Wheezing and bronchial hyper-responsiveness in early childhood as predictors of newly diagnosed asthma in early adulthood: a longitudinal birth-cohort study

Debra A. Stern, Wayne J Morgan, Marilyn Halonen, Anne L Wright, Fernando Martinez

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257 Citations (Scopus)

Abstract

Background: Incidence of asthma increases during early adulthood. We aimed to estimate the contributions of sex and early life factors to asthma diagnosed in young adults. Methods: 1246 healthy newborn babies were enrolled in the Tucson Children's Respiratory Study. Parental characteristics, early-life wheezing phenotypes, airway function, and bronchial hyper-responsiveness to cold dry air and sensitisation to Alternaria alternata were determined before age 6 years. Physician-diagnosed asthma, both chronic and newly diagnosed, and airway function were recorded at age 22 years. Findings: Of 1246 babies enrolled, 849 had follow-up data at 22 years. Average incidence of asthma at age 16-22 years was 12·6 per thousand person-years. 49 (27%) of all 181 cases of active asthma at 22 years were newly diagnosed, of which 35 (71%) were women. Asthma remittance by 22 years was higher in men than in women (multinomial odds ratio [M-OR] 2·0, 95% CI 1·2-3·2, p=0·008). Age at diagnosis was linearly associated with the ratio of forced expiratory volume at 1 s to forced vital capacity at age 22 years. Factors independently associated with chronic asthma at 22 years included onset at 6 years (7·4, 3·9-14·0) and persistent wheezing (14·0, 6·8-28·0) in early life, sensitisation to A alternata (3·6, 2·1-6·4), low airway function at age 6 years (2·1, 1·1-3·9), and bronchial hyper-responsiveness at 6 years (4·5, 1·9-10·0). Bronchial hyper-responsiveness (6·9, 2·3-21·0), low airway function at 6 years (2·8, 1·1-6·9), and late-onset (4·6, 1·7-12·0) and persistent wheezing (4·0, 1·2-14·0) predicted newly diagnosed asthma at age 22 years. Interpretation: Asthma with onset in early adulthood has its origins in early childhood. Funding: National Heart Lung and Blood Institute.

Original languageEnglish (US)
Pages (from-to)1058-1064
Number of pages7
JournalThe Lancet
Volume372
Issue number9643
DOIs
StatePublished - 2008

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Respiratory Sounds
Cohort Studies
Asthma
Parturition
National Heart, Lung, and Blood Institute (U.S.)
Alternaria
Incidence
Vital Capacity
Forced Expiratory Volume
Young Adult
Odds Ratio
Air
Economics
Newborn Infant
Physicians
Phenotype

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{2dec1c8bb94f4456b842b03fd5458ddc,
title = "Wheezing and bronchial hyper-responsiveness in early childhood as predictors of newly diagnosed asthma in early adulthood: a longitudinal birth-cohort study",
abstract = "Background: Incidence of asthma increases during early adulthood. We aimed to estimate the contributions of sex and early life factors to asthma diagnosed in young adults. Methods: 1246 healthy newborn babies were enrolled in the Tucson Children's Respiratory Study. Parental characteristics, early-life wheezing phenotypes, airway function, and bronchial hyper-responsiveness to cold dry air and sensitisation to Alternaria alternata were determined before age 6 years. Physician-diagnosed asthma, both chronic and newly diagnosed, and airway function were recorded at age 22 years. Findings: Of 1246 babies enrolled, 849 had follow-up data at 22 years. Average incidence of asthma at age 16-22 years was 12·6 per thousand person-years. 49 (27{\%}) of all 181 cases of active asthma at 22 years were newly diagnosed, of which 35 (71{\%}) were women. Asthma remittance by 22 years was higher in men than in women (multinomial odds ratio [M-OR] 2·0, 95{\%} CI 1·2-3·2, p=0·008). Age at diagnosis was linearly associated with the ratio of forced expiratory volume at 1 s to forced vital capacity at age 22 years. Factors independently associated with chronic asthma at 22 years included onset at 6 years (7·4, 3·9-14·0) and persistent wheezing (14·0, 6·8-28·0) in early life, sensitisation to A alternata (3·6, 2·1-6·4), low airway function at age 6 years (2·1, 1·1-3·9), and bronchial hyper-responsiveness at 6 years (4·5, 1·9-10·0). Bronchial hyper-responsiveness (6·9, 2·3-21·0), low airway function at 6 years (2·8, 1·1-6·9), and late-onset (4·6, 1·7-12·0) and persistent wheezing (4·0, 1·2-14·0) predicted newly diagnosed asthma at age 22 years. Interpretation: Asthma with onset in early adulthood has its origins in early childhood. Funding: National Heart Lung and Blood Institute.",
author = "Stern, {Debra A.} and Morgan, {Wayne J} and Marilyn Halonen and Wright, {Anne L} and Fernando Martinez",
year = "2008",
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volume = "372",
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T1 - Wheezing and bronchial hyper-responsiveness in early childhood as predictors of newly diagnosed asthma in early adulthood

T2 - a longitudinal birth-cohort study

AU - Stern, Debra A.

