100683 - Applicability Of The Asthma Predictive Index In The Evaluation Of Children Under 5 Years With Recurrent Wheezing

Bronchial asthma is the most common chronic disease in childhood, with a global prevalence of approximately 10–20% among pediatric populations. The onset of symptoms frequently occurs during the first years of life, with more than half of the cases manifesting before the age of five. However, establishing a diagnosis of asthma in preschool children remains challenging due to the high frequency of wheezing episodes associated with viral infections and the limited availability of objective lung function testing at this age.

A retrospective study was conducted in the Pediatric Allergology Department of the Institute of Mother and Child, Chisinau, between 2022 and 2025. The study included 150 children under the age of 5 years presenting with recurrent wheezing episodes. Clinical data, family history of allergic diseases, environmental risk factors, and immunological test results were analyzed. The applicability of the Asthma Predictive Index and the diagnostic approach recommended by the Global Initiative for Asthma were assessed.

A positive Asthma Predictive Index was identified in 67% of the evaluated children, indicating an increased probability of developing persistent bronchial asthma later in childhood, while 33% presented a negative index. Among the major criteria, atopic dermatitis was present in 31% of cases, family history of asthma or allergic diseases in 55%, and sensitization to aeroallergens in 41%. Regarding minor criteria, wheezing independent of viral infections was reported in 38% of children, peripheral eosinophilia above 4% in 29%, and sensitization to food allergens in 22%. Environmental risk factors included exposure to tobacco smoke in 48% of cases and recurrent respiratory infections in 64% of patients.

The Asthma Predictive Index represents a useful clinical tool for the early identification of preschool children at increased risk of developing bronchial asthma. Its application may support early risk stratification and improve clinical monitoring and management strategies in children with recurrent wheezing.