Outcome in preschool age after hospitalization for wheeze in infancy

Background Risk factors for the progression from early infant wheeze to the development of later bronchial obstructive symptoms are not fully known. Aim To investigate if the development of bronchial obstructive symptoms during preschool years was influenced by time of the first hospitalization in infancy for acute respiratory distress with wheeze. Subjects 150 infants younger than 18 months were hospitalized for the first time at Boras hospital with the diagnoses acute bronchitis, bronchiolitis or asthma during one calendar year. For 110 infants it was the first episode ever. 144 children (85 males) were followed up (96%), ages: < 6 months, 67 infants, 6-<12 months, 57 infants, and 12-<18 months, 20 infants. Methods All hospital records were analysed. Structured telephone interviews were made with the families of the 144 children, at mean age 4.5 years (range 3.5 – 5.6 years). Data from medical records of all the children with reported remaining respiratory symptoms were analysed. Results 71 children (49%) still had current wheeze requiring medication periodically (60 children) or continuously (11 children). Episodic (viral) wheeze was reported in 46 and multiple-trigger wheeze in 25 individual with a similar distribution in the three age groups (21/67, 21/57, 4/20 and 11/67, 9/57, 5/20 respectively). Suspected or diagnosed allergy to inhaled allergens was reported in 15 of the 71 symptomatic children (21%) and in one child without wheeze. Conclusions Almost half of infants with hospitalization due to early wheeze had current wheezing symptoms, needing medication at mean age 4.5 years. In this heterogeneous group of children age at the first hospitalization did not seem to influence the outcome.