infancy. In addition, the effects of allergic sensitization and respiratory syncytial virus (RSV) infection on the development of asthma were investigated. Design and Setting. A randomized, controlled follow-up study in a university hospital that provides primary hospital care for all pediatric patients in a defined area. Patients. Eighty-nine infants under 2 years of age who had been hospitalized for infection associated with wheezing and followed up for 3 years. Intervention. Early antiinflammatory therapy was given for 16 weeks; 29 patients received cromolyn sodium and 31 received budesonide. Twenty-nine control patients received no therapy. Outcome Measures. Clinical diagnosis of current asthma, defined as having at least 3 episodes of physician-diagnosed wheezing and either a wheezing episode during the preceding year or ongoing antiinflammatory medication for asthma. Results. Fourteen (48%) patients in the former cromolyn group, 15 (48%) in the former budesonide group, and 16 (55%) in the control group had current asthma. The significant predictors of asthma were age over 12 months (risk ratio [RR] 4.1; 95% confidence interval [CI] = 1.59–10.35), history of wheezing (RR 6.8; CI = 1.35–34.43), and atopic dermatitis on study entry (RR 3.4; CI = 1.17–9.39). Skin prick test positivity at the age of 16 months significantly predicted asthma (RR 9.5; CI = 2.45–36.72). In addition, all of the 18 (20%) children sensitized with furred pet developed asthma. RSV identification (RR 0.3; CI = 0.08–0.80) and early furred pet contact at home (RR 0.3; CI 0.10–0.79) were associated with the decreased occurrence of asthma. Conclusions. Antiinflammatory therapy for 4 months has no influence on the occurrence of asthma 3 years after wheezing in infancy. Early sensitization to indoor allergens, especially to pets, and atopic dermatitis predict subsequent development of asthma. RSV infection in wheezing infants may have a better outcome than other infections.



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