Wheezing in childhood: Incidence, longitudinal patterns and factors predicting persistence

¹ Dept of paediatric Pneumology and Immunology
² University Children's Hospital, Munich, Germany
³ Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Centre, Berlin

^* To whom correspondence should be addressed. E-mail: paolo.matricardi{at}charite.de.

	Abstract

Childhood asthma is frequently perceived as a disease with uniform clinical pathways. This perception might be an oversimplification.

To investigate the incidence and natural course of wheeze over the first 13 years of life and analyse the risk factors predicting wheeze at 11 to 13 years of age.

The Multi-centre Allergy Study (MAS), a German birth cohort, recruited 1314 children in 1990. Physical examinations, interviews on atopic diseases, IgE and lung function tests were performed up to 13 years of age.

Complete data on the course of wheeze was available for 441 children. Incidence of wheezing declined with age. The first wheezing episode was reported by 29%, 9% and 9% of participants at 3 (early wheezers), 3–6 (late wheezers), and >6 (very late wheezers) years of age, respectively. Wheezing at the age of 13 was associated with parental atopy, and with IgE sensitisation to common allergens, elevated total IgE and exposure to high levels of indoor allergens in early life. All these associations were remarkably stronger among early wheezers than among early non-wheezers.

The relevance of an early expression of atopy as a predictor of wheezing at age 13 years declines with increasing age at wheezing onset.