RISK-FACTORS FOR THE PERSISTENCE OF RESPIRATORY SYMPTOMS IN CHILDHOODASTHMA

We studied the prognosis of childhood asthma in a cohort of 406 childr en 8 to 12 yr of age when enrolled. Subjects were followed for a mean of 14.8 yr after their initial evaluation, with a follow up rate of 86 %. The mean age at follow-up was 24.7 yr. We assessed the predictive v alue of sex and various childhood variables on the outcome of symptoms and medication use in adulthood. Although only 19% of subjects were s till under a physician's supervision at the time of follow-up, 76% had respiratory symptoms, 32% used maintenance medication, and 22% used m edication intermittently. The incidence of cigarette smoking was distu rbingly high (33%). In adulthood, women were more likely than men to h ave symptoms (85 versus 72%, respectively). The childhood symptom seve rity and the childhood degree of bronchial responsiveness in combinati on with a low %FEV(1) were also related to the outcome of asthma in ad ulthood. The high prevalence of symptoms in adults at follow-up couple d with the low rate of physician supervision and medication usage sugg est that more aggressive treatment may be indicated in asthmatic child ren.