The natural history of asthma in childhood

Abstract

The incidence and prognosis of childhood asthma and wheezing illness (AW) was studied using data obtained at ages 7, 11, and 16 from a national cohort of 8806 children born in 1958. By the age of 16, 24.7% were reported to have experienced at least one episode of AW. In 18.3% AW had started before the age of 8, but only 4.2% continued to have symptoms in later childhood. A further 3.6% began to have AW between the ages of 8 and 11, and 2.8% began between the ages of 12 and 16. Of those with AW at age 7, 28.3% had symptoms at 11 and 16.5% at 16; these proportions were about doubled if AW at 7 had been severe. The associations between natural history and a large number of perinatal, social, environmental, and medical factors were examined. Those which predicted the onset of AW after the age of 7 were: male sex of child; mother aged 15-19 at child's birth; history of pneumonia, whooping cough, throat or ear infections or tonsillectomy; eczema, allergic rhinitis; and periodic vomiting or abdominal pain.