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Longitudinal Associations Between Respiratory Infections and Asthma in Young Children

Alban Ramette1, Ben D Spycher1, Jingying Wang1

  • 1Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.

American Journal of Epidemiology
|March 17, 2018
PubMed

Insights

Childhood asthma at age 6 is linked to earlier asthma, not preschool respiratory infections (RTIs). Early infections do not appear to protect against developing asthma later in childhood.

Area of Science:

  • Pediatric Respiratory Medicine
  • Epidemiology
  • Childhood Asthma Research

Background:

  • Understanding the relationship between early-life respiratory infections and the development of childhood asthma is crucial for public health.
  • Previous research has yielded conflicting results regarding a potential protective effect of infections against asthma.
  • Longitudinal studies are needed to clarify the temporal associations between respiratory tract infections (RTIs) and asthma development in children.

Purpose of the Study:

  • To investigate the temporal dependencies between repeated assessments of respiratory tract infections (RTIs) and asthma in a pediatric cohort.
  • To determine the associations between contemporaneous and lagged measures of asthma and RTIs from infancy through early school age.
  • To examine whether early childhood infections have a protective effect on the later development of asthma.

Main Methods:

  • Utilized data from the Leicester Respiratory Cohort, including 1,995 children born between April 1996 and April 1997.
  • Repeatedly assessed asthma indicators (doctor diagnosis, healthcare visits, wheeze frequency) and RTI data (duration, frequency, associated symptoms) at ages 1, 4, and 6 years.
  • Employed structural equation modeling to analyze contemporaneous and lagged associations, adjusting for potential confounders.

Main Results:

  • Asthma at age 6 years was strongly associated with asthma at age 4 years (regression coefficient = 0.87), but not with asthma at age 1 year.
  • Contemporaneous respiratory infections showed a positive association with asthma.
  • No significant evidence was found for a direct protective effect of infections at age 1 year on asthma at ages 4 or 6 years.

Conclusions:

  • Asthma in early school age appears to be directly influenced by a child's prior asthma history.
  • Early childhood infections likely play an indirect role, if any, in the development of asthma at age 6.
  • The findings provide limited support for a protective effect of preschool infections on asthma development in early school years.

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