Evaluation of Risk Factors for the Development of Bronchial Asthma in Children under Three Years with Obstructive Bronchitis
Abstract
Acute bronchial obstruction represents one of the most frequent respiratory problems in children. In infants and toddlers wheezing mainly accompanies acute lower respiratory tract infection.
Not every early bronchial obstruction is however based on real bronchial asthma and true bronchial hyperresponsiveness with asthma develops only in a fraction of the children with early wheezing. As the introduction of early anti-asthma treatment in children with confirmed asthma is mandatory, there is a need of identifying the reliable predictive factors for development of obstructive bronchitis into asthma.
We followed 28 children at the age ranging from 3 to 36 months with acute obstructive bronchitis and after one year follow-up identified among them 14 children with asthma. In these children, the early obstructive episodes occurred less often during respiratory infection and the average time to resolution of obstruction was longer than in children without asthma.
The risk for the development of asthma was increased with the positivity of the skin-prick test with the house dust mite allergen (OR = 2.71, 95% CI 1.51 - 4.89). Passive smoking was more frequent in the group without confirmed asthma.
We were not able to confirm a significant predictive value of other anamnestic factors.