[Risk factors and clinical evolution of asthma in children].
OBJECTIVE
The purpose of this study was to obtain data on the clinical evolution and risk factors related to asthma in children followed as outpatients in our Division of Allergy.


METHODS
The asthmatic group consisted of 165 children (107 boys, 58 girls), between the ages of 3 and 14 years. All children were atopic and had a positive skin prick test to D. pteronyssinus. The control group consisted of 40 healthy children (20 boys, 20 girls), within the same age range, without personal history of asthma or other atopic disease and with negative skin prick test to D. pteronyssinus. The mothers were interviewed to obtain data on: a) clinical evolution, b) family history of asthma or any other atopic disease, c) description of the house environment.


RESULTS
1) in approximately half of the cases symptoms started on the first year of life. Mothers were not informed of the condition at the time; 2) upper respiratory tract infections and bronchiolitis were responsible for triggering the first wheezing episode in most cases and remain the main precipitating factors in the first year of the disease whilst allergens, irritants, sinusitis, physical exertion and emotional factors were the main precipitating factors between the ages of 5 and 13; 3) changes in climatic conditions precipitated acute attacks throughout the evolution of the disease and; 4) asthma was not the only allergic manifestation, allergic rhinitis being the most frequent associated condition; 5) family history of atopy (Relative Risk (RR) = 2.40; 95% confidence interval (CI95%) = 1.60-3.50); maternal history of asthma (RR = 2.23; CI95% = 1.10-4.63) and the presence of smokers in the house (RR = 2.30; CI95% = 1.20-4.31) were the main risk factors for the manifestation of asthma.


CONCLUSIONS
a) there were no differences between boys and girls regarding the evolutionary aspects, b) asthma was underdiagnosed, c) family history of atopy, maternal history of asthma, and the presence of smokers in the house were risk factors for the manifestation of asthma.
Camelo-Nunes
I C
IC
Universidade Federal de São Paulo, Escola Paulista de Medicina.
Solé
D
D
Naspitz
C K
CK