SpringerLink
Log in

Risk Factors in Preschool Children for Predicting Asthma During the Preschool Age and the Early School Age: a Systematic Review and Meta-Analysis

  • Pediatric Allergy and Immunology (W Dolen, Section Editor)
  • Published:
Current Allergy and Asthma Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The aim of this study was to identify risk factors of asthma among children < 6 years old (preschool age) for predicting asthma during the preschool age and early school age (≤ 10 years of age).

Method of the study

MEDLINE, Cochrane, EMBASE, and Google Scholar databases were searched until June 30, 2017. Prospective or retrospective cohort and case-control studies were included. Studies had to have evaluated risk factors or a predictive model for develo** asthma in children ≤ 6 years of age or persistent asthma in early school age.

Recent Findings

A total of 17 studies were included in the analysis. Factors associated with develo** asthma in children ≤ 10 years of age (both pre-school and early school age) included male gender (pooled OR = 1.70, P < 0.001), atopic dermatitis (pooled OR = 2.02, P < 0.001), a family history of asthma (pooled OR = 2.20, P < 0.001), and serum IgE levels ≥ 60 kU/l or having specific IgE (pooled OR = 2.36, P < 0.001). A history of exposure to smoke or wheezing was also associated with persistent asthma in early school age (pooled OR = 1.51, P = 0.030 and pooled OR = 2.59, P < 0.001, respectively). In general, asthma predictive models (e.g., API, PIAMA, PAPS) had relatively low sensitivity (range, 21% to 71.4%) but high specificity (range, 69% to 98%).

Summary

The study found that male gender, exposure to smoke, atopic dermatitis, family history of asthma, history of wheezing, and serum IgE level ≥ 60 kU/l or having specific IgE were significantly associated with develo** asthma by either preschool or early school age. Asthma predictive models can be developed by those risk factors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (United Kingdom)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.
Fig. 2.

Similar content being viewed by others

References

  1. Bacharier LB, Guilbert TW. Diagnosis and management of early asthma in preschool-aged children. J Allergy Clin Immunol. 2012;130:287–96. quiz 97-8

    Article  PubMed  Google Scholar 

  2. Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ. Asthma and wheezing in the first six years of life. The Group Health Medical Associates. N Engl J Med. 1995;332:133–8.

    Article  CAS  PubMed  Google Scholar 

  3. 2017 GINA Report, Global Strategy for Asthma Management and Prevention [cited 3. October 1]

  4. National Cooperative Group on Childhood Asthma; Institute of Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention; Chinese Center for Disease Control and Prevention. [Third nationwide survey of childhood asthma in urban areas of China]. Zhonghua Er Ke Za Zhi. 2013; 51, 729-35. (in Chinese)

  5. Subspecialty Group of Respiratory Diseases, Society of Pediatrics, Chinese Medical Association.; Editorial Board, Chinese Journal of Pediatrics. [Guideline for the diagnosis and optimal management of asthma in children(2016)]. Zhonghua Er Ke Za Zhi. 2016;54(3):167-81. (in Chinese)

  6. Bacharier LB, Boner A, Carlsen KH, Eigenmann PA, Frischer T, Gotz M, et al. Diagnosis and treatment of asthma in childhood: a PRACTALL consensus report. Allergy. 2008;63:5–34.

    Article  CAS  PubMed  Google Scholar 

  7. Ducharme FM, Dell SD, Radhakrishnan D, Grad RM, Watson WT, Yang CL, et al. Diagnosis and management of asthma in preschoolers: A Canadian Thoracic Society and Canadian Paediatric Society position paper. Paediatr Child Health. 2015;20:353–71.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Castro-Rodriguez JA, Holberg CJ, Wright AL, Martinez FD. A clinical index to define risk of asthma in young children with recurrent wheezing. Am J Respir Crit Care Med. 2000;162:1403–6.

    Article  CAS  PubMed  Google Scholar 

  9. Kurukulaaratchy RJ, Matthews S, Holgate ST, Arshad SH. Predicting persistent disease among children who wheeze during early life. Eur Respir J. 2003;22:767–71.

    Article  CAS  PubMed  Google Scholar 

  10. Devulapalli CS, Carlsen KC, Haland G, Munthe-Kaas MC, Pettersen M, Mowinckel P, et al. Severity of obstructive airways disease by age 2 years predicts asthma at 10 years of age. Thorax. 2008;63:8–13.

