Outcome of asthma and wheezing in the first 6 years of life: follow-up through adolescence.
BACKGROUND
The effect of early life wheezing on respiratory function and continued symptoms through adolescence has not been fully described. Using data from a population-based birth cohort in Tucson, Arizona, we previously described four phenotypes based on the occurrence of wheezing lower respiratory illnesses before age 3 yr and active wheeze at age 6 yr: never wheezers (n = 425), transient early wheezers (n = 164), persistent wheezers (n = 113), and late-onset wheezers (n = 124).


OBJECTIVE
We sought to determine the prognosis for these phenotypes, with reference to lung function and symptoms, through adolescence.


METHODS
Current wheeze was assessed by questionnaire, lung function was measured by conventional spirometry, and atopy was determined by skin prick tests.


RESULTS
The prevalence of atopy and wheeze by age 16 yr was similar for never and transient wheezers and for persistent and late-onset wheezers. Both transient early, and persistent wheezers had significantly lower FEF(25-75) (-259 ml/s, p < 0.001, and -260 ml/s, p = 0.001, respectively), FEV1 (-75 ml, p = 0.02, and -87 ml, p = 0.03, respectively), and FEV1:FVC ratio (-1.9%, p = 0.002, and -2.5%, p = 0.001, respectively) through age 16 yr compared with never wheezers. Late-onset wheezers had levels of lung function similar to those of never wheezers through age 16 yr. There was no significant change in lung function among subjects with any of the four phenotypes, relative to their peers, from age 6 to 16 yr.


CONCLUSIONS
Patterns of wheezing prevalence and levels of lung function are established by age 6 yr and do not appear to change significantly by age 16 yr in children who start having asthma-like symptoms during the preschool years.
Morgan
Wayne J
WJ
Arizona Respiratory Center, P.O. Box 245030, Tucson, Arizona 85724, USA.
Stern
Debra A
DA
Sherrill
Duane L
DL
Guerra
Stefano
S
Holberg
Catharine J
CJ
Guilbert
Theresa W
TW
Taussig
Lynn M
LM
Wright
Anne L
AL
Martinez
Fernando D
FD
D000293:Adolescent; D000367:Age Factors; D001249:Asthma / Q000453:epidemiology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005540:Forced Expiratory Flow Rates; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D010641:Phenotype; D011379:Prognosis; D012135:Respiratory Sounds / Q000503:physiopathology
D007073:Immunoglobulin E