Predictors of bronchial asthma development in preschool children with recurrent broncho-obstructive syndrome

Abstract

Objective. To study predictors of bronchial asthma development in children of 3-4 years old with recurrent broncho-obstructive syndrome by 5-6 years of age.Material and methods. The authors conducted a prospective cohort study in 2018-2020 with the participation of 61 children aged 3–4 years with recurrent broncho-obstructive syndrome. Inclusion criteria: age 3–4 years; ≥ 3 episodes of broncho-obstructive syndrome in the past 12 months; informed voluntary consent. At the first visit the scientists determined the levels of serum periostin, specific inhalation allergens IgE, total IgE and the number of eosinophils in the blood. In 24 months, at the second visit, bronchial asthma was diagnosed based on the GINA criteria (updated 2019). Binary logistic regression analysis was used to study the predictors of bronchial asthma development.Results. In 24 months from the beginning of the study, bronchial asthma was diagnosed in 29 (47%) children with recurrent broncho-obstructive syndrome. The level of serum periostin and total IgE had no effect on the risk of developing bronchial asthma (p=0,194; p=0,269). According to binary logistic regression, the predictors of bronchial asthma development are burdened family allergic history (odds ratio – OR 3,81; 95% confidence interval – CI 1,14-12,74; p=0,015), allergic rhinitis (OR 4,94; 95% CI 1,37–7,80; p=0,0001), sensitization to the Dermatophagoides pteronyssinus (OR 1,80; 95% CI 1,36–1,13; p=0,045) and eosinophilia (OR 2,10 ; 95% CI 1,23-4,83; p=0,055).Conclusion. A burdened family allergic history, the presence of allergic rhinitis, sensitization to the Dermatophagoides pteronyssinus, eosinophilia are the predictors of bronchial asthma development in children with recurrent broncho-obstructive syndrome by 5-6 years of age.