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Airway function at one year: association with premorbid airway function, wheezing, and maternal smoking
C Dezateux1, J Stocks, A M Wade
1Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK. c.dezateux@ich.ucl.ac.uk
Insights
Infant airway function at 1 year is linked to early respiratory issues and maternal smoking. Diminished airway function in early life and maternal smoking are key factors affecting infant lung health.
Area of Science:
- Pediatric pulmonology
- Respiratory system development
- Infant health
Background:
- Early life respiratory system development is crucial for long-term lung health.
- Factors like prenatal development and early illness can impact infant respiratory function.
- Understanding these early influences is key to preventing future respiratory conditions.
Purpose of the Study:
- To investigate the relationship between early airway function, wheezing history, and maternal smoking on infant airway function at one year of age.
- To identify key predictors of diminished airway function in infancy.
Main Methods:
- Respiratory function, specifically specific airway conductance during end expiration (sGawEE), was measured in 100 healthy term infants at one year.
- Pre-morbid measurements at 8 weeks and physician-diagnosed wheezing episodes were retrospectively analyzed.
- Maternal smoking history was also recorded.
Main Results:
- Infants with prior wheezing, maternal smoking, family history of asthma, or diminished premorbid sGawEE showed significantly reduced airway conductance at one year.
- Multivariate analysis revealed maternal smoking and diminished premorbid sGawEE as independent predictors of reduced airway function at one year.
Conclusions:
- Impaired airway development in early life and maternal smoking significantly impact infant airway function.
- Diminished premorbid airway function may link early wheezing illness to later reduced airway function.
- Maternal smoking is an avoidable cause of impaired infant airway development and function.
Background:
Impaired growth and development of the respiratory system during fetal and early postnatal life may have important implications for lung development and later lung health. The aim of this study was to examine the association of diminished premorbid airway function, prior wheezing, and maternal smoking with airway function at 1 year of age.
Methods:
Respiratory function was measured at the end of the first year in 100 of 108 healthy term infants (93%) in whom similar measurements had been undertaken prior to any respiratory illness at 8 weeks. Physician diagnosed wheezing episodes were identified retrospectively from medical records.
Results:
At 1 year specific airway conductance during end expiration (sGawEE; /s/kPa) was significantly diminished in those infants with prior wheezing (95% CI wheeze/no wheeze -0.76 to -0.14), mothers who smoked (95% CI smoke/no smoke -0.81 to -0.27), a family history of asthma (95% CI family history/no family history -0.62 to 0.00), or diminished premorbid sGawEE (95% CI -0.13 to -0.43/s/kPa per unit reduction sGawEE at 8 weeks). In a multivariate model only maternal smoking and diminished premorbid sGawEE were independently associated with diminished sGawEE at 1 year.
Conclusions:
Diminished airway function at the end of the first year appears to be mediated by impaired airway development during early life as well as by exposure to maternal smoking. These findings are consistent with the hypothesis that, at a population level, diminished premorbid airway function provides the link between wheezing lower respiratory illness and diminished airway function at 1 year. Maternal smoking remains an important and avoidable cause of impaired airway development and function in infancy.