AU - Morgan, Wayne J

AU - Halonen, Marilyn

AU - Wright, Anne L

AU - Martinez, Fernando

PY - 2008

Y1 - 2008

N2 - Background: Incidence of asthma increases during early adulthood. We aimed to estimate the contributions of sex and early life factors to asthma diagnosed in young adults. Methods: 1246 healthy newborn babies were enrolled in the Tucson Children's Respiratory Study. Parental characteristics, early-life wheezing phenotypes, airway function, and bronchial hyper-responsiveness to cold dry air and sensitisation to Alternaria alternata were determined before age 6 years. Physician-diagnosed asthma, both chronic and newly diagnosed, and airway function were recorded at age 22 years. Findings: Of 1246 babies enrolled, 849 had follow-up data at 22 years. Average incidence of asthma at age 16-22 years was 12·6 per thousand person-years. 49 (27%) of all 181 cases of active asthma at 22 years were newly diagnosed, of which 35 (71%) were women. Asthma remittance by 22 years was higher in men than in women (multinomial odds ratio [M-OR] 2·0, 95% CI 1·2-3·2, p=0·008). Age at diagnosis was linearly associated with the ratio of forced expiratory volume at 1 s to forced vital capacity at age 22 years. Factors independently associated with chronic asthma at 22 years included onset at 6 years (7·4, 3·9-14·0) and persistent wheezing (14·0, 6·8-28·0) in early life, sensitisation to A alternata (3·6, 2·1-6·4), low airway function at age 6 years (2·1, 1·1-3·9), and bronchial hyper-responsiveness at 6 years (4·5, 1·9-10·0). Bronchial hyper-responsiveness (6·9, 2·3-21·0), low airway function at 6 years (2·8, 1·1-6·9), and late-onset (4·6, 1·7-12·0) and persistent wheezing (4·0, 1·2-14·0) predicted newly diagnosed asthma at age 22 years. Interpretation: Asthma with onset in early adulthood has its origins in early childhood. Funding: National Heart Lung and Blood Institute.

AB - Background: Incidence of asthma increases during early adulthood. We aimed to estimate the contributions of sex and early life factors to asthma diagnosed in young adults. Methods: 1246 healthy newborn babies were enrolled in the Tucson Children's Respiratory Study. Parental characteristics, early-life wheezing phenotypes, airway function, and bronchial hyper-responsiveness to cold dry air and sensitisation to Alternaria alternata were determined before age 6 years. Physician-diagnosed asthma, both chronic and newly diagnosed, and airway function were recorded at age 22 years. Findings: Of 1246 babies enrolled, 849 had follow-up data at 22 years. Average incidence of asthma at age 16-22 years was 12·6 per thousand person-years. 49 (27%) of all 181 cases of active asthma at 22 years were newly diagnosed, of which 35 (71%) were women. Asthma remittance by 22 years was higher in men than in women (multinomial odds ratio [M-OR] 2·0, 95% CI 1·2-3·2, p=0·008). Age at diagnosis was linearly associated with the ratio of forced expiratory volume at 1 s to forced vital capacity at age 22 years. Factors independently associated with chronic asthma at 22 years included onset at 6 years (7·4, 3·9-14·0) and persistent wheezing (14·0, 6·8-28·0) in early life, sensitisation to A alternata (3·6, 2·1-6·4), low airway function at age 6 years (2·1, 1·1-3·9), and bronchial hyper-responsiveness at 6 years (4·5, 1·9-10·0). Bronchial hyper-responsiveness (6·9, 2·3-21·0), low airway function at 6 years (2·8, 1·1-6·9), and late-onset (4·6, 1·7-12·0) and persistent wheezing (4·0, 1·2-14·0) predicted newly diagnosed asthma at age 22 years. Interpretation: Asthma with onset in early adulthood has its origins in early childhood. Funding: National Heart Lung and Blood Institute.

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