Recurrent wheezing in the first three years of life: short-term prognosis and risk factors.
OBJECTIVE
It is difficult to determine if preschool children with recurrent wheezing are suffering from asthma or will suffer from asthma in the future. The aim of this study was to investigate the prognosis and risk factors of recurrent wheezing in children, beginning in the first 3 years of life.


METHODS
Children who were referred because of recurrent wheezing episodes during the first 3 years of life were evaluated for the presence of asthma over a 4-year period. A child without any symptoms within the last 12 months was considered to be in remission.


RESULTS
The study included 529 (male/female: 2.17) children with a median (inter-quartile) age of 0.6 years (0.3-1.0) at symptom onset. The median follow-up and symptom durations were 2.93 years (1.74-4.76) and 4.30 years (2.91-5.97), respectively. Remission/recovery was achieved in 1.7%, 8.0%, and 14.4% of the children within 12, 24, and 36 months, respectively. A negative "stringent asthma predictive index" (API) significantly shortened the time to recovery of wheezing compared to the positive API (p = .036). Maternal smoking during pregnancy (OR = 4.35; 95% CI = 1.29-14.63); p = .018) and the number of emergency room admissions within the first 3 years of life (OR = 1.10; 95% CI = 1.01-1.19); p = .031) were found to be independent risk factors for the persistence of wheezing symptoms.


CONCLUSIONS
Most of the children who were referred with frequent wheezing remain symptomatic 3 years after the initial wheezing episodes. A negative API is related to a shorter wheezing duration. Maternal smoking during pregnancy and the severity of the wheezing episodes appeared to be significant risk factors for the persistence of wheezing symptoms.
Pediatric Allergy and Asthma Department, School of Medicine, Hacettepe University, Ankara, Turkey.
Umit Murat
UM
Sahiner
Betul
B
Buyuktiryaki
Ozlem
O
Cavkaytar
Ebru
E
Arik Yılmaz
Ozge
O
Soyer
Cansın
C
Sackesen
Ayfer
A
Tuncer
Bulent Enis
BE
Sekerel
D001249:Asthma / Q000175:diagnosis*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis*; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models; D012135:Respiratory Sounds / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors