Bronchial Asthma after Early Infant Bronchiolitis: A Follow-up Until 5 Years of Age

Song, Ae Ryung; Chung, Hai Lee

Abstract

PURPOSE
The most significant fact about wheezing in early infancy is that it is very common. Until recently, despite its high prevalence and hints of subsequent long- term morbidity, the natural history of early infancy wheezing has been incompletely understood. We evaluated the outcome of the patients who experienced wheezing during first year of life until 5 years of age and the prognostic factors for later development of asthma.
METHODS
72 infants less than 1 year old age who were hospitalized with wheezing-associated respiratory infection over a period of 12 months from 1994 to 1995 were included. After the first wheezing episode, the patients were followed-up prospectively until 5 years of age. The recurrent wheezing episodes were registered at 1-2, 2-4, and after 4 years of age. The frequency of wheezing episodes was assessed in relation to the later asthma at 5 years of age. Total serum IgE, the presence of atopic dermatitis, family history of allergic disease, RSV infection on first admission were investigated and compared between two groups of children who had asthma and who had no more asthma at 5 years of age. These early findings were also evaluated as risk factors for later development of asthma.
RESULTS
28(38%) of the 72 patients with bronchiolitis before 1 year old age suffered from subsequent wheezing until 5 years of age. The prevalence of atopic dermatitis(39% vs 14%, P<0.05), total serum IgE(98.5+/-3.7 IU/mL vs 13.6+/-3.5 IU/mL, P<0.001), frequency of repeated wheezing episodes(6.4+/-2.7 vs 3.4+/-2.9, P<0.001) were significantly higher in patients with later asthma than in patients with no more asthma at 5 years of age. RSV infection showed no association with the later development of asthma.
CONCLUSION
The risk for later asthma is increased after bronchiolitis in early infancy. Early atopic findings and frequently repeated wheezing episodes are significant risk factors for developing asthma in later childhood.