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A longitudinal study of lung function from 1 month to 18 years of age
Steve Turner1, Shona Fielding2, Dave Mullane3
1Department of Child Health, University of Aberdeen, Aberdeen, UK.
Insights
Maternal asthma and infant atopy significantly impact lung function trajectory from infancy to 18 years. Early detection of low lung function at 1 month may predict later decrements, though some recovery is possible.
Area of Science:
- Pediatric respiratory health
- Longitudinal lung function studies
- Environmental and genetic influences on lung development
Background:
- Wheeze is a common childhood respiratory symptom.
- Understanding factors influencing lung function trajectory is crucial for respiratory health.
- Lung function changes significantly from infancy to adulthood.
Purpose of the Study:
- To investigate the association between wheeze-related factors and lung function trajectory from 1 month to 18 years.
- To identify early predictors of long-term lung function.
- To explore the influence of maternal asthma, infant atopy, and environmental factors on lung development.
Main Methods:
- Longitudinal study measuring lung function (V'maxFRC, FEF(25-75)) at multiple time points (1 month to 18 years).
- Utilized random coefficient models to analyze changes in lung function relative to various factors.
- Included analysis of sex, maternal asthma, infant atopy, flow limitation, and maternal smoking.
Main Results:
- Maternal asthma, infant atopy, flow limitation, and maternal smoking were independently associated with reduced lung function.
- Maternal asthma and infant atopy effects on lung function were consistent over time.
- Lung function increased more in boys than girls, and in flow-limited individuals and those exposed to maternal smoking over time.
Conclusions:
- Maternal asthma and early atopy by 1 month may determine 18-year-old lung function decrements.
- Early identification of low lung function is critical.
- Some individuals with initially low lung function may experience recovery over time.
Background:
Our hypothesis was that factors associated with wheeze will be associated with changes in lung function trajectory between 1 month and 18 years of age.
Methods:
Measurements of lung function were made in individuals aged 1, 6 and 12 months (V'maxFRC), and also at ages 6, 12 and 18 years (FEF(25-75)). Changes in lung function over time relative to sex, a history of asthma, maternal asthma and other factors were explored using random coefficient models.
Results:
Lung function (maximal flow at functional residual capacity in infants and FEF(25-75) in children) was determined in 241 individuals at 1 month, 192 at 6 months, 164 at 12 months, 106 at 6 years, 183 at 12 years and 141 at 18 years. In the multivariable model, maternal asthma (mean reduction in lung function 9.8%), flow limitation (mean reduction 17.4%), infant atopy (mean reduction 12.6%) and maternal smoking (mean reduction in lung function 8.1%) were acting independently. When interactions with time were sought, the reduction in lung function associated with maternal asthma and infant atopy were consistent over time, but % lung function increased in boys by a mean of 1%/year compared with girls, in flow-limited individuals by 3.0%/year and by 0.9%/year for those exposed to maternal smoking during pregnancy compared to other cohort members.
Conclusions:
Decrements in lung function in 18-year-olds associated with maternal asthma and early onset atopy may be determined by 1 month of age. Low initial lung function in some individuals can 'recover' in some settings.
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