Outcomes of childhood asthma to the age of 50 years.
BACKGROUND
In 1964, The Melbourne Asthma Study was established to describe the spectrum and natural history of childhood asthma.


OBJECTIVE
To describe the clinical and lung function outcome of childhood asthma to the age of 50 years.


METHODS
Subjects were invited to complete an interviewer-administered questionnaire, skin prick testing, and measurement of lung function from the age of 7 years to the age of 50 years at 7-year intervals.


RESULTS
Of 458 survivors (from the original 484 subjects at recruitment), 346 subjects (76%) participated, of whom, 197 completed lung function measurement. Asthma remission at the age of 50 years was 64% in those with wheezy bronchitis, 47% for those with persistent asthma, and 15% for those with severe asthma in childhood. Multivariable analysis identified severe asthma in childhood (odds ratio [OR] 11.9 [95% CI, 3.4-41.8]), female sex (OR 2.0 [95% CI, 1.1-3.6]), and childhood hay fever (OR 2.0 [95% CI, 1.0-4.0]) as risk factors for "current asthma" at age 50 years. There was no evidence of a difference in the rate of decline in FEV1 (mL/y, 95% CI) between the severe asthma group (15 mL/y [95% CI, 9-22 mL/y]) and all the other recruitment groups: control (16 mL/y [95% CI, 12-20 mL/y]), mild wheezy bronchitis (14 mL/y [95% CI, 8-19 mL/y]), wheezy bronchitis (16 mL/y [95% CI, 11-20 mL/y]), and persistent asthma (19 mL/y [95% CI, 13-24 mL/y]).


CONCLUSIONS
The clinical and lung function outcome in adult life is strongly determined by asthma severity in childhood. The reduced lung function seen in adults is established in childhood and does not appear to decline more rapidly in adult years despite continuing symptoms.
Department of Respiratory and Sleep Medicine, Women's and Children' Hospital, North Adelaide, Australia. Electronic address: andrew.tai@health.sa.gov.au.
Andrew
A
Tai
Murdoch Children's Research Institute, Parkville, Australia.
Haily
H
Tran
Royal Children's Hospital Melbourne, Melbourne, Australia.
Mary
M
Roberts
Murdoch Children's Research Institute, Parkville, Australia.
Nadeene
N
Clarke
Murdoch Children's Research Institute, Parkville, Australia.
Anne-Marie
AM
Gibson
Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia.
Suzanna
S
Vidmar
Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital, Prahan, Australia.
John
J
Wilson
Murdoch Children's Research Institute, Parkville, Australia; Royal Children's Hospital Melbourne, Melbourne, Australia.
Colin F
CF
Robertson
D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000453:epidemiology* / Q000503:physiopathology; D002648:Child; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012129:Respiratory Function Tests; D012882:Skin Tests; D012907:Smoking; D011795:Surveys and Questionnaires; D055815:Young Adult
Asthma; atopy; lung function; remission