    Article  CAS  PubMed  Google Scholar 

  11. Caudri D, Wijga A, Schipper ACM, Hoekstra M, Postma DS, Koppelman GH, et al. Predicting the long-term prognosis of children with symptoms suggestive of asthma at preschool age. J Allergy Clin Immunol. 2009;124:903-10.e1–7.

    Article  Google Scholar 

  12. Vial Dupuy A, Amat F, Pereira B, Labbe A, Just J. A simple tool to identify infants at high risk of mild to severe childhood asthma: the persistent asthma predictive score. J Asthma. 2011;48:1015–21.

    Article  PubMed  Google Scholar 

  13. Savenije OE, Kerkhof M, Koppelman GH, Postma DS. Predicting who will have asthma at school age among preschool children. J Allergy Clin Immunol. 2012;130:325–31.

    Article  PubMed  Google Scholar 

  14. Takkouche B, Cadarso-Suarez C, Spiegelman D. Evaluation of old and new tests of heterogeneity in epidemiologic meta-analysis. Am J Epidemiol. 1999;150:206–15.

    Article  CAS  PubMed  Google Scholar 

  15. National Research Council. Combing Information: Statistical Issues and Opportunities for Research. Washington, DC: National Academy Press; 1992.

    Google Scholar 

  16. Sterne JA, Sutton AJ, Ioannidis JP, Terrin N, Jones DR, Lau J, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. Bmj. 2011;343:d4002.

    Article  PubMed  Google Scholar 

  17. Wen HJ, Chiang TL, Lin SJ, Guo YL. Predicting risk for childhood asthma by pre-pregnancy, perinatal, and postnatal factors. Pediatr Allergy Immunol. 2015;26:272–9.

    Article  PubMed  Google Scholar 

  18. Hafkamp-de Groen E, Lingsma HF, Caudri D, Levie D, Wijga A, Koppelman GH, Duijts L, Jaddoe VW, Smit HA, Kerkhof M, Moll HA, Hofman A, Steyerberg EW, de Jongste JC, Raat H. Predicting asthma in preschool children with asthma-like symptoms: validating and updating the PIAMA risk score. J Allergy Clin Immunol 2013; 132: 1303-1310.

  19. Rodriguez-Martinez CE, Sossa-Briceno MP, Castro-Rodriguez JA. Discriminative properties of two predictive indices for asthma diagnosis in a sample of preschoolers with recurrent wheezing. Pediatr Pulmonol. 2011;46:1175–81.

    Article  PubMed  Google Scholar 

  20. Holt PG, Rowe J, Kusel M, Parsons F, Hollams EM, Bosco A, McKenna K, Subrata L, de Klerk N, Serralha M, Holt BJ, Zhang G, Loh R, Ahlstedt S, Sly PD. Toward improved prediction of risk for atopy and asthma among preschoolers: a prospective cohort study. J Allergy Clin Immunol 2010; 125: 653-9, 9.e1-653-9, 9.e7.

  21. Schaubel D, Johansen H, Dutta M, Desmeules M, Becker A, Mao Y. Neonatal characteristics as risk factors for preschool asthma. J Asthma. 1996;33:255–64.

    Article  CAS  PubMed  Google Scholar 

  22. Yu P-T, Chan J, Poon F, Lee R, Leung S-Y, Ng J, et al. The predictive factors in preschool wheezers for subsequent asthma hospitalization after the age of 6 years. Pediatric Respirology and Critical Care Medicine. 2017;1:11–6.

    Google Scholar 

  23. van der Mark LB, van Wonderen KE, Mohrs J, van Aalderen WM, ter Riet G, Bindels PJ. Predicting asthma in preschool children at high risk presenting in primary care: development of a clinical asthma prediction score. Prim Care Respir J 2014; 23: 52-59.

  24. Pescatore AM, Dogaru CM, Duembgen L, Silverman M, Gaillard EA, Spycher BD, et al. A simple asthma prediction tool for preschool children with wheeze or cough. J Allergy Clin Immunol. 2014;133:111-8.e1–13.

    Article  Google Scholar 

  25. Grabenhenrich LB, Reich A, Fischer F, Zepp F, Forster J, Schuster A, et al. The novel 10-item asthma prediction tool: external validation in the German MAS birth cohort. PLoS One. 2014;9:e115852.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Leonardi NA, Spycher BD, Strippoli MP, Frey U, Silverman M, Kuehni CE. Validation of the Asthma Predictive Index and comparison with simpler clinical prediction rules. J Allergy Clin Immunol. 2011;127:1466-72.e6.

