Long term prognosis in preschool children with wheeze: longitudinal postal questionnaire study 1993-2004.
OBJECTIVE
To follow a population of preschool children with and without parent reported wheeze over a period of 6-11 years to determine prognosis and its important predictive factors.


METHODS
Longitudinal series of five postal surveys based on the international study of asthma and allergies in childhood questionnaire carried out between 1993 and 2004.


METHODS
Two general practice populations, south Manchester.


METHODS
628 children aged less than 5 years at recruitment and those with at least six years' follow-up data.


METHODS
Parent completed questionnaire data for respiratory symptoms and associated features.


RESULTS
Of 628 children included in the study, 201 (32%) had parent reported wheeze at the first observation (baseline), of whom 27% also reported the symptom on the second occasion (persistent asthma). The only important baseline predictors of persistent asthma were exercise induced wheeze (odds ratio 3.94, 95% confidence interval 1.72 to 9.00) and a history of atopic disorders (4.44, 1.94 to 10.13). The presence of both predictors indicated a likelihood of 53.2% of developing asthma; if only one feature was present this decreased to 17.2%, whereas if neither was present the likelihood was 10.9%. Family history of asthma was not predictive of persistent asthma among children with preschool wheeze.


CONCLUSIONS
Using two simple predictive factors (baseline parent reported exercise induced wheeze and a history of atopic disorders), it is possible to estimate the likelihood of future asthma in children presenting with preschool wheeze. The absence of baseline exercise induced wheeze and a history of atopic disorders reduces the likelihood of subsequent asthma by a factor of five.
General Practice Research Unit, North West Lung Research Centre, Wythenshawe Hospital, Manchester M23 9LT.
Peter I
PI
Frank
Julie A
JA
Morris
Michelle L
ML
Hazell
Mary F
MF
Linehan
Timothy L
TL
Frank
D001249:Asthma / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology; D008297:Male; D011379:Prognosis; D012130:Respiratory Hypersensitivity / Q000453:epidemiology*; D012135:Respiratory Sounds