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Lung function and bronchial hyper-reactivity from 11 to 18 years in children with bronchiolitis in infancy
Karen Galta Sørensen1,2, Knut Øymar1,2, Ingvild Dalen3
1Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway.
Insights
Children hospitalized for bronchiolitis in infancy maintained stable lung function and bronchial hyper-reactivity (BHR) trajectories into adulthood. These respiratory patterns did not differ from control groups, indicating no long-term lung function impact.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Longitudinal Cohort Studies
Background:
- Infant bronchiolitis is a risk factor for chronic obstructive pulmonary disease.
- Respiratory development during puberty in post-bronchiolitis children is poorly understood.
- Lung function trajectories from childhood to adulthood require further characterization.
Purpose of the Study:
- To investigate lung function and bronchial hyper-reactivity (BHR) trajectories in children hospitalized for bronchiolitis during infancy.
- To compare respiratory development from age 11 to 18 years between post-bronchiolitis children and controls.
Main Methods:
- Longitudinal follow-up of infants hospitalized for bronchiolitis and an age-matched control group.
- Spirometry and methacholine provocation tests (MPT) conducted at ages 11 and 18 years.
- Statistical analysis using generalized estimating equations to assess changes in lung function and BHR (dose-response slope).
Main Results:
- No significant differences in lung function (FVC, FEV1, FEV1/FVC ratio) or BHR (DRS) z-scores between the post-bronchiolitis and control groups from age 11 to 18 years.
- Lung function and BHR trajectories did not differ between the two groups during this period.
- Early BHR at age 11 was an independent predictor of adult asthma at age 18.
Conclusions:
- Hospitalization for bronchiolitis in infancy was not associated with altered lung function or BHR trajectories between ages 11 and 18.
- Lung function development in post-bronchiolitis children mirrors that of their peers without a history of severe bronchiolitis.
- Early BHR is a significant factor for later asthma development, irrespective of infant bronchiolitis history.
Background:
Various trajectories for lung function and bronchial hyper-reactivity (BHR) from early childhood to adulthood are described, including puberty as a period with excessive lung growth. Bronchiolitis in infancy may be associated with increased risk of developing chronic obstructive pulmonary disease, but the development of respiratory patterns during puberty is poorly characterized for these children. We aimed to study the development and trajectories of lung function and BHR from 11 to 18 years of age in children hospitalized for bronchiolitis in infancy.
Methods:
Infants hospitalized for bronchiolitis at the University Hospitals in Stavanger and Bergen, Norway, during 1997-1998, and an age-matched control group, were included in a longitudinal follow-up study and examined at 11 and 18 years of age with spirometry and methacholine provocation test (MPT). The MPT data were managed as dose-response slope (DRS) in the statistical analyses. Changes in lung function and DRS from 11 to 18 years of age were analyzed by generalized estimating equations, including interaction terms.
Results:
z-scores for forced vital capacity (FVC), forced expiratory volume in first second (FEV1 ), FEV1 /FVC ratio, and DRS were not different from 11 to 18 years of age in both the post-bronchiolitis and the control group. The trajectories from 11 to 18 years did not differ between the two groups. BHR at age 11 was independently associated with asthma at age 18.
Conclusion:
Children hospitalized for bronchiolitis had stable predicted lung function and BHR from 11 to 18 years of age. The lung function trajectories were not different from controls.
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