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Lung function in school-age children who had mild lower respiratory illnesses in early childhood
G L Strope1, P W Stewart, F W Henderson
1Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill 27599-7220.
Insights
Recurrent early childhood wheezing illnesses, particularly in boys, are linked to reduced lung function later in life. Non-wheezing respiratory infections showed no significant impact on lung health.
Area of Science:
- Pediatric Pulmonology
- Respiratory Epidemiology
- Childhood Respiratory Health
Background:
- Early childhood lower respiratory illness (LRI) may impact long-term lung function.
- Understanding preschool respiratory infection patterns is crucial for assessing later lung health.
Purpose of the Study:
- To investigate the association between early childhood lower respiratory illness (LRI) patterns and lung function in children aged 6-18 years.
- To determine if wheezing LRI in preschool years affects subsequent lung function differently by sex.
Main Methods:
- Retrospective analysis of physician-documented LRI histories in 159 children (89 boys, 70 girls) up to age 6.
- Spirometry was used to assess lung function (FEV1, FVC, FEF25-75, Vmax50, Vmax75) between ages 6 and 18.
- Sex-specific analyses were conducted to evaluate the impact of wheezing and non-wheezing LRI.
Main Results:
- Boys with two or more preschool wheezing LRI episodes showed significantly lower average lung function measures (FEV1, FEV1/FVC, FEF25-75, Vmax50, Vmax75) compared to those with fewer episodes.
- Girls with multiple preschool wheezing LRI episodes had lower average FEF25-75 and Vmax50, though not statistically significant.
- Recurrent non-wheezing LRI in early childhood was not significantly associated with later lung function in either sex.
Conclusions:
- Recurrent preschool wheezing illnesses are associated with diminished lung function in later childhood, particularly in boys.
- Detailed early childhood respiratory illness history is valuable for epidemiological studies on lung function determinants.
- Targeted interventions for recurrent preschool wheezing may be important for preserving long-term lung health.
Abstract:
We examined the relationship between patterns of mild lower respiratory illness (LRI) experienced in early childhood and lung function in 89 boys and 70 girls 6 to 18 yr of age. The children's histories of outpatient visits for wheezing and nonwheezing LRI during the first 6 yr of life had been documented by physicians in a single pediatric practice. Most children were reported by their parents to have been free of recurrent respiratory symptoms during the 2 yr prior to lung function testing. In sex-specific analyses, average lung function assessed by spirometry was similar in children who had made zero or one physician visit for wheezing LRI during the preschool years. Boys who had experienced two or more episodes of wheezing LRI during the preschool years had lower average FEV1, FEV1/FVC, FEF25-75, Vmax50, and Vmax75 than did boys who had zero or one preschool wheezing illness. The association between recurrent preschool wheezing LRI and later lung function remained after exclusion of data from seven boys who were reported to have wheezed in the 2 yr prior to study. Girls who had experienced two or more preschool wheezing LRI had lower average FEF25-75 and Vmax50 than girls with a history of zero or one such illness, but differences were not statistically significant. Recurrent nonwheezing LRI during the preschool years was not significantly associated with subsequent lung function in either sex, regardless of preschool wheezing LRI history. Detailed information concerning early childhood LRI experience is valuable in epidemiologic studies of factors influencing lung function in children.