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Diminished lung function as a predisposing factor for wheezing respiratory illness in infants
F D Martinez1, W J Morgan, A L Wright
1Department of Pediatrics, Arizona Health Sciences Center, Tucson 85724.
Insights
Infants with lower initial lung function have a significantly higher risk of developing wheezing illnesses in their first year. Early detection of reduced total respiratory conductance and lung volume can predict future respiratory issues.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Neonatology
Background:
- Lower respiratory tract illnesses are common in infants.
- Predictive factors for infant respiratory illnesses require further investigation.
Purpose of the Study:
- To assess the relationship between initial lung function in newborns and the incidence of lower respiratory tract illness during the first year of life.
Main Methods:
- Prospective study of 124 infants from birth.
- Measurement of initial lung function parameters including total respiratory conductance and lung volume.
- Assessment of subsequent incidence of wheezing illness.
Main Results:
- Infants in the lowest third for total respiratory conductance had 3.7 times higher risk of wheezing illness.
- Boys with lowest airway conductance showed a 10-fold increased risk.
- Girls with lowest lung volume at end-tidal expiration had a 16-fold increased risk of wheezing illness.
Conclusions:
- Diminished lung function in infancy is a predisposing factor for developing a first wheezing illness.
- Early lung function assessment can identify infants at higher risk for respiratory problems.
Abstract:
In a prospective study of 124 infants enrolled as newborns, we assessed the relation between initial lung function and the subsequent incidence of lower respiratory tract illness during the first year of life. The risk of having a wheezing illness was 3.7 times higher (95 percent confidence interval, 0.9 to 15.5; P = 0.06) among infants whose values for total respiratory conductance (the reciprocal of the resistance to air flow of the entire respiratory system) were in the lowest third, as compared with infants with values in the upper two thirds of the range of values for the group. Boys with initial values in the lowest third for an indirect index of airway conductance had a 10-fold increase (95 percent confidence interval, 2.2 to 44.2; P = 0.001) in the risk of having a wheezing illness. A 16-fold increase (95 percent confidence interval, 1.7 to 147.1; P = 0.002) in the risk of having a wheezing illness was found among girls whose initial values for lung volume at the end of tidal expiration were in the lowest third. We conclude that diminished lung function is a predisposing factor for the development of a first wheezing illness in infants.