Long-term follow up of infants at high risk of asthma from a deprived community in South Wales
Asthma is a chronic respiratory disease with a prevalence that has increased worldwide over the past 40 years. Longitudinal cohort studies have been designed to determine associations between early life events and asthma prevalence. One such cohort is the Merthyr Allergy Prevention Study (MAPS). MAPS recruited high risk subjects, before birth, from a deprived population in South Wales. The original study was a randomised controlled trial (RCT) of either normal diet for the first four months of life, or a cows’ milk protein exclusion diet with soya formula milk supplementation if subjects were not breast fed. Subjects were subsequently followed up as part of a cohort study. The findings presented are based on the final follow up at age 23 years.\ud While there was a significant protective effect of breast feeding on wheeze at age 1, there was no evidence of an association with wheeze at age 23 years. The intervention arm of the RCT was associated with an increased risk of asthma and sensitisation at age 23 years.\ud There was tracking of both total serum IgE and positive skin prick test results over the years but there was no clear relationship between these two measures of allergy. Although the prevalence of atopy was low in childhood, there was still a clear association with this and wheeze later in life. Wheeze at age 3 years or older was an important determinant of asthma at age 23 years. There was a significant association between those who wheeze from age of 3 to age 23 years and atopic status at age 7 years.\ud In conclusion we have investigated a birth cohort from a relatively deprived area of South Wales and found characteristics in the first 7 years of life are critical in determining if asthma develops in early adulthood.
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