Long term prognosis in preschool children with wheeze: Longitudinal postal questionnaire study 1993-2004

Timothy Frank, Peter I. Frank, Julie A. Morris, Michelle L. Hazell, Mary F. Linehan, Timothy L. Frank

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Objectives: 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. Design: Longitudinal series of five postal surveys based on the international study of asthma and allergies in childhood questionnaire carried out between 1993 and 2004. Setting: Two general practice populations, south Manchester. Participants: 628 children aged less than 5 years at recruitment and those with at least six years' follow-up data. Main outcome measures: 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. Conclusion: 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.
    Original languageEnglish
    Pages (from-to)1423-1426
    Number of pages3
    JournalBmj
    Volume336
    Issue number7658
    DOIs
    Publication statusPublished - 21 Jun 2008

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