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Early respiratory infections and childhood asthma
P Nafstad1, P Magnus, J J Jaakkola
1Section of Epidemiology, Department of Population Health Sciences, National Institute of Public Health, Oslo, Norway. per.nafstad@folkehelsa.no
Insights
Early respiratory infections in infancy increase the risk of bronchial obstruction and asthma by age four. Having older siblings may reduce this risk, suggesting environmental factors play a role in childhood respiratory health.
Area of Science:
- Pediatric respiratory medicine
- Epidemiology of childhood diseases
- Immunology of early life infections
Background:
- Early life respiratory infections are common in infants.
- The long-term impact of these infections on respiratory health is a significant concern.
- Understanding risk factors for childhood asthma is crucial for prevention.
Purpose of the Study:
- To investigate the association between early respiratory infections and the development of bronchial obstruction in the first two years of life.
- To determine if early respiratory infections predict asthma development by age four.
- To explore the influence of factors like older siblings and daycare on infection risk and subsequent respiratory outcomes.
Main Methods:
- Longitudinal study of 2531 children from birth to four years in the Oslo Birth Cohort.
- Respiratory infection history collected at 6 and 12 months.
- Assessment of bronchial obstruction in the first two years and asthma diagnosis at age four.
Main Results:
- Infant respiratory infections were linked to a higher risk of bronchial obstruction and childhood asthma.
- Specific infections like lower respiratory tract infection, otitis media, croup, and common cold in early life were associated with increased asthma risk.
- The presence of older siblings was inversely related to asthma risk, even after accounting for infections.
Conclusions:
- Early respiratory infections are a significant risk factor for developing bronchial obstruction and asthma in early childhood.
- Findings highlight the importance of early respiratory health in predicting long-term respiratory outcomes.
- Environmental factors, such as sibling presence, may modulate the risk associated with early infections.
Objective:
To assess the role of early respiratory infections in the development of bronchial obstruction in the first 2 years of life, and asthma by the age of 4 years in the Oslo Birth Cohort, established in 1992-1993. Having older siblings and attendance to a day care center were also considered as proxy measures of early infections.
Methods:
A total of 2531 children were followed from birth to 4 years of age. Experiences of respiratory infections were recorded in the follow-up surveys at 6 and 12 months of age, and children with symptoms and signs of bronchial obstruction during the first 2 years of life were identified and examined. The presence of current asthma was recorded when the children were 4 years old.
Results:
Children with respiratory infections during infancy had a higher risk of having bronchial obstruction during the first 2 years of life and of having asthma at 4 years of age. In logistic regression adjusting for confounders including other infections, the risk of asthma at 4 years of age was related to lower respiratory tract infection (odds ratio [OR]: 3.4; 95% confidence interval [CI]: 2.3-7.0), otitis media (OR: 1.8; 95% CI: 1.2-2.6), croup (OR: 2.1; 95% CI: 1.2-3.7) in the first year and related to the common cold (OR: 2.0; 95% CI: 1.3-3.1) in the first 6 months of life. The risk of current asthma was inversely related to older siblings after controlling for early respiratory infections.
Conclusion:
Early respiratory infections indicate increased, rather than decreased, risk of developing bronchial obstruction during the first 2 years of life and of having asthma at 4 years of age.