Wheezy babies--wheezy adults? Review on long-term outcome until adulthood after early childhood wheezing.
Population-based birth cohort studies have documented that about 30% of children suffer from wheezing during respiratory infection before their third birthday. Recurrent wheezing is common in early childhood, but most patients outgrow their symptoms by school age. However, recent long-term postbronchiolitis follow-up studies from Sweden and Finland have revealed that asthma is present in about 40% of young adults and over half of the cases are relapses after many symptom-free years. In population studies, the principal predictors for later asthma have been parental asthma, recurrent wheezing, atopy and eosinophilia. In the Swedish postbronchiolitis study, atopic diathesis through the development of clinical atopy, and early passive smoking through bronchial hyper-reactivity or later active smoking led to adult asthma. The Finnish postbronchiolitis follow-up stressed early recurrence of wheezing, wheezing induced by less invasive viruses than respiratory syncytial virus (RSV), early-life atopy and eosinophilia and parental asthma as predictors for adult asthma.


CONCLUSIONS
The majority of wheezing infants and children outgrow their symptoms by school age, but based on recent long-term follow-up studies, asthma relapses are common in young adults. These studies have highlighted parental asthma, maternal smoking and wheezing induced by other viruses than RSV as predictive factors for later asthma.
Department of Paediatrics, Kuopio University and University Hospital, FIN-70210 Kuopio, Finland. eija.piippo-savolainen@kuh.fi
Eija
E
Piippo-Savolainen
Matti
M
Korppi
D000328:Adult; D000367:Age Factors; D001249:Asthma / Q000175:diagnosis* / Q000209:etiology* / Q000235:genetics; D001988:Bronchiolitis / Q000150:complications; D002648:Child; D002675:Child, Preschool; D020022:Genetic Predisposition to Disease; D006801:Humans; D007223:Infant; D012135:Respiratory Sounds / Q000209:etiology*; D018357:Respiratory Syncytial Virus Infections / Q000150:complications; D012307:Risk Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects
D014028:Tobacco Smoke Pollution