High risk of adult asthma following severe wheezing in early life.

Severe wheezing in early life is associated with an increased risk of asthma during childhood and adolescence. The aim of the present follow-up was to investigate the asthma prevalence and risk factors for asthma in adulthood. We have prospectively studied asthma development in 101 children hospitalized due to severe wheezing before the age of 24 months. The cohort was re-investigated at a mean age of 27 years and tested for bronchial hyper-responsiveness and allergic sensitization. The response rate in adulthood was 81% (82/101). The results were compared with a population-based, age-matched control group (n = 1,210) recruited from the West Sweden Asthma Study. Current doctor-diagnosed asthma was found in 37% (30/82) compared with 7% (82/1,210) in the control group. The risk of adult asthma in the cohort compared with the control group was increased 10-fold (adjusted OR 10.0, 95% CI 5.3-18.7), independently of allergic rhinitis, gender, smoking and heredity. Within the cohort, current allergy (aOR 9.6, 95% CI 3.0-31.2) and female gender (aOR 3.2, 95% CI 1.1-9.3) independently increased the risk of adult asthma. Females with current allergy had the highest risk of adult asthma (OR 29.4, 95% CI 5.0-173.3), compared with males without allergy. When separately adjusting for factors present at admission in early life within the cohort, a family history of asthma was a significant risk factor for asthma in adulthood (aOR 4.0, 95% CI 1.3-12.5). Subjects with severe early wheezing have a 10-fold increase in the risk of adult asthma compared to an age-matched control group, adjusted for allergic rhinitis, gender, smoking and heredity.