Factors in infancy and childhood related to reduced lung function in asthmatic children: a birth cohort study (BAMSE)

Area of Science:

• Pediatric Pulmonology
• Epidemiology
• Allergy and Immunology

Background:

• Childhood asthma can cause lung function changes that persist throughout life.
• Longitudinal studies are crucial for understanding asthma's long-term impact on respiratory health.
• The BAMSE birth cohort provides a valuable resource for investigating asthma development and its consequences.

Purpose of the Study:

• To assess the relationship between lung function and asthma over time in a large pediatric cohort.
• To identify specific patterns of lung function impairment associated with different asthma trajectories.
• To investigate the influence of early-onset vs. late-onset asthma on respiratory health at school age.

Main Methods:

• Longitudinal analysis of 4,089 children from the BAMSE birth cohort.
• Data collection via questionnaires at ages 1, 2, 4, and 8 years.
• Clinical examinations at ages 4 and 8, including spirometry, peak expiratory flow (PEF) measurements, and allergen sensitization testing.

Main Results:

• Asthma onset before age 4 was associated with impaired spirometric flows at age 8, regardless of later symptoms.
• Reduced PEF growth between ages 4 and 8 was observed in children with early-onset transient asthma.
• Allergen sensitization was linked to lung function deficits only in the late-onset asthma group.

Conclusions:

• Early-onset asthma, even if transient and symptom-free by school age, is associated with reduced spirometric flows.
• Different asthma trajectories (persistent vs. transient early-onset) have distinct impacts on lung function growth and development.
• Understanding asthma phenotypes is critical for predicting and managing long-term respiratory outcomes in children.