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Can childhood asthma be predicted at birth?

机译：出生时可以预测儿童哮喘吗？

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BACKGROUND: Early life appears optimal for prevention of asthma, but interventions require a relevant target population, to date not clearly identified at birth. OBJECTIVE: We therefore aimed to identify the predicting capacity of factors known around birth for asthma and rhinitis at 10 years. METHODS: The included 614 healthy term babies with lung function measured at birth in the 1992/1993 Environment and Childhood Asthma study in Oslo attended a 10-year follow-up visit including a structured interview and skin prick test (SPT) for allergies. The logistic regression analyses included 37 general variables from an extensive birth questionnaire; lung function; cord blood total immunoglobulin E and soluble CD14. A history of asthma, current asthma, history of rhinitis and 'healthy' (no history of asthma, rhinitis and negative SPT) was predicted on a group level and individual predicted probabilities were calculated. RESULTS: The predictability of the models [area under the curve (95% confidence intervals)] was 0.74 (0.69, 0.79), 0.72 (0.64, 0.78), 0.69 (0.54, 0.72) and 0.67 (0.62, 0.71) for a history of asthma, current asthma, rhinitis and 'healthy', respectively. The best model predicted a history of asthma correctly in 93/124 (75%), and incorrectly in 176/490 (36%) children without asthma. The positive predictive values for all outcomes were low (19-61), the highest predicting healthy. CONCLUSION: Although at best 75% of children with a history of asthma could be predicted at birth, an intervention applied to our predicted high-risk children would be started more often in children without than with future disease. Parental allergic disease alone appears insufficient to identify high-risk populations in future studies of asthma and allergic disease.
机译：背景：早期生命似乎是预防哮喘的最佳方法，但干预措施需要相关的目标人群，迄今为止尚未明确出生时确定的目标人群。目的：因此，我们旨在确定出生时已知的哮喘和鼻炎患者10岁左右因素的预测能力。方法：在1992/1993奥斯陆环境和儿童哮喘研究中，对包括614名健康的足月婴儿进行了出生时测量，他们进行了为期10年的随访，包括结构性访谈和皮肤点刺试验（SPT）。逻辑回归分析包括来自广泛的出生调查表的37个一般变量;肺功能脐带血总免疫球蛋白E和可溶性CD14。在组水平上预测哮喘病史，当前哮喘，鼻炎病史和“健康”史（无哮喘病史，鼻炎病史和SPT阴性），并计算出个体预测的概率。结果：模型的[历史曲线下的区域（95％置信区间）]的可预测性为0.74（0.69，0.79），0.72（0.64，0.78），0.69（0.54，0.72）和0.67（0.62，0.71）分别是哮喘，目前的哮喘，鼻炎和“健康”。最好的模型正确地预测了93/124（75％）的哮喘病史，而没有哮喘的176/490（36％）的儿童则正确地预测了哮喘病史。所有结果的阳性预测值均较低（19-61），是预测健康的最高值。结论：尽管最多可以预测出有哮喘病史的儿童中有75％出生时，但是对我们预测的高危儿童进行干预将比没有未来疾病的儿童更多地开始。仅父母过敏性疾病似乎不足以在哮喘和过敏性疾病的未来研究中确定高危人群。

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