Asthma: From childhood to adulthood

Praveen Khilnani
2004 Indian Journal of Critical Care Medicine  
Parents often want to know how long asthma will persist in their children. In a longitudinal, population based study from New Zealand, children were enrolled shortly after birth, and they or their parents were surveyed about respiratory events from ages 9 to 26 years. Subjects were also tested for atopy, hyperresponsiveness to methacholine, and responsiveness to bronchodilators at various times. Of 613 subjects who responded to all surveys, 51.4% had reported wheezing on at least two surveys by
more » ... east two surveys by age 26. By age 26, 14.5% had asthma persisting from onset; of the rest, 27.4% reported never wheezing; 21.2% had transient wheezing (reported once); 15% were wheeze free at age 26; 12.4% had relapsed (wheezing had stopped and recurred); and 9.5% had intermittent wheeze (reported at some assessments). Of the 168 who reported remission, 45.2% relapsed by age 26. Persistence of wheeze was significantly related to positive skin test for dust mites at age 13, female sex, smoking at age 21, and airway hyperresponsiveness. Airway hyperresponsiveness, dust-mite allergen sensitivity, and young age were significantly related to relapse. Comment: The good news: Many children who wheeze stop by the time they become young adults. The bad news: About 15% of children will wheeze for their entire lives, and about half of those who stop wheezing during childhood relapse by early adulthood. Results of other studies indicated that children of asthmatic parents are more likely to wheeze as they get older. A family history of asthma, early age at onset, and a history of atopy are all predictors of adult wheezing. Sears et al. A longitudnal population based, cohort study of childhood asthma followed to adulthood. N Engl J
doi:10.5005/ijccm-8-1-46 fatcat:plee6pgla5czfj2fti4fsqp2ai