Predicting the course of asthma in children

Factors useful in predicting the likely course of childhood asthma have been documented from a 14-year prospective study of a randomly selected group of children with onset of wheezing before 7 years of age. The children were selected from the community in a manner to ensure that they were representative of the whole spectrum of wheezing in childhood. Features associated with significant asthma in early adult life included multiple periods of prolonged wheezing in the first 2 years of life; onset of eczema by 2 years; very frequent wheezing and the presence of eczema, barrel chest deformity, reduced FEV1, and a number of strongly positive skin tests to common environmental allergens at 10 and 14 years. Age of onset of wheezing had no prognostic significance. Adequacy of long term treatment did not seem to have any effect on the course of asthma.