Persistent Wheeze

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Abstract
In a study of early-life risk factors for the development of adult obstructive airway disease, respiratory symptoms, disease and smoking histories, and spirometry were obtained for 650 children 5-9 yr of age and their families in East Boston, Massachusetts [USA]. Persistent wheezing was the most frequently reported chronic symptom, occurring in 9.2% (60/650) of the population. Children with persistent wheezing were more likely to report cough and phlegm (P < 0.001), a history of asthma (P < 0.001), hay fever (P < 0.02) or past hospitalization with a respiratory illness (P < 0.001) than their asymptomatic peers. Prospective evaluation of a subsample of the 650 children confirmed a greater occurrence of acute lower respiratory illness in those children with persistent wheeze. Parental cigarette smoking was linearly related to the occurrence of persistent wheeze (P = 0.012) and lower degrees of mean normalized forced expiratory flow during the middle half of the forced vital capacity (FEF-Z score). A multiple linear regression identified the mother''s current smoking status and current persistent wheeze as significant predictors of the children''s mean FEF-Z score. Other variables, such as the father''s smoking, children''s personal smoking, a doctor''s diagnosis of asthma and a past history of lower respiratory illness were not significant predictors of the FEF-Z score.