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Prognosis of childhood asthma

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The major identifiable risk factors contributing to both the expression and persistence of asthma are considered below (1):

  • family history of atopy - asthma is linked to both parental and sibling atopy (strongest association is with maternal atopy). A maternal history of asthma and/or rhinitis is a significant risk factor for late childhood onset asthma (and recurrent wheezing throughout childhood)
  • co-existence of atopic disease - markers of allergic disease at presentation (including eosinophil counts, skin prick tests) are related to the persistence and severity of current asthma through childhood - no evidence that these markers are related to the outcome of respiratory symptoms and severity of asthma in adulthood
  • effect of sex - male sex is a risk factor for asthma in prepubertal children (male children are more likely to "grow out" of their asthma in the transition to adulthood). Female sex is a risk factor for persistence of asthma in the transition from childhood to adulthood
  • bronchiolitis in infancy - viral associated wheeze often is followed by wheeze in early childhood; as the child's age advances this association weakens and by 35-40 years ventilatory function and bronchial reactivity is similar to those who had no symptoms in childhood
  • parental smoking - wheezing illness in early childhood is associated with maternal smoking; there is, however, no identifiable association between parental smoking and respiratory symptoms in adulthood
  • birthweight and prematurity - there is no consistent relationship between adult asthma and birthweight. Wheezing is more common in children whoe were born prematurely
  • age at presentation - the earlier the onset of wheeze, the better the prognosis. The majority of children who present before the age of two years become asymptomatic by mid childhood (6-11 years). Note though that coexistent atopy is a risk factor for the persistence of asthma independent of age of presentation

Reference:

  1. Thorax 2003;58 (Suppl I).

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