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Multicenter Study
. 2008 Jun 21;336(7658):1423-6.
doi: 10.1136/bmj.39568.623750.BE. Epub 2008 Jun 16.

Long Term Prognosis in Preschool Children With Wheeze: Longitudinal Postal Questionnaire Study 1993-2004

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Free PMC article
Multicenter Study

Long Term Prognosis in Preschool Children With Wheeze: Longitudinal Postal Questionnaire Study 1993-2004

Peter I Frank et al. BMJ. .
Free PMC article

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.

Conflict of interest statement

Competing interests: PIF has received fees for attending meetings from GlaxoSmithKline and Merck Sharp & Dohme and funds for research and travel grants from GlaxoSmithKline, Boehringer Ingelheim, and Merck Sharp & Dohme. MLH has received a fee for speaking from Boehringer Ingelheim and travel grants from GlaxoSmithKline, Boehringer Ingelheim, and Merck Sharp & Dohme. MFL has received travel grants from GlaxoSmithKline. TLF has received fees for speaking from GlaxoSmithKline, Boehringer Ingelheim, Schering Plough, Pfizer, and Astra Zeneca; funds for research from GlaxoSmithKline, Boehringer Ingelheim, Merck Sharp & Dohme, and Schering Plough; funds for consultancy from GlaxoSmithKline, Chiesi Pharmaceuticals, and Pharmacia; and travel grants from GlaxoSmithKline, Boehringer Ingelheim, Astra Zeneca, Chiesi Pharmaceuticals, and Merck Sharp & Dohme.

Comment in

  • Wheeze in preschool children.
    Russell G. Russell G. BMJ. 2008 Jun 21;336(7658):1387-8. doi: 10.1136/bmj.39559.608356.BE. Epub 2008 Jun 16. BMJ. 2008. PMID: 18558636 Free PMC article.

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