Reduced neonatal lung function and wheezing illnesses during the first 5 years of life

Gugten, Anne C. van der; Uiterwaal, Cuno S.P.M.; Putte‐Katier, Nienke van; Koopman, Marije; Verheij, Theo; Ent, Cornelis K. van der

doi:10.1183/09031936.00214711

Cited by 23 publications

(14 citation statements)

References 28 publications

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“…Lung development and maturation is incomplete at birth and continues during the first years of life making lungs particularly vulnerable to damage during this critical time of lung development. Low lung function in early life has been shown to track through childhood and into adulthood (3,4); furthermore, children born with low lung function have an increased risk of LRTI or wheezing illnesses in childhood (5)(6)(7)(8)(9)(10). LRTI in infancy has been associated with reduced lung function in later childhood and adulthood (11)(12)(13)(14).…”

Section: Measurements and Mainmentioning

confidence: 99%

Lung Function in African Infants in the Drakenstein Child Health Study. Impact of Lower Respiratory Tract Illness

Gray

Turkovic

Willemse

et al. 2017

Am J Respir Crit Care Med

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Rationale: Lower respiratory tract illness is a major cause of childhood morbidity and mortality. It is unknown whether infants are predisposed to illness because of impaired lung function or whether respiratory illness reduces lung function.Objectives: To investigate the impact of early life exposures, including lower respiratory tract illness, on lung function during infancy.Methods: Infants enrolled in the Drakenstein child health study had lung function at 6 weeks and 1 year. Testing during quiet natural sleep included tidal breathing, exhaled nitric oxide, and multiple breath washout measures. Risk factors for impaired lung health were collected longitudinally. Lower respiratory tract illness surveillance was performed and any episode investigated. Measurements and MainResults: Lung function was tested in 648 children at 1 year. One hundred and fifty (29%) infants had a lower respiratory tract illness during the first year of life.Lower respiratory tract illness was independently associated with increased respiratory rate (4%; 95% confidence interval [CI], 1.01-1.08; P = 0.02). Repeat episodes further increased respiratory rate (3%; 95% CI, 1.01-1.05; P = 0.004), decreased tidal volume (21.7 ml; 95% CI, 23.3 to 20.2; P = 0.03), and increased the lung clearance index (0.13 turnovers; 95% CI, 0.04-0.22; P = 0.006) compared with infants without illness. Tobacco smoke exposure, lung function at 6 weeks, infant growth, and prematurity were other independent predictors of lung function at 1 year.Conclusions: Early life lower respiratory tract illness impairs lung function at 1 year, independent of baseline lung function. Preventing early life lower respiratory tract illness is important to optimize lung function and promote respiratory health in childhood.

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Section: Measurements and Mainmentioning

confidence: 99%

Lung Function in African Infants in the Drakenstein Child Health Study. Impact of Lower Respiratory Tract Illness

Gray

Turkovic

Willemse

et al. 2017

Am J Respir Crit Care Med

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“…Children of mothers with increased fat mass are probably exposed to higher circulating levels of leptin, which may have consequences for development of the respiratory system. Children with an impaired lung function in early life are more likely to develop wheezing illnesses [11].…”

Section: Introductionmentioning

confidence: 99%

Maternal body mass index, neonatal lung function and respiratory symptoms in childhood

2015

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Recent studies have shown that maternal obesity is associated with increased risk of wheezing in the offspring. We assessed whether impaired neonatal lung function could explain this association.We measured neonatal lung function in 2606 children of our prospective birth cohort. Information about daily symptoms of wheezing was obtained using questionnaires. Consultations and prescriptions for wheezing illnesses were derived from general practitioner patient files.Higher maternal body mass index (BMI) was associated with increased risk of wheezing in the first year of life and more consultations and prescriptions for wheezing illnesses until the age of 5 years. Lung function could partially explain the association with wheezing in the first year of life. Adding respiratory resistance to the model decreased the incidence rate ratio from 1.023 (95% CI 1.008-1.039) to 1.015 (95% CI 0.998-1.032). Anthropometrics of the 5-year-olds largely explained the association with consultations. Intermediates or confounders could not explain the association with prescriptions.There is an association between higher maternal BMI and increased risk of wheezing illnesses. In the first year of life, it is largely explained by an impaired lung function in early life, especially in children of nonatopic mothers. At the age of 5 years, infant lung function is of minor influence in this association. @ERSpublications Higher maternal BMI is associated with higher risk of wheezing illnesses partly due to impaired neonatal lung function

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“…In recent years, significant evidence from birth cohort studies has been indicating that reduced neonatal lung function and increased airway responsiveness are associated with respiratory symptoms and asthma later in life. [910111213] However, due to the difficulty in performing a routine lung function test, relatively little is known about the lung function in infants with wheezing after respiratory infection. In addition, the natural history of wheezing after respiratory infection has not been studied extensively, and the relationship between wheezing, pulmonary outcomes, and atopy is poorly understood.…”

Section: Introductionmentioning

confidence: 99%

Lung Function in Wheezing Infants after Acute Lower Respiratory Tract Infection and Its Association with Respiratory Outcome

Jiang

Wang

et al. 2017

Chinese Medical Journal

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Background:Wheezing is common in early childhood and remains an important health concern. The aim of this study was to assess the lung function of wheezing infants and to investigate the relationship between lung function and respiratory outcome.Methods:Infants <2 years of age with acute lower respiratory tract infection (ALRTI) who had undergone lung function tests were included in the study. They were assigned to wheeze or no wheeze group based on physical examination. Infants without any respiratory diseases were enrolled as controls. Lung function was measured during the acute phase and 3 months after ALRTI. One-year follow-up for infants with ALRTI was achieved.Results:A total of 252 infants with ALRTI who had acceptable data regarding tidal breathing were included in the final analysis. Compared with the control and the no wheeze groups, infants in the wheeze group had significantly decreased time to peak tidal expiratory flow as a percentage of total expiratory time (TPTEF/TE) (20.1 ± 6.4% vs. 34.4 ± 6.2% and 26.4 ± 8.3%, respectively, P < 0.0001) and significantly increased peak tidal expiratory flow (PTEF) (90.7 ± 26.3 ml/s vs. 79.3 ± 18.4 ml/s and 86.1 ± 28.0 ml/s, respectively, P < 0.01), sReff and Reff. The infants in the wheeze group still had lower TPTEF/TE and volume to peak tidal expiratory flow as a percentage of total expiratory volume (VPTEF/VE) than the no wheeze infants 3 months after the ALRTI. Moreover, there was a significant inverse relationship between TPTEF/TE, VPTEF/VE, and the recurrence of wheezing and pneumonia.Conclusions:Impaired lung function was present in wheezing infants with ALRTI and the deficits persisted. In addition, the lower level of TPTEF/TE and VPTEF/VE was a risk factor for poor respiratory outcome.

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Reduced neonatal lung function and wheezing illnesses during the first 5 years of life

Cited by 23 publications

References 28 publications

Lung Function in African Infants in the Drakenstein Child Health Study. Impact of Lower Respiratory Tract Illness

Lung Function in African Infants in the Drakenstein Child Health Study. Impact of Lower Respiratory Tract Illness

Maternal body mass index, neonatal lung function and respiratory symptoms in childhood

Lung Function in Wheezing Infants after Acute Lower Respiratory Tract Infection and Its Association with Respiratory Outcome

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