What is the prognosis of pediatric asthma?

Updated: Jan 08, 2019
  • Author: Girish D Sharma, MD, FCCP, FAAP; Chief Editor: Kenan Haver, MD  more...
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Answer

Of infants who wheeze with URTIs, 60% are asymptomatic by age 6 years. However, children who have asthma (recurrent symptoms continuing at age 6 y) have airway reactivity later in childhood. Some findings suggest a poor prognosis if asthma develops in children younger than 3 years, unless it occurs solely in association with viral infections.

Individuals who have asthma during childhood have significantly lower forced expiratory volume in 1 second (FEV1), higher airway reactivity, and more persistent bronchospastic symptoms than those with infection-associated wheezing.

Children with mild asthma who are asymptomatic between attacks are likely to improve and be symptom-free later in life.

Children with asthma appear to have less severe symptoms as they enter adolescence, but half of these children continue to have asthma. Asthma has a tendency to remit during puberty, with a somewhat earlier remission in girls. However, compared with men, women have more BHR.

In a prospective study of 484 Australian children, Tai and colleagues found that having severe asthma in childhood was associated with an almost 12-fold increased risk of having asthma at age 50. [39, 40] At age 50, remission of asthma had occurred in 64% of subjects with mild wheezy bronchitis/wheezy bronchitis at baseline, compared with 47% of those with asthma at baseline and 15% of those with severe asthma. In a multivariate analysis, factors that significantly predicted asthma at age 50 were severe childhood asthma (odds ratio [OR] 11.9), childhood hay fever (OR 2.0, and female sex (OR 2.0). [39, 40]


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