Predicting the Long-Term Course of Asthma in Wheezing Infants Is Still a Challenge

Abstract

Background . In recurrent wheezing infants, it is important to identify those likely to remain asthmatic in order to propose appropriate long-term management. Objective . To establish predictive factors for persistent asthma at adolescence in a population of recurrent wheezing infants. Methods . Retrospective study of 227 infants. Inclusion criteria were age under 36 months, a history of at least three wheezing episodes assessed via a doctor-led ISAAC questionnaire and a standardized allergy testing programme. At 13 years, active asthma was assessed by questionnaire. Results . Risk factors for asthma persisting into adolescence were allergic sensitization to multiple airborne allergens (OR 4.6, CI-95% (1.9–11.2) ), initial atopic dermatitis (OR 3.4, CI-95% (1.9–6.3) ), severe recurrent wheezing (OR 2.3, CI-95% (1.3–4.2) ), and hypereosinophilia ≥470/mm 3 (OR 2.2, CI-95% (1.07–4.7) ). Conclusion . While it is still difficult to predict the long-term course of asthma, atopy remains the major risk factor for persistent asthma.