[Truncated abstract] Asthma is a chronic and complex disorder and despite our increase in the understanding of the genetics, pathology and mechanisms underlying asthma a gold standard definition of asthma does not exist. A criterion for recognising and diagnosing asthma in epidemiological studies is crucial in order to determine risk factors for disease. Prospective longitudinal birth cohort studies have increased our understanding of the natural history and risk factors for asthma, yet we are still not able to accurately predict which children will go on to have asthma as adults. It is during the transition from childhood to adolescence where factors underlying asthma change and the prevalence of asthma shifts between the sexes. There are inconsistencies regarding risk factors for the development and persistence of disease during this transitional period. Risk factors predicting the development and persistence of asthma and intermediate phenotypes (BHR, airway inflammation and atopy) may be influenced by gender and risk factors predicting disease may differ between childhood and adolescence. Aims 1. To identify risk factors for Asthma, BHR and Atopy at 14yrs of age. 2. To determine risk factors for persistence of asthma between 6 and 14 years. 3. To examine the influence of gender on risk factors during adolescence. Method The West Australian Pregnancy Cohort is a longitudinal birth cohort. The cohort initially consisted of 2868 live births with follow-ups at 1, 2, 3, 6, 8, 10 and 14 years of V age. ... Strong associations were seen with BHR and new diagnosis of wheeze and asthma in VI teenagers. Interestingly having either a cat or dog inside was protective for persistence of disease; in particular stronger associations were seen in teenage girls not in boys. During this transitional period the risk factors for asthma and intermediate phenotypes differ between the sexes. Different mechanisms are likely to be involved in determining asthma in boys and girls during adolescence and shed new light on the recognised switch in the gender balance in asthma prevalence from the male predominance in childhood to the female predominance in adult life. Our understanding of the natural course of disease from the prenatal period to adulthood and the identification of the various asthma phenotypes has the potential to change prognosis and planning of therapeutic strategies. Identifying those at high risk for persistence of disease in the early stages of life will allow therapeutic interventions to be more appropriately targeted.
|Qualification||Doctor of Philosophy|
|Publication status||Unpublished - 2007|