    Article  PubMed  Google Scholar 

  27. Arshad SH, Kurukulaaratchy RJ, Fenn M, Matthews S. Early life risk factors for current wheeze, asthma, and bronchial hyperresponsiveness at 10 years of age. Chest. 2005;127:502–8.

    Article  PubMed  Google Scholar 

  28. Amin P, Levin L, Epstein T, Ryan P, LeMasters G, Khurana Hershey G, et al. Optimum predictors of childhood asthma: persistent wheeze or the Asthma Predictive Index? J Allergy Clin Immunol Pract. 2014;2:709–15.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Kotaniemi-Syrjanen A, Reijonen TM, Korhonen K, Korppi M. Wheezing requiring hospitalization in early childhood: predictive factors for asthma in a six-year follow-up. Pediatr Allergy Immunol. 2002;13:418–25.

    Article  PubMed  Google Scholar 

  30. Chang TS, Lemanske RF Jr, Guilbert TW, Gern JE, Coen MH, Evans MD, et al. Evaluation of the modified asthma predictive index in high-risk preschool children. J Allergy Clin Immunol Pract. 2013;1:152–6.

    Article  PubMed  Google Scholar 

  31. Strina A, Barreto ML, Cooper PJ, Rodrigues LC. Risk factors for non-atopic asthma/wheeze in children and adolescents: a systematic review. Emerg Themes Epidemiol. 2014;11:5.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Rodriguez-Martinez CE, Sossa-Briceno MP, Castro-Rodriguez JA. Factors predicting persistence of early wheezing through childhood and adolescence: a systematic review of the literature. J Asthma Allergy. 2017;10:83–98.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Zhao K, Song GH, Gu HQ, Liu S, Zhang Y, Guo YR. Epidemiological survey and risk factor analysis of asthma in children in urban districts of Zhengzhou, China. Zhongguo Dang Dai Er Ke Za Zhi. 2014;16:1220–5. (in Chinese)

    PubMed  Google Scholar 

  34. Wenzel SE. Asthma phenotypes: the evolution from clinical to molecular approaches. Nat Med. 2012;18:716–25.

    Article  CAS  PubMed  Google Scholar 

  35. Meng J-F, Rosenwasser LJ. Unraveling the Genetic Basis of Asthma and Allergic Diseases. Allergy, Asthma & Immunology Research. 2010;2:215–27.

    Article  CAS  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Dr. Elizabeth Goodwin of MedCom Asia for providing the necessary writing assistance and editorial support during development of the manuscript funded by AstraZeneca China.

Author information

Authors and Affiliations

  1. National Children’s Medical Center, Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China

    Yixia Bao

  2. Department of Pediatrics, Shanghai EverBetter Pubin Children’s Hospital, Shanghai, 200120, China

    Yixia Bao

  3. Department of Respiratory Diseases, the Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China

    Zhimin Chen

  4. Department of Respiratory Diseases, Children’s Hospital of Chongqing Medical University, Chongqing, 400016, China

    Enmei Liu

  5. Department of Allergy, Bei**g Children’s Hospital, Capital Medical University, National Children’s Hospital Center, Bei**g, 100045, China

    Li **ang

  6. Department of Respiratory Diseases, Children’s Hospital of Nan**g Medical University, Nan**g, 210029, China

    Deyu Zhao

  7. Department of Pediatrics, Shanghai General Hospital, Shanghai Jiaotong University, No. 100, Haining Road, Hongkou District, Shanghai, 200080, China

    Jianguo Hong

Authors
  1. Yixia Bao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zhimin Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Enmei Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Li **ang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Deyu Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jianguo Hong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Yixia Bao or Jianguo Hong.

Ethics declarations

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Yixiao Bao and Zhimin Chen Co-first authors.

This article is part of the Topical Collection on Pediatric Allergy and Immunology

Electronic Supplementary Material

ESM 1

(DOCX 31.7 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bao, Y., Chen, Z., Liu, E. et al. Risk Factors in Preschool Children for Predicting Asthma During the Preschool Age and the Early School Age: a Systematic Review and Meta-Analysis. Curr Allergy Asthma Rep 17, 85 (2017). https://doi.org/10.1007/s11882-017-0753-7

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11882-017-0753-7

Keywords

Search

Navigation