Predictors of persistent asthma among preschooler wheezers: a retrospective case series study

Abstract

Early childhood wheezing can evolve to different asthma phenotypes. Prediction of persistent asthma during the preschool years has proven challenging. Through this study, we aimed to identify predictors of persistent asthma in preschooler wheezers. This was a retrospective case series study over 10 years. Patient data from 98 infants diagnosed with infantile asthma were obtained from their medical records. A multivariate logistic regression model was developed to determine predictors of persistent asthma in preschooler wheezers. The sex ratio was 1.72. The mean age at the first episode of wheezing was 7 ± 3.17 months. The mean age at diagnosis was 14.82 ± 4.28. Asthma was well controlled in 71 cases (72.44%) and partly controlled in 27 cases (27.56%). Two groups were identified: transient wheezers (61.33%) and persistent wheezers beyond the age of 5 years old (38.77%). The average age for wheezing disappearance was 24.28 ± 4.1 months. Four predictive factors for persistent asthma were identified: familial atopy (adjusted odds ratio [OR] 4.76; 95% confidence interval [CI] 2.52–12.45; p < 0.001), passive smoking (adjusted OR 5.98; 95% CI 2.48–13.64; p < 0.001), poor control of asthma (adjusted OR 5.23; 95% CI 2.47–14.76; p 0.0013), and aerosensitization (adjusted OR 7.38; 95%CI 3.87–17.84; p < 0.001). The main predictors for persistent asthma among preschooler wheezers were aerosensitization, family history of atopy, early exposure to passive smoking, and poor control of asthma. The detection of such factors allows for earlier diagnosis and targeted prevention strategies.