Outcome of Asthma and Wheezing in the First 6 Years of Life
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RATIONALE: The effect of early life wheezing on respiratory function and continued symptoms through adolescence has not been fully described. Using data from a population-based birth cohort in Tucson, Arizona, we previously described four phenotypes based on the occurrence of wheezing lower respiratory illnesses before age 3 yr and active wheeze at age 6 yr: never wheezers (n = 425), transient early wheezers (n = 164), persistent wheezers (n = 113), and late-onset wheezers (n = 124). OBJECTIVE: We sought to determine the prognosis for these phenotypes, with reference to lung function and symptoms, through adolescence. METHODS: Current wheeze was assessed by questionnaire, lung function was measured by conventional spirometry, and atopy was determined by skin prick tests. RESULTS: The prevalence of atopy and wheeze by age 16 yr was similar for never and transient wheezers and for persistent and late-onset wheezers. Both transient early, and persistent wheezers had significantly lower FEF(25-75) (-259 ml/s, p < 0.001, and -260 ml/s, p = 0.001, respectively), FEV1 (-75 ml, p = 0.02, and -87 ml, p = 0.03, respectively), and FEV1:FVC ratio (-1.9%, p = 0.002, and -2.5%, p = 0.001, respectively) through age 16 yr compared with never wheezers. Late-onset wheezers had levels of lung function similar to those of never wheezers through age 16 yr. There was no significant change in lung function among subjects with any of the four phenotypes, relative to their peers, from age 6 to 16 yr. CONCLUSION: Patterns of wheezing prevalence and levels of lung function are established by age 6 yr and do not appear to change significantly by age 16 yr in children who start having asthma-like symptoms during the preschool years.
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Some studies suggest the effects of persistent wheeze and relapsed wheeze on lung function are established from mid-childhood, without further decline in tracking of FEV1 over time.
“The majority of studies have shown that persistent wheeze is related to reduced lung function development throughout adolescence (31, 45, 152, 153), while some suggest the effects of persistent wheeze and relapsed wheeze on lung function are established from mid-childhood, without further decline in tracking of FEV1 over time (154, 155).”
From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [155]
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- Authors
- Morgan, W. J., Stern, D. A., Sherrill, D. L., Guerra, S., Holberg, C. J., Guilbert, T. W., Taussig, L. M., Wright, A. L., & Martinez, F. D.
- Affiliations
- University of Arizona (US)
- Arizona Respiratory Center and Department of Pediatrics, University of Arizona Health Sciences Center, Tucson, Arizona; and National Jewish Medical and Research Center and University of Colorado Health Sciences Center, Denver, Colorado
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-11
- Volume
- 172
- Issue
- 10
- Pages
- 1253-1258
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- PMC
- PMC2718414
- OpenAlex
- W1979846404
- Cited by
- 650
- References
- 23
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 17 · 2023: 15 · 2022: 15 · 2021: 24 · 2020: 17 · 2019: 24 · 2018: 36 · 2017: 24 · 2016: 27 · 2015: 42 · 2014: 31 · 2013: 27 · 2012: 40
- FWCI
- 29.77
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Respiratory and Critical Care Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- National Institutes of Health (5k14hl003154-02, 5p50hl014136-25, 14136)
- National Heart, Lung, and Blood Institute (HL-14136, HL 03154, R01HL056177, HL-56177)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Keywords
- wheezing phenotypes, persistent wheezing, lung function, respiratory function, atopy, asthma, adolescence, preschool wheeze, FEV1/FVC ratio
- MeSH terms
- Adolescent, Age Factors, Asthma, Child, Child, Preschool, Forced Expiratory Flow Rates, Humans, Immunoglobulin E, Phenotype, Prognosis, Respiratory Sounds
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