EARLY-CHILDHOOD RESPIRATORY SYMPTOMS AND THE SUBSEQUENT DIAGNOSIS OF ASTHMA

Background: Respiratory symptoms are frequent in very young children, and the relation of these symptoms to later asthma in some of these ch ildren is unknown. Objective: The aim of the study was to describe the natural history of respiratory symptoms in a community-based sample o f young children who were prospectively observed for as long as 11 yea rs. Methods: Subjects were participants in the Tucson Epidemiologic St udy of Airways Obstructive Disease. They were under 5 years of age at enrollment and were studied by means of a parent-administered mail sur vey instrument every 1 to 2 years for 3 to 11 years. Results: Among su bjects younger than 1 year of age, no single respiratory symptom, such as cough or wheeze only with colds, significantly increased the risk of a subsequent diagnosis of asthma. Among 1- and 2-year-olds, however , those with wheeze only with colds and those with attacks of shortnes s of breath with wheeze were more likely to be diagnosed with asthma l ater when compared with children without those symptoms (odds ratio = 2.1; p < 0.05 for wheeze only with colds). At ages 3 to 4 years, sympt oms were even more strongly associated with subsequent asthma (odds ra tio = 7.2; p < 0.0001 for attacks of shortness of breath with wheeze). Conclusion: Although respiratory symptoms reported by parents very ea rly in life are not significantly associated with future asthma, those symptoms that begin at or persist through ages 3 to 4 years are.